|
BUILDING. INSPECTOB RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS O$NER ATIII-DIIR DELCARATION
<br />I hcrby al,tm undq F.rlly, Frjury lh, I m c\cmpt lnrm l,E (i,nl.*nF L..nE li* ror rt: l,)lhra8 E on ls&.'roll I
<br />BunE( .,r! Pn,ltsir Qnc) Any C y or Counry *hrh Equrc! ! Fm[ n, d,idrurr. ilrtr, ,n{'n)v., d.m,lnh or EIEi {t/
<br />nd.lu.- rrtr (, i B\urtu.. rkl r.qlEr rh. qDl.:d n, \kh p.mr n' llL . r8rJ {.rcftnr rh.r lE or {* !s I'cnr.J puFuanr
<br />nr rh. pnrvr[ns ol rh. cl,nh!rr,'r t.ktn{.t b* rchrnr.r L Cohmm'ns w h sd.n 7(rxl or Drvtrbn ! or rlE BurEs ril
<br />Pnncir$n! (ixk ) ,, !tur tr or rh. tr .r.hr rlxr.lnr!rhJ rlFb.nr f(tr rh. rlLf.d cr.q,non AryvobrxrnolSdrbn?0ll5hy..!
<br />{rpl(ant ltr ! Fmn ruhj.ll r rlE .I'l Mnr n' . crv rl FMlry ol nn Bn ih.o frrt ttnl].J J.llxs (t5OO)
<br />_l .! r*Rr of ihc In,Fnt, r.rrlu{klyrn . nr w(h I'ecnscd cnnr(nB n) u 'nnrud rll 0fl+d rs.( 7(x1,Iru\Ns
<br />.ul PDl(\q{ C,rLr I hc O)nrrantr 1L(cne l} Jr\ nn iptlyt, o*nr ol pn,Ft, wtx, hu rldt .i mprulcs rh.r.on.
<br />rnJ *k' ronnx!!\ ktr sorh phr.LG w hn(nnkrlonrrlf,.n{dpu.udrlr.llkO)nrra.ttrsl,r.n*Ir*)
<br />_l d.rcnlF !tut r s.cli,n
<br />UITB$EES:C(&II'NSAIIONIECIJSAIIa!
<br />I h.rchy rllmr utulcr lEnlh y of lEqury oN olrhr bl!'*DI hLlarlr$ns:
<br />I h.v. .,n enl Mi, .i, t C.nrlisr. o, (on{'{ t, S.ll.l ur llr *rrd' $q'cM.n, a FovrLj iitr by Sdi$i 17lr) or rr*
<br />btltr cirk, rr{ lh. rE romc. oi th. m* lor *hrh rhc Fmnr i! Rslql
<br />_I h.ve lid wrll mrmrri. eor*.ra comFni.trn i.rur.tu., r\ r.q!(d hy S.rr M l?(t) ol rlE lrbor GiL. i, llE lEd('lre ol
<br />rlE qrt l# *nrt thB Ftu 6 r$at My wort.6' mhJEn.{rin hsurm..ttrrr lri Fn*y Nnlrr d.
<br />Icd'tylh.r r rh. FnormBc ol rh. w. ntr *h.h rhr IE mlr tr trrun. l ,U nn .nfhy rny FBr rn rny lMr
<br />I' r 6 tx1rtr fuhFr b rhc qr d $nf..rd xri hwi nl calrtumr, {hl aSEc rhrr il I st'ul] h.{od suhAir ro rtr
<br />k,rl.A' $qrtrer rr pftlni,nr nr sdlin !7fl) rt rlE Lhr cqi., I \h.ll. Iini*nh ..n{ly *rrh rh{ Ilnrvni'ni.
<br />WARNIN(;: I'rlurc ro rrw wo,kcr'con{tatii'n.ovcas. r unb*t!I, ar, rh.ll ilhFr .n crq,h!t, n,.flruDl FEl.r tnl
<br />(Nrl trmc un t' oE hunjrJ thre.J 'tollm (31fi1.(ll)). In addtr'on r, thc (.n o{.ompcnsaron, Jaru!.! .r lrovd.d ld rh.
