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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS Oi{NEN BUTLDEX DIiICA RATI{'N
<br />I hcrby lntm undcr Fnolly oi ncrjury rhol I m .rc.q fmn thc Ct.tack'F Lid.n* Lrw for rtu followins Eu{'n ( Sa it-i l 5
<br />Bu{G\ rn, hof.ssnn (in r Any Ciry or CN y *hth Etuirc\ r Fmil lo (,n{Mr. .!s. i,tro}r. iLmhh or EIIU uy
<br />sru.rm, Fn kr i( iisrE, !lq' rcqntr.s rh. +0li!nr tor ru.h Fmi! ro nk ' \Ern {rcr rhn rE or sh. t lrs{d Fumanr
<br />k rh. F'!i\krn! orrh. Co.rmrn\ l,ic.nsd lj* (Chrflq 0. CooENinf *irh s.dio. 7l](tr of Divni,n:] orrtr 8uri,.\r.nd
<br />l\,L(sn. Cod.) or rh.r lEorsh. n cr..q, rh.EfNn rnd rlF h\ii f rtE ,lk!.d .r.f,prnn A.ytDLrbn.fsd.nl0ll Jb!rny
<br />ll'pliranlntrapcmn suhj$lsln lppli(ufll lo i.ivil,.Mhyo! not nrElhon livc hutr&.d dolh6ls5lx)).
<br />l. rs orEr ot rht pn,Fnr. or ny .nplortB *iih !r8.s .s thct nlc mtrllf,nrlrion. vill & rlE sot aJd rh lrnt1E n d
<br />inrcri.n or.ficRl fm {L (Sd 7(ra4. Buriftls dnd Pnlfdtio.t (ixlc Th. c(,nodror'r Lkcn( lrr&6e riTlyn,.no*Erof
<br />rlE |rorrn, *h toil& or iqm6 rlE$tr rn *b d(n *i snl hireror triellnr lhho8h hn d hr orncm0hts.
<br />pR'vidcd rh \uch inl|]n'tmnk m mr inrodsi or ofliE{ fo. $lc ll. fu*cE. rh. hiBitrg or in{'mEftnl irq,ld*irhino.c }ur
<br />old',q .thc llt ()wE Buildd *ill h,E rhnLnofFlnlsrtuh.o.nEdiln t 'rl or iqmr r,E FId, fd rh,rrFror
<br />t,
<br />_l
<br />', rlr FDFi m .rclu.ivcl, (,nrr-riq uh lhueil co,rr&1,n ro onr*1 rL lmrd rS( 7Or4. BGiFr
<br />'ndc ThcConr ror's Lr.n!. 1-.w d*l mr rtplr r, rn o*nd rf in,p.ny whr buildr or inntuv.s th.ron.
<br />ddrfnr uhF.ti{r* h r Co'rrem o lR.<n nuFu r,
<br />'lE
<br />O,ntrdd.t lRnr Lr* )
<br />ui\rd s6ti\ L / .u &P( rorrhr,.a'nrt- r t--F* Ntr"c-r,..",t\ r.rl.r,rl-e /
<br />\ w{rR(Fls' r'rlltlplr'lslTloN
<br />lU -
<br />!EI;AIAII$i
<br />I hcrch, aflirn, trnJcr pcntrlryol rEijury om of th. ftnh*ir8 d6..lur!tionr
<br />I h,rc 'Jn r ill min'rn , C.n 'frnc or Coo€n' ro Srlt IBUE frn *.ds ('ryxneiFn. n F,vrl.d for hy sRlir .r7li, or rrr
<br />Ixhtr Gxt. rir rh. pcrLnre orrhc *nrl for *hich rhc ncm nnru.d
<br />Ihtrvcrlrlw'll rinr{'n solt.r{ c.ntFn\rrtr,. rn\or!ffc. r\ rcqukll hyS..r(,n l7lr,.frhc trtntr (i)d.. ftrrh. nql(rnwrcof
<br />rh. qork lnr shrh rh(lxrnrir r\ \rkl Mrsurkda $'npcn{ii,n insufutu..trrff rlF,lxy.umh.r a.
