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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />Subf loor/VenUlnsulation
<br />Roof Sheathin
<br />Shear Wall
<br />Framin
<br />Insulation/Ene
<br />allD
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lvlason
<br />Pool Fence
<br />T-Bar
<br />De Final R ortU
<br />rtEnineer Final Re
<br />Flood Zone Certif .
<br />FINAL zb
<br />Not emarks, Etc.S
<br />o
<br />OWNEN BUILDrI DEI,CARTTII)N
<br />I lw.hy .lfrm uri.r |.n Iy of Frlrr! rhrr I s.r.n9l tun rli C'odrd6 t.i-nc lrw for ih. rolkrri.! rco-n re rolr {
<br />BuliBs rn Prof$qln Cod.) Any cny ot Cou y *hkh ftqlEs . Fnl t, dr(ruc1. r' nFrvc' &fr'lnh or rcFir uy
<br />\rrucrlE. !ri,ro ils isroak., dls. rcquncrlhc arrlli.rnt for ru.h lErnil k' fik. iisrEdcr,r.m thd ltnr sh' ( ltensd Poftuanr
<br />l.lh. r'ofiirnr ofrlr Conlrtr'r Li.rn!.i Llr (('lufl.r 9. GldErin3 uh S'Lli'n Tlxn 'l Drvthn l of rh' Burimrs nd
<br />Pn,Lrsio.s Cd.) or rh.l lE r .lE r .rcq'i rh.rfn,m r.d rtE hlrn Ii, rlE .lL8.d cr.r{,i,. ,\., ri'l,li'n of Sd'bn 7l''l I 5 by rn,
<br />appli.rflr fitru pcmir.uhjc srh. irpticsnrr,!civilFnshyolnnnxcrhlnfivchundr.ddollas(t5u,
<br />l, r. owF of llr F.Fny. n my.,Irioy$ wnh *re6 tr tlEtr $t drn{EMi,n. *ill d' ,r eqt lri ln' rElE k d
<br />intnLd or oflcEd lM sk lac 70,14. Butim$ md ltofssioN Cd.: TIE C.nfuk l Li..n{ L,* drEr ml q'plv ro s ovF oI
<br />rrE tmFly *ht U! or iqmB llEEn [n wb &( trh s'lt nimr.lfor h.sll or rhrcllh ht tr h.r o*n I'rnhvc6
<br />p.'iil.a rUr 'rtr arFrwdr e d htarbd d ortu frr qb lf. l$s!6- dr laiLlilB d rqmld h $! *ahin i* Fd
<br />;Imrdcriotr in o,Er Builtr r l lhE rlr hnl6 orliivrE rhc tE d {r da r, hiE or inF.E rh. I'opdrv ror trE Flqr']s or
<br />-1.
<br />.\ o*o otrlr ,!fi Fr1y, d.i.lurntly.o rath8 *hh lk.n*d codrrdo. k, ($nstur rlE FrFd (S€ 7o{4. t6tr(
<br />!d h,t.in Cod.:ihc Co ttcrrn rt,t.nt. tr{ d,rr nol lnrlvro rno*n.rolpnrpcnvwlk' huildt ot iDprovcr llrrcon,
<br />uJ wh, ro rRl\1,tr \urh IrI Fd' q'|h r c'm*d'' .*ri:fl
<br />"::;*-/r e!-*"*r*Z-,I) IIIIBEXSIAATIISAITA!DrllJ&lul.rr
<br />I h.n ht .fi]rD unds ncrulty ol Frjuty om ol rrE rdllot in8 .,.tludri'nr
<br />I hnE d $ll minrain . C.d ifEtt. ol G,n*nr k, S.lal nu,. tn *0116' llrqtnqi i'.. i\ Jr.rdlrl ft' hy S(r x'n l7U) of ilE
<br />llti, Cndc, lrtr lh. Ilcrfqtuftc o t ltE *o fr *hich rh.IErn is hsucd
<br />-l h.rc.'n sill @inrln wml.^ oqrnsrhn iBurr. .i kautcrl l', sdrnn.l,00orr,E Lrhr Cod'.
<br />'or
<br />rlE FrfdmN ol
<br />lh. wort tu *hi.h ihi. n mn i nrxd. My *ork6r co'npcnsri,n insurumc.Mir itd [[li.v nnmtE ac
<br />-lccnirythdinrlEFrfIrmNofl,E*nilfn*hrhthitlqmini(Ed.Irh.llB.rtli'v.nvFN'nin'nvmnFqr dr ro tE<om subjccr ro rh. wort6 onllffslion hss ol Crlinrmid, lnd isEc rh{ if t sh,uld h..oc NbjEr l' rlt
<br />sd6 o,n{Etrgrirn pnriii)trt ol Sdr i,n .l7m of llt L,ln Gdc t {dl- fdheirh Ntllllv *nh rlrE P'oYiriotrr
<br />WARNIN(; inlE t, {lft k tds o,nv.rerhn ortn!. i. unLstuL .,n rh.I {bFd .,!rlt'Fr ro miBl p'fr]
<br />.r'l nn.r u. rn oft hunlJ.d rtk'u{nd dnllF Itloo.0o(r, 'n
<br />&ld ui i' d{ nn' r (nn{xiqtr.n. dr 8's rr Fn}rlcrl
<br />sertun toT6ofrtr lr,n' c.d..."*u."a "..*r . rcd I n ,/
<br />^, toJtoJtQ L-("-"--,:. L-.I I ,z I t(.FNSFt! (.oNTR (',ToR -I t Dfru[ar0!
<br />lEEby rflnm lnld FMlly of Frrry rhd I .n lianrn tnl.r Frviiion ol Cte0rd e I rnmin8
<br />I rh.llhi'k\\nid ltol.\non\(inlt. inl ry
<br />toxs:I8uqr8.r.Eulll8li.{iE lr
<br />I rftby .r,m und.r Fulr, or Friury lh.l lhdt t r d,mru.lioi LrdnU rS.Ev nn rlE Fnol1rrN orltE mrr lor $ltih thn Fmt t
<br />i3tud tss ltD7,civ. c )
<br />Irnlcls NUM
<br />-
<br />APPLICANT N}'(:I dRATIOS
<br />I linttann r od€i Fotrhy ol Ftpry oN rfrh. n,ll,trn8 d.{ln'Jrl,n\
<br />lXnknirn,nPrnnih.A(h.no\Nor'li.ulion l.dcol R$rlnhunrIIirlc lr). l'rn6J
<br />Rcqutrdl t (., ol lldifrdr'.
<br />lcdilyrhd r h. I.dcrll rsul,r ()N E8{diry a\hc{or rcnx'val .rc no! qflf,uhlc ro rhn F)j(tt
<br />l.cnrfyrhat I luv. r.nd !h. ,Ipl
<br />unl'n!ftci rBr Srllc trsr mhrimtr.r."",*n.* f".nnr n",y6
<br />^optk.nt
<br />or
<br />^tqt
<br />s4n tn)/
<br />P.ddrFEm(Ddrrr: /
<br />-
<br />tdrirn dri (.r.rhd lhr!h,k inr.mErnn t comt l.8tanr6fldruirhtll( irvtnd(-r'untv
<br />{nr.ri,trLulhrr.hytrurlurn.rcfl.\crnrrvr\.frhi\('iyrtrd(irunrYrictrrcrtr}rnrtr
<br />Yrlb
<br />ID/SIG.
<br />SLAB Floor
<br />Handicao Req.
<br />V4c )
<br />Certiticate ol Occupancv UI
<br />tt
<br />;:rf+,5/dt
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