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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE IDiSIG.COMMENTS OWNER EUII-DER DEL(-ANANON
<br />I h.cby rflnn unLr pcMhy ol F4ury rhd I m .tcqr rnn lh. Codrrirx lrcnc L.* lor nE nnbrq! ras (Sc 7011 5
<br />Boqn.s anl trroli$r)n ('dc): Ant Cry or Cou.ry *hrh r.qur.r . Frmd ro . nnru(l. rlr(. ir{,mr., Ltml'rh or qEtr mt
<br />(d(rur. Jrrtr b nr n!u!Er,.Lnr rcquft h.lpplrrnr lnr rorh|im t' lik.rqmd n.l.mnr lh.t lror rh. ! lircnBl pu$.nl
<br />to rlr Fovn$ht ol rll G,nrturd'r LEn*J lr* ((bCcr 9. Col|WBE! * l Sdr$ 7tU) 6, Drvrs. I .f rh. Butc$ .nl
<br />PDf.!.r,nr CodcJ d lh.r h.or rlr trct.mpr llrtim.nd rh. h.nr ttr rhc rll3.d.r.ry,lo. Any voLronolSarr)n7(1115 hrD,
<br />.mlr r ldr r txmn ohFlrs rh. aFirlk.nr b r ov il p.ndry ol nor d)G rhrn liv. hotu]r.d Jolhfi ls:lln)
<br />-1.
<br />I o*rr dl rhc lr.Fny, or m,.tr{,krFr * i *t3cr.r rtEr qrk (rrlEnslr'n. w l rlo rlE krt.[i r,t nur@ . n
<br />0fcnkl orolt.rd tn sl. rSe.?041, Busr.$ r.J Prn.sion! C,i.] Th. Cdnrrrttr t Uc.nt.lru d.{r nor.nnly ro uo*B.ol
<br />rh. Flxny rh!L k or rrtkr*! rlrc)n. ml rb &- *h $|lt fimt.lr or lrR lt or th^,!th hL. .r h.r .w. .rfl,yc.r.
<br />pR,y!.J rh.r rBh mF'Erdr R a 'lolAl qoflftn for q! ll- bEs, ilEtx lrB{nrtFrxBd*g r.hnoFFr
<br />ol ()rr{lL's6, rh. ovn.r llu,Ird "{l hlw rn. hrdd.f ln'bs rhr lt or sh.,id ftr ho or lnl|n'k dE FltElt I(tr
<br />'h.
<br />pu{r,s of
<br />_1. {\ owftr .t rhc lf,nn d y. !m .r.luiv.lv ronhd m8 *tr h lotrcrl .od,!do^ n
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<br />$n(rud rlI Fo.r..r (Scc 7l}4{, Aurm
<br />dd hn&(in C(rlcr Th. Conr.cktr'( L,c.n\( U* &Er not dltly !, d orn.r of l{ Fny wh' hurldr or mfnv(s rhcrc...
<br />rftl rh r E k !i, ui ImFn *nh r (i.rB_ rdr) lrcnEJ p!^unr h rrr (idrrntr r l-xcre l*r
<br />_I rn.r.mfl trnirrS..rtr
<br />laaf,E8s:.courElsartq!
<br />DECLATATTON
<br />IlxRhy.llnft u.d.r JEM,tyof Flu .NolrlEtulllt!trtJ..l-dr,..
<br />I I'rvc vlerllnuurnrrCcnrlrrr.ol(i!,qnrkIS.ll-ln{tr(ntr*dk(n..n{ir\axon..rpr)vrllalLr$ySc.rtr,nl?(Xtolrh.
<br />lrh, (irl..nr rh. I[rintuBcolrh. *.'t ntr r'hrhrhr tm tr riu.{
<br />I l[r.od w'llnrdi work.r! .omll.nfrn 'n m{fn.r. xs r.{urc $yScrrln, lTlx)rl rh.latlr(i r,ldtlt ncrt.nuL..c ol
<br />0r r! tur*hf,hrln\ Fnnn 6 s{krJ l\ly*ork.F L ! rp.nskn, ,nrurrrt. .ftr ml Fn.y nuhh.r r.
