|
BUILDING- INSPECTOR RECOBD
<br />SITE-WORK DATE COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulationi Enerqy
<br />Q4twall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />FINAL z t l-t7 Zc z?
<br />Certiticate of Occu pancy
<br />Remarks Etc.
<br />OTVNFI BI'ILDER DEI,('ATATION JI h.rcby rfltrn undo Fmlly ('r Fr,try rh, I d.r.n!'r lDm rh. G)nrr.(k,F' L*.ns Lr* lirr rhc nrucwins Et$n rs...70.!t t !
<br />Burm( .r Pn'fcsr'. Cnl.l: Ary Cdy .r Cou.ry phrh Eq!ftr r Fd () dnqM, rXd, ,rg ,*. ,r.*r..rr or'^1,* -1 -
<br />{nduE, rEr r, r tr!u!k-'c. rbo r1urcs rh..pddnr r{ su.h Fmr tu filcr l8Etl nd.mnr rh.r lE o! rlE a lB..si plmr.r .
<br />n, rh. InrvsFni nf lh. Cont8lors l..rn*l L.w (Ch.Fd 9, (immhrn8 v h Sd'nn 7Ox, or Drvrnn ! orlh. EunEs I
<br />Pn,rcrloni Ciilc) or rti lr i* rti ! cr.nq, rh.rclnn itn rlE 6.!! n, rh. nh.d crr{i,n Any vi'LrFrolS-rir 70.115 hrr,
<br />rfFl*rn!htr.|xmlruhFrrrrlE.mlr.nrt'rctr'lFMlry r d,rnn.rhr rtr. hrnlEJ Jollr!,Slmr
<br />l.r!,'umr,'rihclnlFny,dmv(mnl,'rr.(*hs!8.!rtrh.u!,kr.n'Fnsrtr,n.r Ju rh.wd rnl,rr {turm tr
<br />ur.rLl n ofi.En tu qL (S& 704.1. SurE( .rJ P^,l6rIB C,rk Tli C'drit{ I l.r.M I:r J.r d +nly h u owrr ol
<br />rlEFlt{ny rh, tlut,r rth,6 rlFro.. dt wh' ttrs t*-h srt h,nr.llor h.r{ll or rhmu8fi hr or lEr os!rpl,y..r,
<br />Fovi&J rhir {.h utr!'mdr E a{ i,rcBlol o.onarl nf, e! ll, h)ka, rh. hlill[3 n -rn'Eftn i! olj *irhu dr F!
<br />dl !rrq*ri( . Omr Buft, rdl hrE rtr hmLn ol F,vua rh, lI u dr Jrl r, t .r !rF,w th. FDFny d ilx F4Di of
<br />_1. * Nftr ol rh. Ih'trny, rm cr(lllkly rodndo! e h lEcn{J rontetuB t, on{dd rtr FrFr (s& 7u4, Bustr*
<br />rnl Priiarrh (ir].: Tlr Codr.!'rorr l-ic.nsc L.B &Es Bn rml, r,,.n owns ol t oFny*h' huildt .r ih[n,v.r rh.rco..
<br />.nJ *h, $dturr nx l**h F,j.rh w h ! Ci,nrrtu(n l.lnrn n!F@r to r,r Gl.l.Ns r lrtns t,*)
<br />_l nrkhF unk Se.nn_
<br />uaaf,[8s:(oilfEli$ra!
<br />II!:SAAAIIO!
<br />I h.rchyrrruh nrl$ Irulryor Frurt oN ollh. nrl['wn3 Jrlr:ik,n\
<br />_l hrv. [n *ill minr:n ' C.d iard. oa G]nrd k, S.lr-lrrurc htr brk.c omt nsai,n. as poli&d for hy Sernn lT((, ol tlr
<br />l:h, CrrL- for rlI lx.ixlrar ol rlE *fi nr ah.h rlE rrrn, 6 srEd
<br />_lhrw.rle l mdrm wo*.8' rdmo..{rb. o.um.. r Bt!(i hy Sdrnn l7(x) of rlr libor CirL, for rh. tErilM of
<br />lh. md nr ph.h thlr Ftu s Rskl. My wMtd' $n{f,ndx,n msrm. ffE !n Frhy.umtEr e:
<br />".,,",,"^", 7 e Qg ( iZ q a /+
<br />--l r.n'lyrhrr
<br />'n
<br />rh. Frlormreorrh. *or[ li,r rhrh rh! pciml r !{'.,1. I .hrll nor cnpl,y.ntlx^on
<br />'n
<br />rnytun*r
<br />{, ,\ n) h(rrm rlhFl t' rlE rrtrtdt ('mFn\iln Lw( ol ( rl mu. .dl ryE rhi n I rh)ult h(1{m .ul,j..r n' rtr
<br />wort.rs, (.m!.n\!r on lDvirn'ns .f S.rrkh l rlxl {, rhc L.htr G{c, I stull n'n h*( h dn.ply w,rh rh,r povr(,nr
<br />WARNIN(; h'lurc n' \.'u. *ort.^'.onFnerr).
<br />L'r'l in.\ up n, om hutrJRtl rh,trlrn,l ,loll.n (3lo(
<br />s.(oon xr76.lrh. uhn orl.. Drr.( rnd r omy'r
<br />\hrll luhiar :n -nt!,v.r r) (rll1ml JE I$ inl
<br />^r ol rohttnsrrnr. Jrtu3c\ r\ t ovvl.'l nt rh.'
<br />,/, e/t qrr-
<br />DFCI,An TlO\
<br />Ihcrbyrltnu LrFnlllrol tErjury rh.t I m liNnr! u .rIn,vsirolch!..9(lr'nmEinrwlhSdion?Om)ofDrBi,h.l
<br />ol lh. Bnim( rn! Pn,l6*rr Cdk, .nl my l..n< s o lull tunt rd.lfdt.
<br />,^n, t /'16/10T--1-1
<br />cotirS!,itflllNrEBDlNri-a{iElt}
<br />I h.rby lrlim unal.r Ftr,lryol Frjuryrhrrih.c n !.onsrru.rnn LniuS rS.ry li,r rh. p.nimN. ol rlr k nrrh'chthsIEmd (
<br />Kiu.JrSd:\{'9? (iv ( )
<br />AITLIIANIIEI.LABAI,IIII
<br />ItrRhyrllinntrnl.rF-. trlryol p!rjtrryoft olrh.l(,ll(,wi.E J..ln8r!,0\
<br />l\axnnrr I'.rtrrh-A{r{ r N(rr,r.r!r l-.il.,rl Rctuhti,nr rIrl. !u).I'$6)
<br />-RcqumJ
<br />lx(crol Mr(irnn
<br />_l..ddyrhx rrr l.d.nlFlolri)nr E8{Jrg rsh.(x r.n,vrlft ft, $plr.hL to lhr tin'j.\r
<br />l.cnrlvrhlr I lr.tk!.1 rh$'k,nri,mrk'. is corer. I rrK t. dmply vnh lll Cirytnd Coonry
<br />tRh, .urhtrG EF*d.trB or thtr Ciy .d Cbud, ro .dd qr,n tltonlrMk.i rnd Srrr. b*\El,
<br />xlrn( ftr urJ l)n,Irny
<br />,\p0li...r or ,tR.nr SiEnrru
<br />I
<br />(lr
<br />ID/SIG.
<br />Flood Zone Certil.
<br />Notes,
<br />Orrr
<br />'g 4-t?
|