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BUILDING. INSPECTOR RECORD
<br />SITE.WORK ID/SIG.COMMENTS OWNEf, BUILDER DEI,CAR TION
<br />I hcEby a,ttn udcr FMlly ol Frpry rhll I d .r.tY,r rmm th. ci)ntra.1oE Ltcoq lir for llI f.nk'*ins rcagr ( ^* 70l t 5
<br />AusiN$ !n fto,c.si,n Cdtr). Any c y or (budy whah t quirct r Fnt io (,.(dd. rhn. iq'n,t. d.mli:h nr EIEi rny
<br />(ruclu.c, ritr ro r i$uffi., rle 'quiEr llE l.'lliul for such Fftr k, nb . silmd std.r ihc b. or llr k lk.n€d rlrsltn
<br />ro tlE Frvkirnr trf ltt Conl6lq r l-i.cnscd Ue (chrfln 9. (t,mNin8 *irh S.tran 7ml.f Ditnhn I otrh. Br(in.r( Md
<br />Iti,fc$ion\ c.d.) or rh.r & or rlE ir.r.npt th.Efron.,n llr bcrn lor rlE dk!.d .r.mtrion Any vi,brbn or Sdl i,n 70ll 5 hvt.v
<br />.nnli.zhr rd r trmil subjclrth. lpllilr ro !civilp.uhyofnoi.r,Brhln tut hu'nEd dollsr(l5frlt.
<br />-1.
<br />us owftr .r 0E lroFny, d my .npl,Fs uirh w!8cs !s rh.t s'r. .on{EndDn. will do rlE e,rr .,n 0E rlnrr8. it d
<br />i.rcidrd dof.r.rl f, -k (SE ?04.1- Burircs d PrrLa*)nr cd. Th. Cotudd\ Latn- li* &- , qtlv r{, m o*mr ol
<br />rhc rFrdy *l$ l-'Ur .. 'ntn|6 tltor si *lr &s uh hxt hintlf or ltrlf or rhm!8h his or ncr o*i .nl|)hfcs.
<br />F,vidcd rhar iuch irnl'mErdr E mr atd.ri,roltsd nr ih.ll. hnedE, rlF botlli.e or itForcntnr ! sld rirhin om !r
<br />ot csrI'brin dr ()vmr 8uirr, sill llE llE hldcn of I'trvins lhd lF or srE drt mt boild d itrIFG tlE FDt6y fM l,E lrirln- nr
<br />l. r! owE orth. FnFlr. d.r.briv.rrconrdinS *nh hansd conk('on b.on<ru.r llE tmr.tl (S< 7tx4. B$Es
<br />.td h!6sin Codc: Th. Commtoi. LEcflrc Lr* dcr mt .poly ro r .*mr oi FoFn, *ho l ild: 6r ifrProvcs rhcrcotr
<br />!.d who N Els lor sEh lirl..rr eith. Co.trdd13) litnrd punurd lo th. Contldoa. t-i.nE L!r)
<br />l.nnr\cn\n oNl.. Sc.rr)n ll &l'(-n rhn, !r
<br />llrr. orftr
<br />Ellxtrllls:(l]lltEdsAlltlN
<br />IIIiCIJAAIIII!
<br />I hc6htdm n utrd.r l.MllyofIsluryoM ofrlE folkrwin8 dcht.ri,n\
<br />I hrE lrn *nl mrnrri. r Ccniaf,iic or Con*nr (, s.lr ltr\uE ld w,ksr o)qxns! i.,n, .\ F'vild hr h, Striir l,m or rh.
<br />Lrh, Grlc, f.r rhc FrfonmN. .( rh. *olt fn thth rh Fmi ir irud
<br />I hlE .d * ill minl.h Borls d,f,p.nr.ran m\uram.. !s kauncd ht S&rir lT(Ir of r,E t,$or (bd.. ritr rrE P.rfornw or
<br />rh q rd *hrh0B ptm tr n\ud Myw.rl6 otrFnqli,n iF',-cs* - /* tttot4 trtn z2)t: o,l4
<br />urxBc.aftr nl Jhli(, numlE e
<br />- t, ,v"t*y N",,*,, --- .t)r c.D4$i l'alf' -,vi,*
<br />-!..niry
<br />th't rrrx p.rrormffiorlhc *orr ld rhahrhirFrnn ir krEd.l rhlll Nr.mlhyrnl6mn loroymml
<br />$ .s ro b.drE subj.rr ro rlr *ml6 6mFMi6tr L*. ofc.lilmn- rnd r!ft rhd irI rhuld lr<ft {r,itr lo llE
<br />wod(6 drrtENlhn FovirhN oI S.dkrn lm) of $c t hn Atc I rtlll ronh*nh 6q y rilh llN t"ntii'm -WARNINC Fritu( n' Gft F 6 c,mFrrslnn (r,kE*c n unb$tul, .nd tlull ruhFr d .'q)hF r. flmiul r@hict &d
<br />cMt 68 up x' 6nc hundrcd ltnNid d.nl.r (tlOO.Ul,,. m.H nn r. llF o{ of dtrp.nqrron. drm3.! rr tloviLd r'r rh'
<br />:rJ{qfr''*1 ( /a/-I
<br />I iErby llfrm un&r lEuhy ot F.rury rtu I m litn$d undcr Frvki; orCh!,'!d gid,mmminr *i'h sdi'n 7(ro) ofDivnb.l
<br />Dr oE aurihii,rn Pbf6lirtrr Cod., d my li.d$ is in tul! lorc. cfid
<br />,#g,t-;^/ 5r'/-"'l
<br />I lEcb, rfrm unlr Fnrlr, ot Frrury rhd ltm is . .otrrMrion Lnding rt.N, for rlr Frrolrrm or ih. mrt for *hkh
<br />'hs Ff,ir i!
<br />'\\udts( l(R7. crv ( )
<br />APPLIC NT DE(-I AR TllIN
<br />I hdE6! dfm u*lcr ncnrh y or p.rJury oE .f rhc lolkruin8 d.c l$rri'n\
<br />Dcnr,[hn P.rm]k Artr(os Notif{d E. lsl*.| Rcgullrons (Tnld.l0. Pd6r
<br />R.rtln d L.n.r ol NrifErin
<br />Ic.ni{ylh, rlE rsLt! E8lhrnm E3drlir8 !\hc o\ t :r,vul e nn {T,li!hL ri, rhn psj.<
<br />-l ccdify ih! I h& rc.d lhir rn lt.ri,n ud rr'rc rhd rh. rhnt ir6nmti.,n n c.nc.r I r!r.c lo drrlCly wnh rU Cir,
<br />nd,Ntu.r Irl Sr!r. t:ql15!lo htilrin! co.@.riotr ud trEby lul,Dtu! rlrllreri\c of rhiiCily.nd C.xnry'
<br />rtovc nEnri,tun pmFd, r(tr '..
<br />= *. rollADoli(0| orArrnl SiruluF .0/--
<br />LtY 5C1r,,4L
<br />ltt
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq
<br />lns u lalion/E nero y
<br />Drywall
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Reporl
<br />Flood Zone Certil.4.1
<br />l7tu7-+ Yrn4-tl-Zl-lV LWA
<br />FINAL 11_7t_ty r-w\0
<br />Certilicate of Occupancy
<br />Notes, Remarks, Etc.
<br />DATE
<br />Ext./lnl. Lath
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<br />I !xl.r s Addr\\
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