BUILDING- INSPECTOR RECORD
<br />SITE-WORK ID/SIG.COMMENTS OWNER BUILDER DELCARATrcN
<br />I rEr.hy rlltrm u.iLr FMlly ol Fqtry lh.l I m .x.qx nDft lh. Codmrn l-itns lre for lE rolowh8 Ersn (S< 70.t1.5
<br />Bu.i6r rd Prcf6li.n On I Any Cn, ot Cdn, whih EqriB . pdri lo lntrrntl. !tq, irtew. d.mlih or rcFi ey
<br />(tu lu.c. pnn ro its i3il,tN, rl$ cquiE. th. .opli.ur r(tr ssh IEmi ro 6k . ligcd d.rd
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<br />b rlE Fovirh.r of ttt ConrrEloi! l,ian{n Lr* (Ch.pr..9, Conwkir8 rnh Sclion rUL of Diri!i.( I or llE Burin.s &d
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<br />rpnla,d ror !Fmir birr! rlE +plEd rorcivilncrhyorFr mErhrn riv. hudEn dol$ (t5d)
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<br />rr o*r. of rlE INFnr. or my .npbF! wnh wr!- N ltEir $L $r{ruriotr wil d. rlE srrt .,i rlE *trE k n
<br />i d!d.d nofidEd ld rL (Sc roar. BuiBt..rl Pnrc.b6 C.d. TIE coddq\ LitE L.* dc er q'prr ro a ow.l
<br />rlE F?dr, *lh tlildr r rpiDs ttEEtr rd wlD &6 qi s him<lf or h.Mlf m tlmrat hir d h.t oM.n?hrs.
<br />povidcd rhri o.h in{eEmnB e dn hknd.d $oiftr.d f., sE. ll btE rh. hlildine ot in{rctrnr t $B elhh om rt
<br />or cotrTLrioc rlE ()*E Build6 *iI llE lE Ultla ot FuA rts tE r {E dn ml bild or in!6E dE FFy lor llt F,Po: or
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<br />!s owEr ofrhc I,nnsry, !ncr.lxliwlycodn rinr wirh lkcncd ronir&1oF k'.lnntod rtr pmhcl (Sf,c. ?O,tt. Buriftn
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<br />.trl Bho s .rrifGGhFFk*irhrG'fldo,!\rlk en puNrn brlEcolnrrlr'r LiiE br)
<br />I xrcrchtn uftlcr Sc.innr
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<br />tl()Rr( r'Rs' (r u\r IfNsAl lo\
<br />D[lL1$Alll]!
<br />I ll ri,\ rllnn,un'l{ Il(n.,h\ .fIl(rltrr\ o'f, 'n rhc r,n[,tr trrr.kcl$r!r\
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<br />havc lrn *ill minlli, d Cd rr.rtc or conr.nr ro s.lr.lnsurc rr wodsr o,ml.n*ri,n, ss Ftvitcd lor $y SNrn,n l7{x, or rh.
<br />L.h)r Codc. for ltE Frfornmc ol rhc w'l rltr *hkh rh. Fmi i i*ucd
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<br />d will Niniin wortcn' oiIEtrqriD inrur.r.. c Eqlircd by Sar6n.]7Ur of rh. trnn (-ln . tur rh Frforu. ol
<br />rl My$nrllrs comn(iux,n ntrtrrnNcc{rtrr udIi
<br />f{l'\LCt &EoCL
<br />6\/o\l20 4
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<br />anifyrhll in tlr FlmmN or'lr woll rr whi.h rh6 Fm! c tr{oi.l rlEllmr crrlb, d!,,tRr. i.rnymnE
<br />gr sh b.coft isbiir h trr *dt6 orFnuFn h*s.ac:lifomil. Dd asB rhs' itI rh'uld tE om (ur,Fr ro rlt
<br />*Drldr .a,qrnsari,n ,mvisiohs .l Scclio. l7lx, of lhc L.hn Codc. I rh{ll. tdh*nh .or{'ly wi'h ihE lmvirioi!
<br />l4ARNlNc l'lilurc ro rff *orlc^ Nqxnerirn n,m*c a uil.wtul. .sl rtlll $6Fcr .'r?r'y.r ro ainiDl Fulr.r xd
<br />!, oE hund rhooqd dolLr\ (!lm.(Ul,. m rltlnr,. ro lh. $d of.on iEnatnn, d. 3.i !r F.rn.n [i, rlr
<br />DICIJSAITN
<br />I rrEh, rm.r, undar Fullyof p.rjurr ltlr I s'n li.!oa{ undcr Iiovililn orchrli$ e (otrmE-'ins enh Sdrion 7ux, of Divnion l
<br />of rh. BuriFs rrn Prof6ri,6 Cul., .rn my lr.r ii h tull fora !n.lldl
<br />czq ,41a€.{3,
<br />D,r" .\tULZ)+2o14
<br />1c:117 ! ttb !a$LB(IqJAi2r}!,_rir.ur
<br />I n Eby.,rrn !i&i FEh, or Frtrr rhd rlEE ir. oddbn Lndha .3.tr , ttE Frrffi of ll!6t to, "tih rht Fmi it
<br />ir cd rsd. !o)7. Civ C.)
<br />tind.l. Nrm.
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<br />lind.r'r Addr3(
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<br />I nddry .frmr ud.r p.ulry ot FrrIy oE or ih. rolb*in8 &.I$rthn\
<br />rrem,lirion turnrnl^rt nos Noriliurio. F.ddrlRcgxhrionr llirk rl0. Prn6r
<br />-RcquiEd
<br />l.rre. of &ritr,ti{
<br />I (cdifyrhrrrhc Ldrrrl'cEU1r]('tr\ r.grltr,E r\hcno\ '.trx)vrlrr( ortrptlkdhf,^kirhit,niJL.r
<br />I (Mity rhd I rEtr Erl rlh .pflrd ir ..d (.r. rhar r.hNinn)Idb.'iRffit I qE ro oiply *arh rll Cdy.,n Counry
<br />oi,iMm6 md sri. b*r Elrh8 ro h,iuins cotr(tucrin rd lhr,, .urlr,iz r.Fc*rd nlr or fiis Cir y .d Counr, ro sl€ qnn rlE
<br />rhrc nrnr i,trf,(l |nincny l, tr
<br />,\DDlicanr or fmr SkMruF
<br />57enc e,/' l3o.rr}ra
<br />,*,, lof tz /lb
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFEB Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />Rool Sheathino t//t?/].[^,7rcr*4n ,/
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lVlasonry
<br />Pool Fence
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />FINAL lo lzr I &-/,///46\47Certilicate of Occupancy
<br />Notes, Remarks, Etc.
<br />DATE
<br />-bL 3\bo-o\ - o \
<br />T-Bar
<br />Flood Zone Certif .
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