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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS (,WNEII BUILDER DELCARATIoN
<br />I rrdi, rlrrn lLld FMl, ol p.rJury rhIl I s .krt, rnn ih. Codrat6 Lrcnr lre ror r,I lollowui! E.$n (Sd 70ll 5,
<br />au.mr. .tri Prolcs$n Cnj.,: AI, Cn, or Cddy *h.h rqur . F{mr ro ('n<Nr, rhd. ,tpi!w, &mlnh ot EF, u!
<br />{B-.rur. Frf, h nl (illd.. rt$ Eglr. lr {'t ..nr lor ut Fnr ro liL ! n8rJ qd.rHl lhd tE o. {r 6 lt.nr.tl Pua..l
<br />k, rhc FrvcDnt oI rlE ConrEttr'\ l-Nn<J lrw tch.Fcr I, CommBhS *dh Sdrrli 7ull Df Dtv,rnn .! ol rM Bu.n( nl
<br />Prnt$n,r Cirl.) or r,ur lr or stx r .r.F'Ill rlErcrNm .fij rlE t.nr tu,rt rlk8.rr.kn!ii'n tuy vioLrion ol Serin ,01LJ l,y rny
<br />amlt,nr fi, r Fmn luhl.ik trF lnplHtrr n, . .rvrl Fulry dl mrfrr.rhm,rvc hudrcndollu (s5m)
<br />l,.s owrrnrrt lnlliny, or nt .n{'[)rr.s w(h w!8c. !s lhcn $b lr,mlcn{l$n, will Jo lh. wi,k url rlt {erm n frr
<br />inrc .rl or orl.r.d r(r {k (sd.7044, B$ftst ud Pn'..(n'rs CGl€: Th. G,nt&ttr t l-.cnt Lr* n*t to, {'f,ly lo s o*Er ol
<br />rh. F{Eny *hr huilr d urprDs rtfrr. , wh, J,Et un *rrl tunt.U n hcell d. rtF{8h hn or h.r own .r{k'y..r.
<br />rrovrlcd rh:r ru(h hF)Erdr e n{ dar}rl .ic..n nr q! lt ,r)kE rlt t! ry d inFrwnr B 5!l *nh4 r* Jtr
<br />or6rr+Lt{. rll (hmr Bu tr *il h.k ilt htrd.nnl F)vs! rhlr lEorrrrdrl d, l! ld [lr,E rh. F)Fry tu 0r l{rPedf
<br />l. .. o* 8. ol ih. IIoFd!, d .t(,unvcly $nr.(ih3 *rh lNnsJ .odrlrrn t, r..{ru!r ttr Fi)F (Se 7(!ll. Burm3l
<br />rn Pnda n Cd.r l h. (o.lB1orr l-rcnr lr* Jmr fr r|l?ly b , o*rcr ol proldy whd buitdr or mlmEr rlno.
<br />.n! *ho .r r_'k n, iuhF,Fk rdh. G'nrn!r.dr) llcncJ po^Mr brh. (rrrtl*i llttre lr*)
<br />I rtr,.wnnr trfrI.r S.rr(
<br />1,I OR'(ERS' CONI PFNSATION
<br />lECldEAIrqfl
<br />I h.Rhy rrrtrm unrl(r FMhyol FjuO oE ol rh. n'lktwm8 Jebr{rn5:
<br />-
<br />I lllE lrt erll md.x . Cdii..l. ol Clo.qll b S.lt-lnruE ld srt6 .rmp.ndDn, 8 F)vrlal ror by *.ipi l7trl dl rlE
<br />L.tltr Cir,.. nn rlr Frr()lIrW or tlr sfi ft{ *nxt rlE Frrx n r\kt
<br />-lhr\rrn!*nlh!r0rworlcG.orr'lxnurlnN!r:m.,:5
<br />rnurJhySeri'n.l7U,olrh.t $r (id., ntr rh. Frlr,lrrlnt of
<br />lhc wo l,trwhf,hrhtr JEm Ls nnE! My *dkr' onF.d$n ,n.urfrc .MEr i Fnrynumh.rN:
<br />' )'Jaft 'l-.,l.a L,
<br />p.r,., x-'*,, / /O l<'( t) et 4.s/t,e/zo7r
<br />-l
<br />enrry rhi r rrE Frf.lmN. ol rlE *ork kx *hrh rhn p.mr n srud. I rlull d .n+h, ry Fen in tn, ,Mrr
<br />$ .rr, tr$r at'Fr b il! rdi6 u,tEnd$n Lprorcdlforu.. .sN rh:' I rl$u! lE!-E !!6Fr bllt
<br />sfici nr{E r.t,n F B.N ot Srrr'. l?ff) or rlE L.h, CaL. I .lult ,onh*.h N,Aly wrh llEr FDh,r!
<br />WAXNING: fdlR k rG ro.t n' lr,iIEn{ii,n .strg. ir shptuL .rn rh. rur'Fr u drpriF b @l Fnl6 .
<br />d\,1 I'n.r trf t, oM hundrd rhu.rd Jollr\ lil(tr.r m rdJii,n r) rlr (r! ol q,,!tn\rrts'n, drN8.t ,\ Prurrld ntr rh.
<br />S.dir Jlr76 o! rtr lrhxGic- or.r.{ rtul omy\
<br />JPr/t77-7
<br />I h.Rhv,'lltrm rlcr Nnrlrt ot ,itury rhJ IrDl'..tr !n('h.td.'.)r!,trnnrn!rtsIh5c(tnnrlrr,,ol I)'\trr :r
<br />{l lh. BurEs lri PNf.*b.r Cdlc, tn ny lr.nE i! h tull,oc ] .lli\t
<br />?-s /r'9?J-/
<br />^,. .'\/ z/ /7
<br />,\u(l(S(( l(D7. ( rv (')
<br />knLr'r A&tE(
<br /> DPLICANr DECI {T TION
<br />I hs!r' dlm unr.r lFnrly or Friry or ol rlt lollownt deldbtr :
<br />D.mnnpn F.mrl^\rr<oi Nr{'lk.l r'. lqlcnl R.3uLlrr\ (-I'rk 4{,. Pd6}
<br />R.qurd lrrrdol |lrlidrn
<br />I({1'rtrhIrh.rrJ.r11rc3trhr(tr,\'.txkl'tr!x\rt{o\mnn!1rk'tr.!}ffl'.rhIr!!hN|r'r.r
<br />l.cnrlyrllr lhrv. r.d rhr\ ipll&rr!r $l i.n. ($r rlt fi,lc ,nli'rnurtr,n rl ror.lr lx3kirrromfly*nhrll(\ryrkl(i,uiiv
<br />onlnrtu.\ rnl Srrr.lrf,\ r.brd3 lllrn3.otr(ru tr,n. r h.rby rhtrc rcl'(tnrrr,rc\ol rh(Cily.d(i'u yn'.nt.ruF)nrh.
<br />rri^r n11trrri.(l |n"trn! ntr
<br />c'?,
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loorivenVlnsulalion
<br />Roof Sheathino
<br />Shear Wall
<br />Framino
<br />lnsulation/Energy
<br />Drywall
<br />Ext.i lnt. Lalh
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif
<br />/-FINAL o/ r{-47 f &.rcl tL PF
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />Set Backs
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