|
COMMENTSDATEID/SIG.SITE-WORK
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />Shear Wall
<br />I IFram i
<br />allD
<br />Brown Coat
<br />Pool Fence t,T-Bar
<br />Handica R
<br />De U Final Re ort
<br />E ineer Final Re ort
<br />Flood Zone Certif
<br />?9FINAL
<br />Certificate of Occu n
<br />Notes, Remarks, Etc
<br />{)\\\t ll Br fl trr I r)l I r \R \ rrt)\
<br />I hn.h.fim undd pcuny.l Fjury lh,t t d.rm n$m rlr (odreloE l.*!e l.E aor $c folb\rits Gitrn (sa 7(rlt 5
<br />Busher dt Ptofdion Cod.) An) Cny oi Colil) qhi.h r<utd . Fon ro mtdrud. .lrd. improE dimlirh or rqri',6!
<br />iruduq FiJ,ro irr isuft.,.k rapt6llE {rltor lor r(t Fn rofik.risNdnidld tht lEor lE it lic6!'d ptmd
<br />lo rh. Ii,rbioN otlL (hmEclors l-icc$.n ljw ((-hipro 9 ( omnlm.irs trnh sdln'n TOiI) of Divkion ll oflh' BGind dd
<br />ircrdF8 Cod.l d lhd lE d it ir aaip! lhactom dd rlE t6i! lor lh. ilLe.n crdFi{rn An, l iohnn of s'dio' 70!L t, m,
<br />lpplicant for . r.rmil ilbjet lh. slplicanr r. ! .ir il toohy of @r nor. rhM fi\ c hundr.d d.llm (tt00)
<br />t, ar o*nd of rh.IroFly. dr mr mtlor6 $irh {.g6 s rnd sL onFneior \illd. E trdt ed ft rnnr ' mr
<br />;di.d mofldql fu oL (sc ?o44. tlusird tnd ProlsioNcod. rh. ( oflr&ioir Li..M t,s d.. nor 4Plt lo M o"M ol
<br />tlE F!Fn) * rn tliti! d itrFor B rhaFtr nl *lF ttE kfi sdl hiMtt or hd*ll or rlNush h! r hq our 'nPht6'pmvid.J rh6l nrh imln\€rHrr E ml inrdd.d.r 0116o] tor sL. l( ho\r66 ih. hriidnts or trr'rr.\ffi ir sld *ihin 'ft )@
<br />;r6nDkhr llE onE sdlrn ril llw lL hrla olF.\i.s thi rEtrsh.ddfln tlild o, 'n+ro$ tlE FqErv tu E F'D(l-or
<br />l. s.u6 oltlt FoFy. e.r(lGn.l! conlrrlins \nh fi..cal codrxr.6 h mdrucl llE rnjd (li( 7G{'1. 6ni'K
<br />a l PFisbn ( o.Lr i * coilrdo.s l-ic.nk l..v 1106 R .ftlvro ann$nd orFopdtvwho hoildror imprordlh6on'
<br />.nd *ho codn t. fM 3uch Foj.rr! rith r (tdtulonn ltos.n tEEun lolh.( 6dftm s ti.e Ir{).
<br />I m cr.mti undd s(lhn . B & P( ltr this t.asn
<br />OnrE
<br />n ( rRlii rL(i(-orriPLN\^ r loN
<br />DfgiaauQ!
<br />I hr.b, amnn unJs pcnrhy or lFjury nncollh. follo"ins leltrsxotr3
<br />Ih.\t&xlsrllm nrri.a('diliur.ol(,)6drt's.lt-l6otcin*otldr'comFMkr'6lrrddn b S..lin uui ol rh'
<br />Ltv ( ,ilc for rh. p6t!lr@$ oirh. tnt nn shich rh. Fmn i! isu.d
<br />I hak xnd $ ill marrarn 10116' ..mFm.l ion insur0Ec. N r6l,'n.d tl sd nrn Uu) of th. I !k" (-od' for lll pdr'frlfrr' or
<br />!h. trdl tq $h(h rh*rff B s{tl Mt t.r\6'rnmt<lMrn '6uro'. cad 3d Pnk\ numh'r ",**tOAIol tL"bv fioar?.t r - -
<br />^,*n*,( JA gL<n 54'iz 1n29t4.,,,^ tt/r /zo
<br />!c.n,tyrh, in rh. Fforold. or rn rorl for *h.hrh" Fn 't su..i l lrtrlls oph,.n! Frn i"'\ lMF
<br />* * r, h<torc rt4o r r',trc"ort6 omfftrat'on l.tr ctl'Fl'h,mri. trJ NR rhar 'l I rh'iuld r(cm' ruhi(r rc Ih'
<br />{ 16 clmrENrbn Fo\ krB ors(rhn !7tx,orrlE l.hY (o&.Islull- tonh$nhcompl! qnhllrrxFovilFd
<br />wanntr<; init,,. r,i:,,. nort6'coFF6dn.n (o\dis. i! unla\ fur. 8d rhlll tuh|tt M dnploF ro driBl FuhB dld
<br />d up ro oE hundr.d rhoNnd l. in .<ld rcn h rh. cor of.ornlEMtion, d,mar6 N poid.n tu lhc
<br />1076.rrh.l,kr cdL, mr6c(
<br />urcllEalrQ!
<br />| 6r .,Im uftrd tEslr o, Fju r- lht I m li.q!.d u.ds F!\ 6bn or (.li4ri 9 (mn'ffilns *irh sclion 7(I)0) 'r Di\ irion I
<br />o, $. Bdin6! md fmfdioN Codc. dd my li.m. i. in ful! forc. I .,rEl
<br />*"?
<br />'O r.,,....,,,,,,.,/'{41< .,,,,,,,X-- 0n,a(l)n$BlJ(IIA!l[!Dl!li-6C$lCr
<br />I h€.n! .flinn un&r F h).f Fju^ rhd rlHr k lsldtudhn kfllhs tldr frtr rh. Fro@m' ollh'$uI tu shi'hlhir Fsir i!
<br />'rsu.d
<br />(se 1097. Cir c)
<br />l..dd'r N r.
<br />AIII(ANLD}1IIIEAIIQ!
<br />I IEur* lllm u.d6 Fduh' !l Fjuq oE ol I h. aolhr i.8 .hlarrl iont
<br />t).mohon PdmireAltEnd Noli6.r ion F.d6!l R.sul.rio.r(TnL40. Pd6)
<br />Rqutr.d lit6ot |tii6<im
<br />I Gl ri r h.l lhc trld.l tquhl xrE r4ed'n! 6lqtol roRr al d. N qDlitbk ro rhs F)d
<br />lrdr'arrhdIls\.r.ilrhssmlkirnnidsrur.Ih rh.il!\ci.f,'matn'nis..trst la$.cloNmplv\ h3ll(itvand('mrv
<br />or.[Mn.6 anJ \kk tr{r rck'ry ilA,,r.t.x ,"t-r,'n una *..1'-t aurlt",. rcrtNrdn6 of !fiir cn} d (
<br />'unl}
<br />kr drd u,!rn rlE
<br />il:"-::,;-y'i);^r*n,r ; zfd/tq
<br />e^rr*^. ,qa"o, l/ ( /
<br />BUILDING- INSPECTOR RECORD
<br />74 35cq4<
<br />Roof Sheathinq
<br />{r.+cr,
<br />lnsulation/Enerbv lt ur
<br />Ext./lnt. Lath
<br />lvlasonry
<br />Vxvictp 2t)
<br />ut
<br />9lzlD 1 l,hfud,at
|