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G- INSPECTOR RECORD
<br />SITE.WOBK DATE ID/SIG.
<br />Set Backs
<br />trs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground- _
<br />SLAB Ftoor lgu 7lt1lt0 L<44t-
<br />Subf loor/VenVlnsulation
<br />Roof Sheathin s
<br />Shear Wall
<br />Framing @n
<br />lnsulation/Energy
<br />Drywall
<br />Brown Coat
<br />Mason (Y
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />En gineer Final Report
<br />Flood Zone Certif
<br />FINAL 8'?-'8 i\Ec4
<br />Certificate of Occu pancy
<br />Notes, Remarks, Etc
<br />I On wl^.
<br />\
<br />OWNEN AUILDET DELCARATION
<br />I h.rchy llftrm xnddr ,.uhy or Fl]t,y rlur I o .rcnpr fn'm lh. C.nrErnF Li.nr D* Ior rh. t{'lh*in& rcd*,n 1s.. 7{).l l 5
<br />Burin.rr .nl l,rofc(ion Cnk)r Any Cny or ('oudy *tth r.Iuiri r l(mir kr d,n<tur. 1116, iq)rort. &frnnh or E atr dy
<br />{Mur.. Fix ro irs nium. .Lq, rnun6 lh. rrpr..nr lt, luh Fmn h fik. {8ftJ {rr.md rhr' lt or .lE i lirnrn prud
<br />ro rlE Imrisionr ol rh. Cont8t.l! Lk.n{d trw (Chrflcr 9. Cu'rmri.B riih Sftrl'n 7UI] .f Divkhn I ol rlx Bu\R\i dd
<br />Prorcrrk,nrCod.)or rhrt ltorthc iiei.mpl rlEr.fnm.fri lh. horr for rhc rlkBcd.rcmFlio. AnyvioLlinnor56lionT0ll.5lrr.ny
<br />lpr i.. (, Frmn hFb rlf, rprlklnr kr..irilFEhrolmr nnc rh,n til. hu'dnn d,oll8lltmr
<br />l. .r o*mr ol rh. IlrlrFny. or my..II'k]J{.s *th r!t.\ rs r h.t q,h .omDeo$l on. sill Jn rlE erk !,ri
<br />'lE
<br />c rfttrn
<br />htcfllol o.ofrcEdn{nklsd7rX{.A$iElrrndPinfcrinrCi.'llrc(,ntatf,\Iis*|^&6mr.mlt!o...rftrof
<br />rh. tn,Fdy wh't iLl\ or iq,ot{ r,.En- snd wno d,s shh uott h,m€l( or hcrrlr or rhn,qh hi! or h.r o*n cnll,klr$.
<br />IrovlLd rh.t shh inrtFm .c il.nLd,trofisdtuql la h'*rE. rlr h'tltrla or inFMftd n a,B *lhin or F,oaort'brirlh.O*mrAuitk*lh.r:ttEhhld!ofFriryrhdLorttrdiln,l Uurp.oKt-In{dyftrrlrFry*of
<br />_1. {{ o*mr of r h. pmr.ny. .m (xclusivcly .nnsr in8 *r h lic.n{rl nrnr&1tr\ rJ .on(Mr rlr pn,,.r-l ( SE ?Or4. Bu(iE(
<br />aBl Pnrtoarnn (i'd.:'Ih. Cont{nn ! l.kctr\c LN drEr nor lnnlylo !! r*xr ol pmrE.ly sho hu'ld\ or inDro\tr thdon,
<br />! l *h' odtrr{ fq rkh F,Fdr *'rh. Conrar,,( r, li..n<n purud !r'rh.conrE!tr i l-i..n< l,*)
<br />lu,c\.nq und.r Sdi,n
<br />D,l. ()rEr
<br />rlrnf,!85r(aull;rs/utlrt
<br />IITLIBdIIIIN
<br />I lf,rrhJ r,ltrm trkhr ncnriyflpcl,rtr) oR,'r rh( r,ll'\ tr,t i(l.rdr'n\
<br />I h.t rRl $r ll roinroin ! CcniaKorc .t ( onrnt t| Sclr' ln{un nn wolrsi onrpcnqri{,n. !! Imyidci lor hy s.diin .17(xr or rh.
<br />L,hr ('od.. lo.llE Flolrrm orilE srl lr rhth rh. ,Ermn s ^rh,
<br />_ l n.E a.d will mdlin wort n' omp.n{'irn mrurB c. .\ Ejxt.n h! sd' i,n .17(D or rlE l,ti{ Cod.. fo. ilr lirftnmK of
<br />!t *orl ru Phtt lhir rmil ir iqrd My *ork6c mqtd$n imur.N (tri.r In F,lay numlE e
<br />-l..nrfy
<br />rhxr in rh. p.rlontumc ofrhc work for *hi.h rhk Frmir ir irsucd. I \huu nor.n{rk'y my Frqrn in rny nantr.
<br />g' r\h tE(B ruhrd b rlr qrltqr'.l'qrn$rin t.f,. .r C.lirohr. .d lrN rha' ill rhrld hcom ruhF.r n' rlI
<br />s od6r n'n{fnsrirtr pmvi\btr\ .a 56-rio" 17rx, ol rhc l,try ('ql{. I {ull. tmh*ith .rrryly q irh ih'. pmvnbni
<br />WAXNTNC Fsilur. b s$c Mrl.h .$f,F.nsri,n.o!.rl3c ir rnlswaul, Md all sxbFr rh.mpkryrr ro cimr.llEMlras.nd
<br />.!il limr up k, oF hunlErl rt ued dolL6 rtlfi).fl!)r. in !d/ x,. io rh..on or.onlinstirn. drmFi.r pmvil.d for rh.
<br />sarkin :l(176 of rh. I abn cnL, inicrsr 8rl dbmy r f.{s
<br />D.l.: ADctol:
<br />r rt rnsrrr cirrtrprlrrrn
<br />IIECI4f,AIIIIB
<br />I lkEh, rflirm u.d.r F lry of F.lurt lhd I d lienrd under Foltbn ofchq'h 9 ronrturns *irh Sdrirn ?O(lO) of Di$hih .1
<br />or rh. Bu\itu$ and Prnf.ssi'nsC.d.. ltd my llcnE is ir 6ill foN !,rl cllccr
<br />c0lEral(Iu!.rElrllliltiEd{:L
<br />I lrEhy lrrn u,'&r rEuty of lr.Jury lh.l ltm ir. $nrrudirn hrlinr r8.Ey nn lh. FnohEm ofrlr q'(l nn *hih rht Fmir ir
<br />nrud lscc. 1097.Civ. C,.
<br />arruQtxt-D[(t a.aila!
<br />I llrchlrllitrrurlerynrlly ol trrI.y otrc ol rhc hn['wnr!,lc( ln rn,n(
<br />l)enin{i Pcnn !A\h.io\ Nnrlr.(r,n I.(l$ilR.!ulrr(nN 1tnl. {0 l,rn6l
<br />klqun.J l.rlcrol Nor ieM.n
<br />l.dntrhd rh( r.d.hlrcphrrrn\ RSddint,\hr{o\ rcnrnxlrrc ior:ltlirbk r, rhn prul..r
<br />/nhov. mnii{,rcd pml'cd
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<br />.8rE r,.nq,lI rirh lll(-'rtIi n,unrt
<br />nsyhn( i, r (,rdyr, '(ur,r,lr
<br />\",tx*
<br />.lI(-\
<br />Ext./lnt. Lath
<br />IrrlciI A(lilr\\,
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