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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDAR DEI,CARATION
<br />I h.rcby r1tutu !nJ.r ,tMlry ol Fryry th, I m cr.t{, ln,m rht (inrr!ftm' l-rcne l-s n, rt f(,lk,}ua E.1n lS.. r0.ll 5
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<br />nn'.rurc. pnrn' \ tr{knr.,ah r.qumslh. lpnlErnr ttr tuch pc.nnr r) lil. r \+ftd d0r.mnr lhrr tEor ih. tr lkcnkrl luruanl
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<br />Pnn.q|'n\(irl.torrhlrh d rlr s.(mJ'r rh.Elno.BlrlE hrs\ r,rrh. rlk!. crcqxi,,. A.yvi,liri,)dDlSer$n70ll5hyNny
<br />,ml'crrr t tr r lEm[ luhFG r lk .tttLrnl i!' , !,!,1 FMlry of n nri.rh.nnYchu lr.J J.lhr (35m).
<br />-1.
<br />4{ owNr olrh l'n,Fdy, fi mycmploy.cs wlh wJ8.{ !s rhctr a'1. tumFnsrrtr}h, wrll.lo rh. worr nl rh nnErm Nin
<br />d.rLrt ,, olf.rd f* qL ( Se ,Ol,l. 8u{trlr rnJ Pn ..ix,ni C(iLr I h. ( onrrnt \ l-(ne li* (lts ft{ qtplY n, :n orNi nl
<br />rh F)Ir.ny *h)$o 1\ r inqmtrr rlrNrn. rnJ *lr) d(Es nxh k hmrcllnrhcrkltorrh(lulhhrorhcr.wn.mliryc.s
<br />ni,vrLd th.r \kh mlnrErnr e ri d.hki dondd t({ r! ll.h!Ka,il*h{ lrEd. uqn,Ern ng E.hooE)!,
<br />of on{krr,n. rh. Ouror Burtlcr v l haE rh( huL. ol n$vrg rhnr b or (lr rl! B, huill or hlht rh. FrFdy lnr lft Irrlr't ot
<br />t. rr,'*ncro,llr I'I,Fi!. !n c rclurvcly $nn rd nt w hI'r.n{J.o tlroF !' Li'.{n(i rlr l(,J.d (S.(.ll!4. Fu\fts
<br />Jnl Pr.hnn(iNL l h. (ntu{t't l i.ny l.rr J.L Bt' /aflIt_tr\*
<br />,ntl trh. iirl&rsli ru\hFrr\r." h r ( i{tr!rc4ir.rn' ruur'
<br />n unJ.rS(rtr'n
<br />I h.enyrltr uftkr Fnrlr, ol |ruurroN ty'l(
<br />I havr rl wrll rornrIn . C.d 'rr.r. or cont to S.ll ln$r nr *ork.^' uomlEniar Dn. .r F),r!.J ntr hy Ser k$ .!'70(r ol rlE
<br />tjhE (i .. ntr rh. Frl.lru. ol rlt *rt f!, Ehrh rlE Fimt ! Frhrl
<br />-l htr rnl * l drrrr *o.k.n $mFnsrim t.{r.tuc, .3 r.1lu!.! I'y Sdrln ]tm.l rlE uk, C.iL. for rtu Frtrlllmc ol
<br />th. *ork ltr*h!hrhn lcdnr ir Nrkd. My worklr' (onllEns.ton rorrr.lmetm, Fn.ynumtEr sc:
<br />-1..n'ltrhl
<br />m rh. F.lornrB..lrlE *lnk ntr *hrhrhs Frnnr n ^r!(rl.l rhrll n cmlk)v :hv FRrn n rny mnRr
<br />$ r(n'h.crtrF ruhEct n)rhc * .B.nnfcn$rr hrsol (-.il"mD. Jftl4Rrhlr rr I\h\ru h(.nt shrtr hrlF
<br />dull. ldhl h urmply r rh rh)r nn'v.i,fisfts (r{Enqr[n lrlrurnr of Sdrrr 17(, 1rh.l:hf,
<br />WARNI\(; l'r|,tr. ri *(tr'( qurtlr\ (otr,tttr\rrn,trl . rl nl'll !'[rrr rtr .n'r, o!.r r! (' n ]l Erlr!\ trnn
<br />crvd ntur qr ro oE h!d!.J rh,uqd JoILB (ro r& ..r o, .ontFndnn. d. 3cr r\ Frv,.Ial for lh.
<br />s.(rr r rl116!n rh.ltrhtr(rrl. d.r.{inJrrt
<br />Dtgt8aEqr
<br />undcr Ir,rFtr'n ol (}.fl.r 9 ((.nrFnu88 wnhS.(ron?Ir(xr) oll)Nrtr'n.lIl'.'.ht, rtrn' u l.r Nn.'lrr olF'trrv rl,
<br />or rh. Buifts .d PDlc(Dns (ixk, .rt ny lrctrc B n full l!trlt .d cll(r
<br />l-k.n{ Cl2s
<br />-
<br />gqlil8lEuoNlE8llalilli.ENlr
<br />I h.dr illtmun,.r tr ht!ltxqurJ- iharls.n..on{RrInt-l$3r3cEylrnrlElirlortuhrolrlFrorklitr*hf,hrhsFmitr
<br />srucd (Sc..lOr7.C* C )t d.ar Nrm'-
<br />APPLIL:ANT DECI AXAA1ON
<br />I hdtt, dim uhi.. F.riy .l Frlur, or ol rli li,lld*o8 &(l{tl in.
<br />D<d,l rln P.rhn+AltE(or lli Ertr'n Fq].nl R.8!LrirnrlT.l.4lr, P.n6)
<br />_R.qurd L.(cror N(* ijIn
<br />ffi-#
<br />d rh. l.J.ialF8olrihN r3sLi.! .{hc.kx rcn$ulr. n{ {flr.hL t' tru.ln)Fl
<br />r,I ,vc 'nr,nturxr n (.Gu-t 2{rLi r,(rhtl\ } h.ll (i!v rnJ (\,unrv
<br />ivc\olrhFCiyelC uory n' cnr( upBrtr
<br />,\ppli{nr or ,\rcnl Sipnslun
<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 />ln s u lation/E nergy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Ivlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />FINAL Y/?/rl ,v \ 4,1
<br />Certif icate ol Occupancy
<br />Notes, Remarks, Etc
<br />D.t
<br />-(otrl
<br />14-
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