<br />S..rpn 1076or rlE l,htrGri.. u .rn J.romy'r td\
<br />D ,,^- 3--/a
<br />!!1!f!t ! !!ll
<br />I h.rhy allim u j.r Fntlry ot l.rFy rhr I m lEtrsn url.r lrl,v!!n olch4d 9 (dr|:mtur! * h ScdDn'7C{D) of Drv.ir l
<br />ol In Busftrr 0d PoLsnns Crolc. ifli ny ll.n( !s in fuu fou .tn cale.r
<br />l-N.n{ CLrr:-I-i.tnr Nun*Er
<br />CONSTRU(TTOiI LEIIDINC (:EN(Y
<br />I hcrc$y allrm utulcr lEnalryol p.riury rhlr rh.l. !. Lln{mlhn knlns '8ctuy fur rh. Fnrne. ot rh. krt f!tr *h.h rhr Fd E
<br />l.cn'lyrhrr rhc l.dcral rcSlh trms Esddrn8 !!tE(ds r.n)v{l {rc noi rt irubk I' rh,\ pntlccr
<br />-l
<br />rcd 'ly rhrr I luv. r'd rh6 ryrlcrr rcn rd n!1. rh.l rh. .h)v. hld.mr ir s .(llBr I llc b o'nply wrh .ll Ciy .rn C.udy
<br />.xJE t!ul sri. L,*i rldn{ r0 hlrtl0a c.nntutbh, .nl h.Ehy.urh,,r RF.Enrlrrvct or rhr c y lrl colnl! lo .nlcr utn. ilr
<br />$ov. mnrox'l n^,pcny nn iniF.ri'n trrFEr
<br />Appll.sl o.,tg.nl Siemtum
<br />Set Backs
<br />Forms/Steeli Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Roof Sheathing
<br />Shear Wall
<br />Framinq
<br />lns u lation/ Energ y
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />FINAL 1\\L\$/*4\\9)
<br />Certif icate ol Occupancy
<br />Notes, Remarks, Etc
<br />_1. 8 o*mr ol rlr trltlny, rr my cq,l,Frr wnh f,.pcr rh.r qrlc onvEn{rrEr, wrll ,io rh. u'lt ,n dE ntu1E . r
<br />ur.rLl or ollcrcJ lbr qk (Sd 7044. Bu!*s .,rl Prufc.rx, Co&: Th. Conr-!(i lxar ll* &El d .f'?ly r. u .vF of
<br />ih. FDIrny *b hiur or BtmF itrE n, ml *h' &xt ikh krt hmr.ll !r h.rElfo. rtFruSh h! orlrrown.f,Pkry..{,
<br />ln,vrlcJ rhi rkh lrr{n'Emdr & n{ .rc 16l { oll.Erl [,r {L. ll. n'rw. ih tx!!ry d mttuEmd K r'! wrhn rr y.r
<br />ol(ulI,llon, rlr O*n.r Br .kr wdl hrE rh. r,aLn orpn,vo3 rhr rE or {r dn mr h.dl d lrtFrE 0E FrFry rq rlr ltiF* or
<br />,,n2 - 3- /? .'on o"^,
<br />$u.\t rS( r09r, Crv. C.)
<br />lrBlcil Nrtr
<br />AETLICANUTECI4SAIAN
<br />I Err, dlm udLr Fnrt, of Frjury or of llE fdldwn8 daLr{bnrl
<br />tllmn $n FcrhrlArlEro! l&rdil,l&n rai.El R.s!lrli,n.tI'rk 4{). Pd6r
<br />Rcqur! L.lrcr ol Nr irlin
<br />-,,,2-5-/7
<br />Subf loor/VenVlnsulation
<br />Pool Fence
<br />Flood Zone Certif .
|