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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.
<br />Sel Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />Subf loor/VenVlnsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq
<br />lnsulation/Eneroy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lVlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />) 9)6<- /4,4Zt4rJ f-'t "t )/.r-Q_.,a ,?/
<br />FINAL /_'-../L /5,/./t '/4\''-1/
<br />Certilicate of Occupancy
<br />Notes, Remarks, Etc.
<br />OWNER ATIILDFI DEI,CAN-ATION ' 'I h.r.by .ill! utucr rEnully (,t nerixry rhut I m d.n'r, rn,n rhc Conl...to6 l.acnt ljw ro h. rouowin8 rclitn lscc 1)11 5
<br />Busitrcs {d Polcsion C,rL): Any Ciry d cou.ry uh.h rcIui,.r o lEmir k, .r,n{tur. !lrd, ir'I'mvc. dc.r,li\h or r+i.ny
<br />(tudm. Frtrh ih ksu.r'c..ls rcquiEr rh. qdald ntr.(hFm k, fiL. n8rri {alcrnr rhLE or rrE 6lRncd ,[rulnt
<br />ro rtE rrovni,nt of rlE Conrrd( r Lr..€d t r (Ch,ptd 9, C.rnmNii3 *i'h s..rr,n 7cu) ol Drri.ion .l of rlt Btrsitu! rnl
<br />Irn'lcssion\C,nl.r.rrhrr lEn\h. t.rcmpt rh.E6o rrl rh. h.rt turrhc lllcgcd .x.n{rrion Any vi'hlarnofSda,.7O.ll5 hylny
<br />trpplicanr rn r ,.nnn uhj{rr rtE {t',,licotrl l0 a civil I)unrlry ol mr dtr. rhsn fivc hufrncn dolls\ I SlO0)
<br />l,.sowncr"arhconip(dy.utrrcrclu\ivcly.onirrrins*irhlnrn{,ir,'nhMn)Nn)conriruclilEPRIe-r(56.^ 7lx-l, tlu{Es\
<br />uftl Ptr,lia\in(i .: Th.(in r,.rors l.rrn$ tjwJocr n.r trpplyn, snowncrol lr'ncny{h. huik[tr imtov.s rh(.o.
<br />,nd \h) irrrlsl rk'h ImFk w ha G,ntr!.tn( \ | lr.ncd n!^udhrh.(itr m.roi\Lf,ctr(li*)
<br />I rm(rr rt uRl.r SNrtrn,
<br />l).ie t)*n.r
<br />rrorn r rs' c'oll prrrsrrrr rs
<br />r[l|J.Ballrui
<br />I lE.chr rriirnunJcr F-h,lr\ or Fjury.r or rhc nnk'tr m8 d.\la6ri,n.
<br />I h!vc ui !illtruinl!in x ( cniftrrt ofcun\cnr tr stlllnsrrc liri *otkerf conlPcn\dn,n, a1 ,n,vnl.d lorl'ysucri,,n ]7u)olrlr
<br />lihtr CdL. f(,Ihc FnnrnuN. ol rhc *od nnrhi.h ih pc''nir ilsk{
<br />-l h.vc !'n *ill minr.in *o (.^ on{rn{tirn in(ur.r.. .. Eluircrl ht S<r b. l7m ot rrE l/trtr ('o&. ,ot 'lt Frrm! or
<br />rh. sorl ru wnich rhii p.mit i! ksu.d My *ort6 conlEnqrion int!tutc ffir .d lElky numls E,
<br />Polky N!mb(
<br />-
<br />-lccnify
<br />lhrl in tl* pcrlorn
<br />r, 8 ro ttd,m rubFr b rlE
<br />h*d orqEnqtirn tDvn
<br />WARNINC: l.inrE lo <u
<br />rivil 6n$ !p x' ore hoidE,
<br />Sdtion 1076.lllE Lih.r (ir
<br />,.", lo ltuIrd
<br />hi.h rhirFrni n lrucd.l shalln,l cllll)loy.ny Fr$n inan, tunrcr
<br />L*t ol (,riromn. .rld .gr rhd ia I rlDuld b.roE bFi ro rlr
<br />rlE lrtd Gr&, I ai| finn$nh mrplr *irh rhE Frvi.imr
<br />nll.dd otr
<br />Iq^
<br />.nlPhFr to qiru l FEbs rnd
<br />!on. drm8( !r Frvid.d ntr rh.
<br />![ctA8Allll!
<br />Ihcrcby tun undlr lcmh y ur lcUury lhlt l0m lktnsn u ct pmvtbn ot Chlprcr 9 (N.ImminB vili Ssrin rux)) of Divhn'o ]
<br />ol rh auriFr .ri Prcf.abns CdL. !n 6, Ikds ir in fuu fore .il cllNr
<br />clo 8L\L&1
<br />,,.,.1o11rag
<br />APPI ICANi NEI] ATTT!(IN
<br />I H'}dfmu Lr rEn.h y of Frjury or ur !h. folbr rn3 d..Lnrins
<br />lxnniion P.rmr*Ash6ro\ NnrirKarion !'.d.61R.$hril.! (Tiilc 40, fd6r
<br />R.quir.d trus ol Nrirtrri,n
<br />I .dirr rh,r rh f.ncr.l..pEthnr Esrdin8 &.tBtr Emul m nn rPila.bL rt) rhn pnFr
<br />r uhovc inli"nulion itcoBr.Ir8B lo
<br />!,n n Ehy !urb'n! rclfttnrrri\6.lI
<br />comoly wnh rll ( nydnd Coutrry
<br />nil Cny&n Cornryh.nr.r uF tr trr
<br />-. tuttt, [td
<br />lccnilyrhur I luvc rcud rhtapplicrri,,nrildurcrh lI
<br />ohltrr!rf,c. rnJ S!.rc li*\ El4iry rr hoiAn!. n{rucri{t,
<br />rrrn. mnfi{rn pn'Fnr ix h.r..r.rfr&'-,\
<br />Appllcrr or A*ar sieMruE
<br />,.-r* -..,r"r,, B f ,'nn^ GUZa IrS
<br />COMMENTS
<br />SLAB Floor -1.
<br />.s owE or E FoFny, d m, .'rt,LrFr Enh w.t6 .r llEt n|. on{tdio.. qll do dt q rn dE rrErft k d
<br />iddtd M olf.nn td qk (Sa.7O44, BuriBr md Pnfdrioni Codc Tlt Coddft! Lilm L.* d,.. d, +ply ro x osEr oa
<br />rhc DorEny *ts hildr or inrNkr rh.6n. .,n *ho dB uh M* him€lf .r hccctr or rhouBh hi. o. rE. own.mJ,kiFcs.
<br />,rhvidcd rh.r ruh in{romnl. E mr inl.ri.i or ofictd (tr {b r. tl,kw. rh. tliuin3 or iq'mEmd ii sh *irhii om F{
<br />oroDllLii,tr t E 0*6 ari&r *i[ h.E llE hr&n of F,ving llEl tlorttdit mr tlid d inprDw r FoFi, fd tlE Frto*{r
<br />hs.d (Se. l(})7. Cit. C )
<br />L.nd.r'3 NrE
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