<br />I,, I t (on?t,,t al ,^,.r.(( I:", I
<br />",-.'"..*. 1z ll rtL Ob'01tLCtl7
<br />_l(.tr yrhsr rrhcFrlortukcolrhcwork ntrwhf,hrhtrFrnxi f tr{r.J,I ih:llhorcnll)l'yrnyI.N n in rnynunncr
<br />e, .in) la{m.luhA*r t' rh. *rltdr .rrqEnsrr)n L*r ol CalrlnmE- nnl UB rhr rl I \h,ull tE om ruhj(r I' rlr
<br />*r*cn' (.nFner i'n F,vr.$nr ri Sr. rnn t7m .r rh. l:h, C(xE, I rhjll. lonh* h !r)r{'l} $rih rh)- potilr,n!
<br />WARNIN(;: l;U|trrc t' y.urc workch conrFnidt,n.(v.r,g. '\ nh*ltl, ,nd \h!ll \xhj(t nn mtl('y.r lo dmrul rculrrx u'l
<br />.iv,l I'k! up r, om hunJr.J rh,!\!ntl Jollrn (!Ifl,,(Xxl), m r& r,n (, rlr.oq ol oqEnqnd( drm8.t.r fovi.lc,l ntr rh.
<br />Sr(r,n :r0i6olrh. tlhn (iri.. nrcr.i ail r(nrdt't l\.-\tt-?-q- t1 D \ /14 Irr \
<br />LlcEn_SED (rNTnA(rOn
<br />l|[claa6r0r
<br />Ihcrcby,lltnrtr cr pcnllryol Frluryrhrr I Jn lkcneJ urdcr pn,vs'on ol ( hrflcr ') (.ommtuhg w h Scd$. 7(XX)) ol Drvron l
<br />ol rh.llurtr\r el PrncsFrs (o1..:rd nry lrcn< tr n tulllttr!..r{ cllr(r
<br />loEd 111
<br />,,,.,.".,,,. ALll E ^,i^.r16aq--,-)
<br />colsrB!!,:uaNrEdpaclcB$
<br />I hcrhy rltirm undn JErjhyo! !.riury thal thcrc s ! $nnru.lkln Lndin8 rrcEy l{n lh. p.rfome. olri. turk ntr $'hah rhF IEmd 6
<br />ssu.J(Se .t097. ct!. C )
<br />APPI ICANT ITECT.AR TION
<br />I hsrtty dim mlr ncn.h y or p.rjlrr oE ol il* lbll'*'.! d..hr.r $ni:
<br />D.fr 'l!tr,n P.rnrG^rh.n.r Nd .I.n F.d.nl Rcf uLtrri lTrrk,lO, Prn6)
<br />R.,tutrcd l.rtrol Mi,lidr0n
<br />_l udlfr rhd rtf, t &r.l Elr,tr.$ E!{J'n! th.{oi mvrl m d rpplarhL b rh{ Frr..r.
<br />91 En'ry rh, I rErc Erl rhr..Fpl..rDn !n {.l. rhd rtE.t E fro,dnn s c6B'r. I .3N ro.-r{ir *rh rll cdr., coun!q{!la.r.,nSr.r.bsEhrElotn'lda!(lnnursr.,nlEEby.urhi.irEFlc.xErolrhtrCn,.rnCou y 'o.dq '{or ttr
<br />?rrrAf t" L1- |
<br />Dqtr,') A ,'r [r r I
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsu lation
<br />Roof Sheathinq ?tvr +-Ll nln L /,,t tt &s,4 /o-,
<br />Shear Wall
<br />framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Erown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handic ap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif .
<br />FINAL olte/tq i €srt,/b3
<br />Certificate ol Occu pancy
<br />Notes, Remarks, Etc.
<br />*-*ar* 0
<br />f -1.'- t t<
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