|
SITE-WORK DATE tD/stG.COMMENTS
<br />Set Backs
<br />Formsi Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Roof Sheathinq 1 c tll fL{Oft W
<br />Shear Wall I
<br />Framing
<br />lnsulalion/Energy
<br />Drywall
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif .
<br />FINAL t/tt la tulDi
<br />Certificate ol Occu n
<br />Notes Remarks
<br />BUILDING. INSPECTOR RECORD
<br />OWNER AUII,DER DEI,CARATioN
<br />I lERhy.tlrn uLl.r FMlry r F.rury rh, I d.krr, lnn rlr ConrttE' l-a.nc 12* tur rh. folk,rnl rc.rr (Sc(10115
<br />,lunk( . Phic.rrn Oric): An, Ciy o. counry whi.h rcqor* . tlmnr r' d,n{ruer, .lrd, rr{'n'w. &B)lnh i, qEtr ,nv
<br />{rucrur. l]rrtr r,, rr\ ir!urR.. ako r.qurEs rh. q'nl.-r r,tr lEh lrmn ri' lik r {!r.l {d.m rh.t lr or \h n lkcncd ,'uo.
<br />b rlE ln vni'.s of rlE (i'nrrrtr'r l-En€J Irw tchefl.r 9, Conm inf *ith S(t n 7ul0 ot Drvr!'n I oa rh. Btrn*( inJ
<br />Pnncsi,ni C,nl.) or rh:r h. or rh. (.r.mli rh.Ehom!tulrh. hanr nrrne rlks.J.t.n{ii,n AnyYi'l.urofsdftrrllll5hvrnv
<br />rflrl(ani ntr . Fm[ .uhjcF rlE .pt,lk.nr k' r .,ql Fuh y or nn nft rhs fry. hu,rlrc,l ,k)llr\ I S5t$)
<br />l. !! owrcrofr,E r'fl,ltny, nr my cn{lbr$ wlrh w.8.s:r rlE! q,L.t,hFnq'r'n. *' u' tlr wtt [l rli {drE r nn
<br />ulnN or.rr.EJ itrqkrs( 70aa. Burm( $J Pn isi'ns(i c lLCD rr&tr 1 Lic.ne Ij* Jo.s n,r .prly n) .n o*mr or
<br />rhr pnFdt whrhu .l\{ irq,n'€sth.N'n, ui wbdEtu-.'h*ni h'msclr or h.rull or rlmr8h htr d h.r own .r?t,Fcr.
<br />FovrLJ rh.t orh uqmwdrenr d.nld tx olli:d i,trsk IlhrkE,rh.h! lhllxlqmFtud n $U e hDomFr
<br />of(r'.t{,k1rn rlr OwF, Buiu.r *iI hrh rt hurd.noffx)!o3 rh, h.orrh.dd n{ hd tormlrtrcrh.FIdyft*rh.FrFc.f
<br />-1.
<br />r\owrtr olrh. SIrdy, itrrc!.lu.rvcly$ rr.r13 wih lk.nrJ Lo rr(!tr\r)( {flEr rh.lxrF.r rs.\ TlE-l lllqtu\s
<br />rd hr.(rr(iL lh.((n r,(!n'\ Lk.h\. lrs d({\ ft apl,lvr! m.wrcr I nrcFd!{ho hr, (ornnpr'E\rh.r.!r.
<br />rnJ wl'o (n rn(\ ntr \uch pn'r.t wihJ (i)nrri(tr r, l(cn\rl
<br />')Unurni
<br />t'rhc(ir ru(rtr ( Lf,.tr{ I rf,J
<br />-Irn,.(n,I{
<br />u'rt r S.rtntr-
<br />llotl(ERs (-ollf flis,\TloN
<br />IrIC!I8AIq!
