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BUILDING- INSPECTOR RECOHD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNEI BI'II-DI:T Df,L(ANA )N
<br />I hftny .tfEn und.r JEMhy ol Frrury llEr I m crcnt,l from rh. Co r.cr.F Lis{ l:s fo. lh. folb*ha E.sn lS.< TOJI t
<br />Burift$ rd Prof.$ion Ccicr A., Cny or Counry $hih Erun6 ! Fd k, d,N 1. th6, iqmE. d.d'l!h or t Fn u,
<br />nurE. Fir ro its nffi. rlv, dtoiB rlt qlllu.! ft, 3Bh Fmr tu fik r riSEd (tl.rnl rhd lE o, d! . lift...d PUNMI
<br />t, rh. Fsvirio.s or E a-onraclols Lic.nEd l,w (Cnrfl.r e. Commmins *ilh Sc.ton ?uD or Divnion I oflhc 8u.inc!1lnd
<br />Ptur.rsiotrs Cod.) or rhst lrorilE n d.mpl rlErcfmmand lhch.ri! r rhc dhg.n.r.mPrirn Any virhtion of sarir 701I Ih,rny
<br />rp0liclnr ra, ! Fmir subr.rh
<br />'h€
<br />rtpli...r ro a civil J,.n!lr, or nor mE lhs fiv. hu ndEd dolltrs lt5oo).
<br />-t.
<br />&r oeF of rlE FoFny. .{ nr.rl9k,Je6 wnh *.r.i .s rlE $l.onpcndbn, *ill &! llEkilrnllt{nsrmir d
<br />in.f,j.d q olH fd El. {Se Ix4, Bu.iftS ind Prorsionr Ctr,.: TrE C.rrndd r lirE L.* &.r tul +ply '. u oqBr of
<br />rlE Frdy wlD triilk n inFr6 Ecnrnvh.&6st* hitulf or lE-lror rtmuth ht d lE orn."rt,r!...
<br />nnrviLd th.r sh iryrow .cmri..!ndqnfi*dnnrt lf. no*G, rtE tliH-B d irl'ftlt n irrld*thhd ]d
<br />olo'r$Lria tlt O*c, Bu k * h.E Or hntn of FsvlB thd lE n tE dn r{ hrild d iqnE lrt Fqd!, n dE FrF& of
<br />l.rso*.r.frhcFnltrny,dmcxclulivclyconrrlclirgwilhli.rtr{d.ohhcn)^n,.onnru.rrh.|jRri€r(S.c 7(rlt,8t^iE$
<br />r lh'l.alimCodc:'lh.(i,nrrttrrLirtns.Lwdoc\iorrt, y!) rnDwocr ol,'n,ncny*lk, build\.r imrn,vcs rh.rron-
<br />. d {lxi codB.c li'r ru.h pn,F.tr wiih a Co.tEns \ r li.tr{d llnnunr h, rh( CuM*ttr-{ Li.cn{ ljw I
<br />l.m.rcmp{ ud.r **ri.n
<br />lr.r. O*er l*orl(rk\' ( ilntPFr$ATIoii
<br />ullLa8afl,r
<br />I h.rb) rnn undfi |Enllrr rf |trjury orc ol lhc tulkr*inr &cLrd i '\:
<br />Ihlwdtrrllminrlm!(.nilt!r.olConEnlr.Sclflnrur.ln.*o ds.on{c.sri('n. nmvidcd ii,r bySccri)n l7(Dolrh.
<br />lrhr (irL. fm F lxlfomm. ol rhc *o* aor *hth rh Fr.ril ir t\rtd
<br />-l
<br />h.w rd rill oinrrin rort.R ..n E. rirn iNurrft., r\ EquiEd by S.<tnn.l7lr) oft,E Uho. C.&. tor lhc FfclN of
<br />rh. rvl rd *nth fii! F n n iqtd My *dt6 onrf,nai,n intlffi ffir !n p[.y mn$.r G
<br />44 z6)1
<br />-l.cnify
<br />!h!r in rh. FrrormLr of ltu wort lor whth $n pcrdil n i\skd, I shsll not .rPhy .ni Fmn in 8ny tunftr
<br />r' rit tRlm $bFt lo llE wdm .lrrEN.lbn Ltr olcrlin mn. !L +E th.l rrl rn,u! lt or subjttr rorlr
<br />sltd. oqErqtion Foviriont of S..lbn .l?m ot rlt l,ts C.xL, , .ldl fonhwilh mq y *nn 0b- FbrtbF
<br />wAf,NlNC: FihE io rr@ wl6 .up.ndbn 6mB. n uLvtuL .nd {Elt iuhrd m .rploF to aimid Frra5.,ncir likr up ro oE hd,ai tt uun doLF (slm,{xnr. in .ddnion lo rlE o{ ol (orfEnslion. drmlF.3 F,riH lor ft.
<br />Sdli,n .1016 of rh. t brCdL. hrcr{r ^J*_66i.fIts::",:,,H ' DI"CLAiAT|()N
<br />p.nrhyolrrjrry rhlr I rn lidn:il uftl.r lltnNi,nofChdDrs Dl(\nnn[xins * hsdriin7(xx)roll)iri\i,n]
<br />Pn,L(i'n\(ixL. rrl my li.n{ n h lllltukdl.ltcr
<br />l"r"",,'tO/8 I €vP A(A x $Lo
<br />(llNs-l Rtl(1'l(rN I ENDINc Acl N(ll
<br />n\uol rS.. .1o9?. Crv C I
<br />l. Lr'r Add$s _
<br />af&&r$rDEclaMrlll!
<br />I hod,y lfm undcr lcnalr, ol Fr]!r, .E of rh. followin8 rlahnt ionr
<br />Dcm)hn'n t.rnils'Astrno! Norific n ! F.i.nl R.!ul{!k,.r {Tirl.,o. Pan6)
<br />-R.quncd
<br />L.tr€r of M,rifrnrii
<br />l.Ln'l\ rhd rlr rrd.rd rc3uhri,n. rc3{ding n{r{o' hrrtrrlrrc '!, lrdr3hL t, rhh pii}tr
<br />4A 4rr,-,t, , t...,, ,nn {lPIxarK,n dr, {dc thJlrr uhr r rtnnrr,x,n r.orrtl I rtl( n, !r nly tr rh lll( 't} xnl (i{,nrr
<br />or'ltrn'r.\n.dSr,rcu*\rcld'trtrihlkntr!.on{ruerN.atrllkr.h!rurhnir.rcrcvnrnrtsnlrhnCirymd(.(runrtn)cnr.ruF rlt
<br />il-:,::;il"- \ffi''Lt * Qe--,>n- rc/ ef ry
<br />p.mi,R'm.,prin,,: *- A/fu fi4 6rrrn /
<br />Set Backs
<br />Formsi Steel/Holdowns
<br />UFER Ground
<br />SLAB Floor
<br />Sublloor/VenVlnsulation I
<br />Roof Sheathing lo/,/lld -#;l)
<br />Shear Wall L
<br />Framing
<br />lnsulation/Enerqy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />l\/asonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />I
<br />FINAL 1//t/tq ,-?#U )
<br />Certificate of Occupancy /
<br />Notes, Remarks, Etc
<br />--+
<br />Erection Pads
<br />Flood Zone Certil.
<br />I
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