<br />Ser $n :1076 oI rk bhx ('id. inr.Eq lrd ,ntrEv 5
<br />, "r\",( \ uli on cl olto -tt- rB
<br />I lBEby .r,m untn Fmlry of Frjury lh, I m litrrn !n&r Frvilir,. .r (1!!t6 9 (d,nmR_in8 *nh Sarbn ?0(u I of Di! i.hn .l
<br />ol rh. BuriEs. rnd Prnt $irft ('r&. d m, lkd{ h m tull f,rd dn .ffftr
<br />gatuaullrSJ.[altNil$lBsr
<br />I hcrchyufinnrutuls F lty of Frjury lhol lhd n . onn rudi,n Lndin! o8.r'y for rhc |f,rlormtrc or rhc q,k for *ith ihi\ Fmil i!
<br />i..Ed (s( lm7. civ c I
<br />AITLII]ANLITECIJ8AIII]!
<br />I hodry dl"mn u ndo o.nolry of rcrjury orc ollhc hlh*inx d(hrurhnr
<br />D('nrlhhn ltrnnr A{E{o{ lk{ifrtrhn tu r.l Rc8uh'rrr ( rnk {). Pd6r
<br />kcqtrtrr,1 l.rtr.l Norill.rritr'
<br />l.cn'frrhd rlI fcdcrdrc8thhon\ rcErdi',! r\hcsl,x rcft)vullrc Nrrpnl'.lhlc i, rh'\F'r.r
<br />l.Lnifl,rharl hnk rcad rhr\q,Ilf,Drtr,hrn]{!r.rh.r ih.!h'r. rnlnnuri,'n ncmn.-r lrsrekicofrfly$irhrllCirtrfii(,,unry
<br />r,itrtr' tr!c\ rrtl SrJrr liw. mlJl inE rt hu illiry .,,n{ rucr i,n rl turlhy rurktir. R.trscnrd ir cs oll hh Cir y .nd (t'unry k, rnr$ u} rlr
<br />;;;,;;;;#fl,ii,r"r\ t \^&( ,",.1o- (r-\€
<br />,. Un" -,,,,on"ut./
<br />Set Backs
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Shealhinq / o/tt //]/(rytu"zrt-/o-'
<br />Shear Wall
<br />Framing
<br />lnsulalion/Energy
<br />Drywall
<br />Brown Coat
<br />lvlason (y
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif.
<br />I
<br />FINAL /o/tttt//,1 qriltn-/b..--
<br />Certiticate of Occu T'- 'pancy
<br />Notes, Remarks , Etc
<br />-l
<br />c.nify rhd in rlE FlnDm of rlE *ort iq wnah rhn F mil 'i FsEd.I rlull rn cq ry.n,Fmn inrnymntr
<br />r, ft ro tt..m rubjet
<br />'o 'h.
<br />srrl.x'$mFn$!un la*\ o,Crhlodi.. rnd a!N. rhd irl rhould lrror subFl !o 'trv.ddr dln{Enurrn tmlisi.,nr ut Sd ir. l7(tr or Or lihrr (i,L- I aEll. f.dhrnh (,mply s iih rh{ pmvirir.s
<br />\'tAtNlN(; l:a'luE to Ru. wrtcr! oqEndnn dMnBc ir lnt *tuI. !'n itulr ruhFl .n 6{'l,rar i,' .itlwl Ffll'ix lnd
<br />civil fincs up r0 om hundr.d lhoulind dollss ($loo.lx[lr. in uddirn'n tu lhc co( ol comFneri,'n. duru[c\ ss pn*idcd r,r rh.
<br />Forms/Steel/Holdowns
<br />Ext./lnt. Lath
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