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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.O\f NEI BUTLDEA DEIC RATION
<br />I hs.try !flim un&r pd.hy of Frju.y rhd I o ddpt fred th. Conlrr.loB Lc.nx L.$ for th. fDlhrins r.@n (Sd.70l L5
<br />Buin* ed ProfBio. Cod.): Ary Cily or Counly *fitn r.qoir6 r Fnil lo .odrucr. !h6, improvc danolth or tpotr m,
<br />3rrudue Fin ro iMG. rlo r.quc rlE pplter for sch Fhn lo fih r s'gEd nd6mt rnl lr or aE is licos{ pl@rln
<br />ro th. FrvirioE ordE (-onlr'.1d', Liccnt .l Ls ((luFa 9. CoMins wirh s..rhn 70m ofDiviio. ! otllE BuiE ed
<br />PmaabN Cod.) d rh,| lr o nE b d.nF fia*om .!i rlE b6i! aor rh .llq.d qolFnn Aiy rioLrDn of Sdbn 70:11.5 bt at
<br />.pplicst tur , pdnit !!bj6rr llE lprlicul ro ! civil p.Mhy o t rcr noE rh!. fiv. hu.dr.i dolld (tJoo,
<br />_1, a olrG of rlE FvFly, o, mt aDplorG enh wrr6 a oEn $L LomFsdirn. lill& tlE $61td llE lEdc. mr
<br />iddld.d or ofid.d lor sL (se ?044, aci6 d Pmf6ioB Cod. Tl'. Colrb.rMi Lroe t * &6 ('l +ply ro x orG of
<br />th.FoFty *lb bir& or hg!6 dEan d srb &s sh *nrt hl,Blf or lE*I, or tlmwt nir or hs o*r dl,lltc,
<br />lrovi(H lh.r such Err.vqld e 6r nctd.d d ofiEed tr -r. lr, lbM, d. t!it!,8 or intpmvoEd ir Dld wirhin om )a
<br />olcompkio,\ tlE Ow B{iniq will hrw llE hdn ol Fllins $rr lE or nlc d'd @l hi( or mFDv. d. F0FD-- fo, tlt FiFE ol
<br />-1,
<br />B NM olrlE FrFry. d eicluir.lr olr.rlms r (t lk6!.d.offard ro odtud tlr FoF ISc 7014, &a{B
<br />Ji PhhinCo&: Th.Conlr..loir ti.@ t w do.r mt l!p,y ro r o*n6 of Fopgly * to b{il& ot mp.o!6 rhcan.
<br />lnd who cod.!ci! f.. ruch Foj.dr wnh , Co.incro(r) lisaqj Nn@ ro r ftnlriclrn s Lk.N lis)
<br />I M.ropr ud6 S6rion-. B & P.C*"-V-2, Zottr,^-
<br />I hr.by 0mnn unds n n.lly of psjury ooc of thd followi',s
<br />-l
<br />hr! sd vill ridrh . CqlifKd. otco&]r to Sdf't@ tor wdl6r' ffip.n.ton. B FD*i.d for by S<ti:n l7(D old!
<br />L.htr Ccla 6r rlE Ffrnrffi. of llE $nt for " n llE Fhn it i$.d
<br />-l hrvc and pill no'nriin sork.6' comD.nsarion irouraoc., 6 rqut.n by sdrion lr(n ot lh. t-abor ( od.. for lh. Ffomm.. of
<br />lhc Nork lor whjch rhn Frir i3 isu.d My world- &dFrldio. iaura(..mid sd rDlicy numhs &r
<br />Policy Nuhbd:-Erpc
<br />l.diry thlt in lh. Ffolllmc of th. {orl for rhkh lhG p6nn n iru.d I shtll @l dploy my F.e. in uy mM
<br />$ B ro b.sm stixr ro rli "qro onFliio. l^! oacrllomir si +r rld ir I rbuld b6or $t!61 t6 tt
<br />*orrd'.ldFs.lnnproriioBofsdiio.!?molrt rlt.r Calq I idl fdrllu nt omdy *nl lh* ForbioB
<br />WARNING F.ihtr. t. ffi srl6' mmF6rhn m\6!s. ir urhrtul. &d .hrl $bi.d d dploF lo ainiNl FdB and
<br />.ivil fin6 up io orc hundEd lhouund dollm (ll0{,0(x)). in addirion ro rh. cor ol.onFMrion. dm!86 a providd ror lh.
<br />Sdtnrn:1076 ofth.lihtr ('odc. itrrE.n od tnomy . tc
<br />,.n,'7-2? 2la5
<br />DECIIAAII{I!
<br />I hscby nflim undq FndlyofFruty rhar I d li.aEdi trnda F.visnrn of(-hapl6 9 (commocins *(h s.{{n 70m)ofl)ivhion 1
<br />of rlE ltusiB sd PrordioB (\d., ,ri mr li.@ is m tull ror.. tuxi.lTdr
<br />COISIAICIIAdI.IIIIIGIGEII:I
<br />I halby .ltm un4r Fdy orrdjury Or lhd. i! . @tao.{o. hdnlg .g*y 6r llE F otrlIe of dE $orl 6r rith rti! Fnl ir
<br />nru.d (SE. 1097. Civ. C ).
<br />atll.l.(AlLDECt ASAIIA!
<br />I h6*! arlm unds D..!lly ol p€quy ooc ot th. follosins dElualbn!:
<br />Dd@hion Pdrirg&t6r Norificlio! tcda.l R.8ulllirN (Tirl.a0, P!n6)
<br />-R.qun
<br />d rnGoltldft.i
<br />_I (drrylhd lht lcJorl,+uLrioa Eldine Bb.r.r rmgtdl uc nor lpplrc.bl. ro lhn poj(!
<br />&(.-,u,*,*'.,-,n.*r-,-,^,^,,r&r(,mrodnn!.md r.xra,oo,Ipr' wi,h.rrciy.d ('"unD
<br />odIE6 ej sd.l.tr' Eli@ ro hlldlll oii olt i hottl,.ulhM r.r.6drtr6 orthE cn) rdcodyr. drd upontlE
<br />ibo\. lJdnn d omDdry 6r !Erct-"t!"$* ,V'
<br />rppucrnorrgdrsrlm,urcX,, ? , . D.,..'|29 Zo1/
<br />r-r,--..rpa,,,X r('c4L rJ -C/,7. n,
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subfloor/VenUl nsulation
<br />Roof Sheathing
<br />Framinq
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />FINAL sTzs/tq 4/fu
<br />Certificate of Occu n
<br />Notes, Remarks, Etc
<br />+
<br />COMMENTS
<br />Shear Wall
<br />Brown Coat
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