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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS oWNAA BUIT,DER DEI,('ARATION
<br />I h.r.hy .llim uBt , FDk, t'f Frirry rh, I o .r.nft lom th. (i,trt*tln L.c.( lir lrn rh. fotl'rh! ,'!rD rs'( Torl 1
<br />Bunn.( .al PoL*r'n C,rl.) Any C y trr cotrnry wh*h r.rlu!.r r Fmi ro d,n{nkr. .lrd. itlroE. J'nrrlnh 'r rlEr 'ny
<br />nrurrorc, lrrtr r' (s r\unkc.rllorclurclrhcan0l.anrturruchFrn nr rit a r!n.n (ll.trnr ri,r t or 'h. ! l.cn!'J Nsalnr
<br />nr rh( plrvsom ol rlr. c nrn.ttr \ Lf,cnqJ lru (chlPrcr 9. commRrns *irh strx)n Tuxl ot t ivirn'n I Irh. Bu\in.s rn'l
<br />Pnn.s(r\ cirl.) .r rhlr tr { ilr r .r.nll|l rh.Rhom ul rht &nr itrrltr !ll{.tl .kml'r!'n rv vlrhran of S(ri'n 7{l.l I 5 hyrnv
<br />.ml'.rni ntrelEmlr suhrNr\rlx .rTli. n' r .,f,1 FMlry of B'l mrr rhrn in. huBlGl &'llxr ( !too)
<br />L a! ow*r .l r h. nn'Eny. ,, ny.mpltlrs * h *r!cr rr rh.r q,k n)mfcnd Dn. wllt ' th. wxt rn !h. rriw ! n{
<br />d.nLJ n. d0.rcd tur sk lS( 7044. Eusrs anJ Ih .\\x'n( C,i.: I h. Conkk(tr r l.t.nt lr* &8 rx .pply r. th o*mi ot
<br />rh. nn'Fdy *k' ho ii or m{r,,Er rlI(,n. i rh' d,f,s uh u)* h'nn.ll or h.r{lf or r hnnrah hn nr hct own .rll)lrv.cs.
<br />p.'vd.d rhrr {'.h impnllcmhh m d ur.nicJ or oll.mJ fot !!k ll, lY'r.vr' rti hu rU63 t r{mYcm ssrll*dhmoncttd
<br />.l (l.rl)lcrr'n. rh. OwN. tt!'l&r wil hrt rlr h' .n ol In,h8 rhd h. or rhc Jrl nn horu .r tqntE the F)lxnv lu tlr PUIIxE 'l
<br />l, .. o*rr o, rh. F{xny. rm crctunlcly ()drar dI rnh lf,.n(J .odrarnr o c.n<tur I lr IftrFr tse r_tll! Au(m(
<br />:n th -5m Cdl. l h. (i,nrr{ntr'i L,(.n( 1,.* ,hr( nr .Pr ly t' .n osncr ol I'otEd v * h' I'u r!l! or imln'Y.! ih'rd''
<br />.fr, wh, !$rnBd 1 nr nkh F*.1r *iih r Cod ran'n r I lEnsc,i pururnr b rh. ().rtr trrI-r.n€LawJ
<br />Itll86EBslgllltEdlallg!
<br />DESI.AEAIIA!
<br />I h.r.lry rlltrh und.r Fn.hy ol p.4rry od olrh. nnl'*r3 d(llarxr!:
<br />l(ntfyrhrr inth. Frturtutuc ol r& rort ktr whrh rhr pcrnr tr rlud l rhrll n .n{k,y.nv IEr$n,n dv m.nmr
<br />v' rr b tnnm $hj.rr t,lh. *trtft ontEnt ll'n h*\ ol Crrrfomr, .rn.!N rh, 'i I (h'ull IEaoE \!rrd lo ill
<br />*o .n .ontE.{ri).prnrrrnrof s&iN)n !'rlrlr
<br />$ARNIN(;: lanur. n' (ur *'trkcr' $qxn\rr
<br />.Nll lrn.r uI' t' oft hunncd rB)uranJ doll.ii 13
<br />hsnh !.r{iy *dhrh){ nnrvri'nt
<br />S.(rntrj ll)i6olrhL I-run ('!'rlf. trrictr\r
<br />lrrl.:- A
<br />I tr t \\[], ( r)\ l R \r I{)R
<br />!I!r.!-8-\ll!.t\
<br />Clufld 9rlr,mrh-'mS $rh S..r.n'71,u)) df Dtrri,n:lI h.rhy rrlnnu.Jcr n uhrotrt4u.y th.r
<br />ol rli Buimssand Pnn.(trr\Ori., !n my ltr.nr N E tiill nie. dt.tntr
<br />I lrr.hv rlltr n unJ.r Iinrlr! 'n Frlrr_ rhi rltr Lmltr,t r(n.y ntrrh( ti1nrnutr. Irl'.*!ikl!{!h(hrl,rlrrn N
<br />'\nk\t lS.( r()9?,Civ. ( )
<br />lrhnT's Nrm:
<br />AfItI ICANT I)I:(] ARATION
<br />ItrnhyJlnnu .rlxtrrli) "l p(rttrrtr eolrh(r"l1')utrrS(lcrlirrrntrtr
<br />llnx,l[in, I'sn \ A\lt{o\ N rrltrrr('n lirl.trl Rc!trhrNn\ I I rl. to l'r 6)
<br />R.qtrtr.(l lrrr.r ol Ntr'l(Jrhn
<br />I(dlfylhallh.lcJ.r r8tlrlhns cg{Jr! r\h.dor rfr'vrl.r n 4l'l..blc b rhn FrJ.\r
<br />I r!'.(n)(on\ny*rrh xll(''r\ r l( (n'nrv
<br />.tr hnv.r.fr.\r.ir(\olrlr^(ivin,l(intrrvk).nrd lr rl.
<br />L.---
<br />r
<br />Set Backs
<br />Forms/Steeli Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Sublloor/Vent/l nsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq
<br />lnsulationi Enerqy
<br />Drywall
<br />Ext.i lnt. Lath
<br />Brown Coat
<br />It/asonry
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enoineer Final Report
<br />Flood Zone Certif .
<br />I
<br />FINAL 1 /-z /tzt -/X4r vCertif icate ol Occupancy
<br />Notes, Remarks, Etc
<br />lrtr.krn|n trfrl.r S.,rrr'
<br />Ihrholwillnr rm 1 ccll rli.llc ol Cotr\.hr r, s.ll_lnn'rc ntr *or[d I onrF-n\d trtri x\ t)n)vd.J lq h, s'd rr lTlxl 'l rhc
<br />l jhtr (irL, tur rhc pcrlrrnuRt frh. wo* ntr{hih rh. l.rn s r{nrl
<br />-l hr\c rnJ $,lt.rtrr.h u.ncr'.nmFnerr rn$r,Rc. 11 r.l|or.l hv Se..r $n lTlr I ol rh. ljktr Cdl. t{ rh. Fnolfue ' ol
<br />rh. wort l(n uhkh r hr pcmn ,\ NrxJ f,iy *.llr! ron{--nsr i!. ,h\urrL. .rthrl Fnr I nuohcr dl
<br />5Y.L
<br />Pool Fence
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