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BUILOING. INSPECTOR RECORD
<br />SITE.WORK DATE COMMENTS OIr?.IET BUII-DET DEI,CARATTON
<br />I h.Eht rrum und.. Felry {,r Frjrry lhd I n.rcrlPr lom rt C.nt{k,h Larns b* to. lrE Iolh*inB Hsr lS.( r0ll.5
<br />auimar In Prof.s\n. (td.) Any c(y o, Cir y *hrh r.qu'B r Ff,a n, mnnM. r!'d, 'rpmw, d.dn$ or EFtr u,
<br />ndclu.. Fir.ki irt hsurE..., al$ r.qurcs rh. {ppli.. rrr qchltnnirtr, filc! stkn sl.lcmnr rhdlEorslEili.cn<n loder
<br />tr lhc Frviri'n\ ot rtr Conktd. Lir.r.d li$ rcrqrcr 9- Conftrrns \ih sftr.n 7(II) ot Divrim ] oa 'lr Burims md
<br />Prnilriuf,s (i)dc) or rhtr rE.r sh. ir cr.n{,l rh.Efrofl nnd rh. bari( for tlE drh!.d ercnlnrion AnyvioklionorS6rirnTl)ll5 hylhy
<br />{,pli.nr tn r rmir obj.rlr r,E rppltrir r. . dlil rrdl' y of n'i mE rlu ar. ho.drn doll,r ( l5(Dr
<br />-1..i
<br />ow, nf ilE lroFny. m ny ctrplrF.r *nh rr3G.t rh.n eb n'r{Endbn. *rll rh rlE *st !,n r,t nturE ii br
<br />inrcnddl .' ollrcd for slc ( Sr 7(N4. Burincs rnd PmL\sl,nt Cod. Thc (lrntr.tor's I -ktn€ l rw ks mr ipnly k, u owmr ol
<br />rlE IFIEny *h' hoiLir or iqrB rL,stn, rd rtn ds sh knl timElf or h(*lf nr rhsqh hn r tr o*n .qllotar,
<br />pnrvd.n rhat ru(h rqmEmds e d hr.id doficrqi nn ql. lt tnw- rh. tniuula w ulhkftd n sE Pihin nm Fi
<br />of.ortLrbn.rt o'rftrBoilkrwillhlrrlEhoni.norF.vrlsrtYrlrorslEdd,buillorin{roEtElxofdlyforlttrufol
<br />-1.
<br />.r o*x, ol rlE rmFny, m crclu1nlly codrrur8 *irh liB(d rod.rrm ii' on{er rh. I'l Fr (sL 7ol.l, aBcs:
<br />nl llll,n$in (ldc 'l'h. (i,nrEnn s l,rccos. l.!* d,c\ ml .ml, n, an o*ncr ot t)rt rr.dy who huild( or imprcrcr th.r$n,
<br />{d f,ho d!.rftli fd tuh F,F<s *ith a Conrklo(n li..tr1d |'!^unr ro tlE Codft1r'r li.nr L.*r
<br />l.n.(.rnr u s Serinr-
<br />lr.lr ()m..
<br />llon(Fls coi!pr4lsATIoN
<br />!!t!,Axallo!
<br />I h.rchr rmrm und.r FMI!y.f lsjury oe ofllE lolkrry &{larll'nr
<br />-l
<br />h.u. arld *rll mdu r CGd iltolc ol ConEnl to Sclf-lnrurc n work$ corrlFndiro. {t FoviLn(trhysdri.nl?moftlE
<br />trtrx C.nc. fttr rtE Frflmr. ot rlE *rt fn xtah rh. Fmr a isEd
<br />t h:rr rnd *rll m'nrrin *orkr! .oq*nr.r x,n in\u,rm., I r.qurcd tt SNhrn l7(x) of rh. lrrir. Cndc. n, rk Frinrlltn. ur
<br />rhc turk Io. ph.h rhis lE.m is i\xu.d. M, worlcn- .umpcn$r ion insur0ne.ri.ra rinkynumhcre:
<br />_l ccn'iy ihrr in rh. Frnn@E of rlE wort lff *hrh rhir Frn a 6rucd. I rtull ftr .npt,r ony Fm. in any ,MEr
<br />s, asr,trconE subj.rt rothc work.^ con{Ensurm. bwsofColifoiri!. on(lreRIhal illslnuld h(o.! suhrd brlr
<br />f,o*6 oqrnerx,n pmvrir.s ot Sdhn l71l) of rh. tih, cod.. I slBll. f(,lh* irh corily *ith rrIB Ftrririrn!
<br />WARNINGT liilurc lo surc eo cF n,ryrn\rlion !r'vcm*. is u.h*tu|. sJrJ rhrll subi.rr !n .npl.xr !' aimml lr.lhir lnd( il 6"( up n, om hundrcd rlEoqd &,UaF (Sl(l),(xr,)). in ad r ro rl! con or..nFn{iion, &m8.r !r royn.d for llE
<br />SNriotr :tllTii ol rlE l lhr C.rl. nrmn rftl an.rrv\ l€s
<br />to/+l?0,{
<br />DE(;IJSAIIO!
<br />I tErh, rrrm und.r FnrxyofF JUry rhal l.n liansn und$ Fnvirion ofCtopld 9 (cxnErcin8 uirh sdirn 7fit)).rt)ivrirn l
<br />of rh. 8urtrsr !n ProffidB C.&, rrn my l..n s r rull foN !d.lkl
<br />'u/u/a7[
<br />I h.Eby !fliio unl* Fnilry ot FrJury rh, ltEE ir r $nsru<ii,. r:ndi.8 rg.my f rh. Frfonluc ol lhc ,ort fot *hih rhis pc.nln it
<br />nl*d ts6 -1]l,7. ci c ,.
<br />AI8J.IAMDO.Af,AITUS
<br />I hsd,y rrim uftr.r Fndr, ol FrJllr, otu !f rlt krl,erS &{larDr nnr
<br />l)cnDliii(in Pcoik A\hcsnN N.riliuriM ltdcrDl Rc8rbii,m\ rTnb {), P[d6r
<br />Rqumrl lrricr ol t{d'rf, alin
<br />,l.dilyrhor rh. Ld.ril rcBlhr kh. rcg.rdin8 !sh.so( Enrr'll {. dn ryltlhk b rh'\ pn,Fr
<br />-l
<br />.drfy rhi! I h.r. rc.d thn !Frrl..r ion ml tttc rbd rrE .hrw ink{ner r'. is .nd I lgE h .-.!'ly *hh rll C y ..d (.unrt
<br />odiMncc{ rnd srlrc liw\ rcldin8 r} huildins con(rucrion. dn h.rchyrurhoric rc[r{.rarircs orrhh Ciryet Counry lo cnls uln.ltr
<br />ahrw m i,ftn toFn, fd inr
<br />\DDliunr.r t(rnr Si(Mturt
<br />*h''[']^os
<br />t4ACt$lo/l+l+,\d
<br />Set Backs
<br />Erection Pads
<br />UFER Ground
<br />Subf loor/VenVlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framinq
<br />lnsulation/Ener gv
<br />D rywall
<br />Ext./lnt. Lath
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Beq.
<br />Deputy Final Report
<br />Engineer Final Report
<br />L
<br />FINAL /o/zz/t/-#tqj \
<br />Certificate of Occu pancy
<br />Notes, Remarks, Etc
<br />ID/SIG.
<br />Forms/Steel/Holdowns
<br />SLAB Floor
<br />Brown Coat
<br />Flood Zone Certif .
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