<br />I h.kby rrTtrn unJcr l^..nihyol Brtury.nc ol rh l,)ll,"tnt (Lalrlrx,nl
<br />l hr\. sill 'mtr rD r (.d'ri r. ol (i$anr tt S(ll-hNurc l(tr rorldr' !,mr-_nunn. r\ lhnrlcd ntr hr S..r$n rr_llr ol rlx
<br />lrhtr (irk.l'trrh pcrr.rrurcorrh h* nt rhrhrh( rirsn I r\u.11
<br />-lhil.rnls'llm,,nr
<br />n$orkc^.dmn(n{rrkrrn\trlRci\nqutr.Jh!Sr\rDtr\rU).lrhli&r(iilc.l({th.|tnorNk.ol
<br />t.{ Ehrhtr. nq ilrrsEn Mt }nrlcr..-mncl
<br />ahY--ilsduu
<br />^*, 46-tuts3,l'ol:07
<br />xrrDn tr^nrrr. (nr'.rnrl Fn(y n n,h!r tu(
<br />{'t -202d
<br />l(nrry rh[ o rhc ltrloflun. ol rh. *ork nr *hih rh^ Finn u tr\u.J. I \hxllnn .qtl,! !i! f{^"n nr lnv 'Mhfrr!, rs n! t\(.L- su6F( | r, rh. *0lt6r (.n\En\irDn liws.l (illl(n'x. rel4rc. rh{ ,l I drn'ld h.i.ft sulrl.(r n' rli'
<br />*orkc $ ,txh\rr (r tr,lronr nl S.di'n ril,(r.l r lE l.'htr (ixl l \lllll ndhu dh dnnplJ_ $ [h rh,t Il(^ trr,n(
<br />rVARNln_(;. rnllrr. t, r.u.. *rrt ^'.on{th\:ritn $.r.8. '{ utrl.*lul. rtrJ \ltll nrht rr M cnfl)ycr n} mnnnrl lf,nlhf,\ rkl
<br />.Nrl Itrr\ trt n, rc hunJnal !ho!\md doll*\ (Jl(x),(xxrr. rn rdJdi)n h' rh. (N !,r (on$nsrDn. (llNScr 15 Prcrr,.d nn rh
<br />Sr(ir 1076 ol rl* lrhtr(irL. nr.r.n drnorNy'\l..r?'t - tq
<br />lrECLdEAIrO!
<br />I ltdtlya,rnn uLl.r lxElryol lt.iury lh,I li..n<Jonl.r F,vrr'n.l('h.Pr.ri) (rommR-'ing wnh Sclrim ?(f,Xi)) or D,srdn I
<br />o, rh. Btr\N\!ni I'roli(dnrC,xL, el my lun\c R o ltllttr. uJri.fl(
<br />,.",'.".,,.. L'3(5-l 4
<br />I h.rehydlnnrund.r lEnrlryol Frrrryrhd rh.r.1co.n [,n Lultns tscny n, rh. F lolrlr*c ol r,I kx* nt shf,h rhs Fm F
<br />r\o.JrS( 1097, CN. C )
<br />Afl'LTO{NT DTCLAIIATION
<br />I hdri, rlllm undcr Fn.lrv ol Frjury om ol rh knk,wms d.rlrflrtrft:
<br />l).n,l r)n P(n r^rhcnoi N,{rl(!l!'. licJ.ral Rc8uhrx,n\ (I 1.,t1}, Pid6)
<br />Rcqum,l lrlnr.l N,irli(rkm
<br />l.cnrlt rhr rh. lcJ.r.l rquLrons ftp-dmt a(Esln\ (nDvllurc nor rml(dhl. [, rhA nn+!l
<br />ih. lhr!.n,!,rh^rDIl(nir,url!..rhrrrrr[r.tr,lonj'!{i'\( rrc(r li!'..rt(o rllyw hrll(Iyrtul(o trr!
<br />.urh{r. rcFrr.rrtiw! orrh,i Ciry t n ct'udt t' .dc uFln rtr
<br />Subf loor/Vent/l nsulation
<br />Ext./lnt. Lath
<br />T-Bar
<br />Etc.
<br />I
<br />7kt1
<br />I
|