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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE rD/srcl 'll' coMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUl nsulation
<br />Roof Sheathin ,1/,, ,4 r'z ,lr'qT_Shear Wall
<br />Framing
<br />lnsulation/Ene rgy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />!lqsonry
<br />Pool Fence
<br />T-Bar
<br />Handica p Req
<br />Qeputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />I IFTNAL /O I I I ?nt . loU
<br />Certificate of bcbupaniy
<br />Notes,/Rfrnarks7 EtC /1 ,/,u
<br />-t
<br />O\f,NER AUILDEN DETT(-ARA TION
<br />I h(.t\ rrhn und.r p.uly ol Fjury rh! I m .r.nq to'n lh. ( o' ,.cr.6 1.kru li$ ror lh. follosin! rt 'n ts<mtl5
<br />uur,Br rld Pruf*i)n con ): Any ( I! or ( ou.rv shi.h r.!ur6 . Fnnir r, ..dtud. !h6. idprcre &rslirh or q.n $t
<br />rddrc Fsr ro i!3 isud.. dlo ,.qui6 rfi.4Illkd lDr su.h Fmil l. 6lc a sisn.d sldadr fid h. or sh. ir trd!.d pltru,n
<br />to thc FnyisioE .a tlE Contrrls'r l-k.Md lr* (( hdr,16 9. Commdcins qilh Sd6n 7ffi) of Dntion 1 of rh. BuriB sd
<br />rmtsnrn. Cod.) or rh lEor.h.is.r.n lhq.nom ed rh. b..n for rh. all.lcd .rdF,o. Anyrrt!|nr.ofs.cthn'70115 tD s.t
<br />iptlicant for r Fmn lubjftrs rh. +Flicrnl to r civil p6ih, of nor mr. I hM nr. hon&.d rhlld t t50ol
<br />l. B ownoof rhc pmFny. ormy mplora $irh *.*6 8lhir hL Nr{ddFn. rill &' rlE rsi !nilErME s d
<br />itndd.d or oiLrcd lu $lc (sc.?04,t, &1IB 6d ftoa6bB ( od. TIE Co.rrstd t l-i..@ trs &6 not qr r lo n otrE ol
<br />llE Flrcly wls hilt d drFor6 E@ rxl trh. &E rl' eo* hin's.lf or h.&lf or tlmush hie or hd osn @tlov6.
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<br />L 6ow.6 ofrh. F.!.ny. d .rlulrv.ly comricrin8 $nh li..Gr{ (o rah ro @lrnn(l th. F.rc.r (Sr. 7Or-{. ItsiB
<br />tnd Plni*irn Codc: Tn. ( o.k:tor'. Li.d.. lju ([B mr !r'rrl' ro .r o" k ofFoFny sho $.il.k or inpiofG rh6Fn,ud whr 6dEds lor!.h Fj.tr! \nh t Conrdonr) lirr.d pn6x,r krrl! Colnr.cim t t.ke ts,
<br />I en .rm,{ lRLr satiotr
<br />D.r. ()0nd
<br />\t oRhERs, (r tuPf,nsA t loi
<br />Dr0,1&lr0t
<br />I hd.l^ nmrm und6 ts,h) orFrru\.ncofrh. nnb\nrr &rlar.rir.ni
<br />Ih!r.ltl$illtuindt. C.nifrd.of (orM! ro s.lf-lnrur.lor \or\d comrqstion. d filr'dcdforbyS6tion!700olrn
<br />tlhr co& tor lh. I'sfo'trr4. of rlE f,ork aor shich th. Fm ir Bu.d
<br />I h!t. .nd * ill mlinrrin $ork6 roop.a$t no insur.m.. 6 r.qun d t, salhn !7(,o of rlE lrhor ( od._ nr rlE Ffol]M. oa
<br />rh. {,yt for r h*h !h6 Fhi . sEd M} so.\6 onFd.n 'Nltr. cms nld p.l.r nudh6 nc.
<br />,*. l4eLt t [r,r,.P. i "s'F."., I
<br />,,..,-:J; q-otq2'75 rrptr. - ts /tA/ ['?
<br />I c.nifrlhar mlh.Ffomm.of rh."orl for$hichlhisFnn n is.n.l Jn![ mr 6p[D e) F$n in I, nnF
<br />s E '. tEom shi<r ro lh. trcl6 omFrdbn L$r orc.fiLmia di.sc rhd il I .Luld t<oft stitt to lrr
<br />*!*6' mnpdsrion F\n.N ot S.(i)n l7r, oI lh. lior ccL. I lttrlL lodhq nh 6"VIt *!rh ltbs Fnvilios\lAnNrNC E iturc lo sur tr(rt6 omFdi.n (\d.r. n unb{tul eld slEll $hj(l M onp
<br />rnJ nn6 ur lo orc huodr.! lhou$nd dnl6ltlm-ulo).
<br />'n
<br />adiilnr r. rhc c.ll oa
<br />s^ri'n I'176.f th. |jtv ('odc, rnr6d eJ dhm('
<br />",,",.7/ 1 1/ I Q
<br />^,,,,-*,
<br />DECIjAAIjq!
<br />I h.rd, rllm und.r FDlly of Fju.r lhi I e li.a!.d u.dd reri.ir ol( hspl6 9{Nnotuins $ith S.dion 7000)olDrsn'fl lof rt B{riB $d PmtcioE c('.b. rn my ltoe i in tull for. ! .IIEI
<br />.q ( 1o, (,( Q ,,l7 ,*"*". X 5
<br />7
<br />.7 /'.il
<br />(oNsrRUcTION I f!iDlr!(: clrt( }',
<br />I h.Eby afrm nnd6 F.rlr, oa Fjury rtdr rhc t . otrrndni knins .8ft, for rlE Ffdlje. of E *n,t 6r rtih thi. F6i i
<br />i.!u.d (s< .!097, Civ. C.)
<br />AIIII(ANI-AECIJAAUAN
<br />I hodD lrm uid6 FEI', of Fiu, r. or nl rlE hlhu
<br />'nn
<br />d6lult hne
<br />Damh ion PonheA3hdd Noria<d b. F.d.r.l ReuLl i.N ( I nt ,r0. P!n6,
<br />R.quncd ldts of Notncd6n
<br />I cslily rhd lhc a.ddl r.BlldioE Egrdin! Bhdr6 rmr rl e. N| rr'plalbL to thu Foj.r:r
<br />:f-l .drf, rhd I hn c raj
<br />'hE
<br />rpplraFn rd rd. rhr fi. .lF\. i.rondi'. it ..ran I .g6 ro orply *ilh .I an' .,rd ( ounty
<br />trtrrhrvc a.]I(6rartr $ of rhi\ ( (\ and (in,nr\ ro nrLl uB)nrlr
<br />ty^-
<br />Md$!.G ,n nn. lju: Elri,B ro hriHiry coNMntr nd
<br />Jrp*)
<br />7/t l/11
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