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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNER BUII,DER DEI,('ATATIoN
<br />I h.r.l', .rrm unicr FUhy ol F4rr, rhd I d.r.rfl rmm ih. Gdr*r6 l$nc lr* nr rh. roltlrm! E.!'n ls.t 7l)ll J
<br />Bu\r.s! rDl Pn,l.* n C,rlc): Any Cily or Counry whEh r.quEs r Fmr k, $n{rud, drd. npmvc, &mhsh or .cJ!r M,
<br />nru.tu.. Frtrt' rrr irr!h-... d$ ErtuiA rh. .pplrur fr, !u( h Fmn n) lilc I rSxi nrl.rnr rhrr li o. rlr s liccnBl p(ruor
<br />t' rhc liov6$nr dr th. Conr.cktr ! L.tnr.J lr* (Chr d 9. Colftkn8 r(h S.rtrr ?Un ol Drvrrn I ol rh. BurE( .rd
<br />Pnncsrnrc(dc)or rh,rlrorrh. r .r.nir rh.ftrirm (xl rh. ban\ Iorrhc rlb3.J ci.mpxon Anyvk,hronolSetbn?0.!l.5hyrny
<br />rmli.rrr tu.Fmnr suhj({rrrlr rfi kt n'.(ivrl,EMhydl n, frErh.r livc hlnJr.J '10116
<br />( lJoO).
<br />L .r owRr ot rh. lmFdy. or dy .mtlorc.\ wnh rr!8 i\ rh.r {,h onPcnsiron. will &' rtr e(t arl rrE nulE (
<br />rrcDlql o. olT.rd in eL r Sr.7(Xa, Burtr( rnl Pn,l$srr. C,n : Trt Cirrtutr" r lr.tr( tl* dEr d, r0pl, ro i uwBr ol
<br />rh. F'Idy *h, tn k tx lqFE rlrcn !n *h &- ab uxt hmrlf or h.rEll or rlFu3i hrr lr. om ..pbyel.
<br />,r.vkl.d rh.t su.h mtnrEmrt! m r, [l.nLJ I ofl.rtr] fff sE ll tr)ktr. rtr t[$o! or lrtmEcnr ir i'lll *nhs,ft Fa
<br />or$noLr.trrh.OwkrEu Lr *ill h.E rtE hnjc.ofl,trvnS rhd hcor rh. 'lil ftn ho,! r nImE Or l!'pdy rr df, FrF,cof
<br />Lrsowftrot|hcpn{iny-m.r.luwcly$nta('n!r hl'(.n{d. nhd.rn).ondtu rk nn)iL! rsc. 7(}44. Bulrs
<br />,rl PNk$rrCi!.:Th.(idt-tr'rLxcn{lr*!iE!n,,I!t!lyrodoqmrdin.'Fny*h)6unJ!o,mln*!.rhc.n'n.
<br />lnd *ln) Lal Br\ftr{.hF,r.r\! h. G).rturrrti) l.ocd InlFu.r b rlr (tnk{i, r trcn( trw)
<br />I Ja.r.mB ud.r Se..l
<br />woxl(rqs' coMPFNsar(tN
<br />IESABAITII!
<br />I h.ehy rlltr !tulcr rEnrlrrol r.rjDryoN olih. tnlL,*o3 Jc.hrrrfnr:
<br />-l
<br />h.E rn *ill ditrs r C.d L.t. orc.Md lo S.lr-lniR nr xxts oiiEn{ion, ai Fovrral for 1,, Seran l7m ol or
<br />lrhn Co!, rn rlE Frfclret ot rh. s* ld *hrn rh. pdnr u B.u.i
<br />_I h.E rd wrll rudrm mrt.^'(omFrru iN!68., ( krilr.rl hv s(rm t?oo ol rlE tzttf coL. tu rlE Fntm! ol
<br />th. Rrt ntr ehrh rh$ F hll !i aGt. My k,tt6' NrqtMr,n ffIlmt mr !n poEl tumru nl
<br />Cair-
<br />Po[., Nunb.r:-
<br />Iccd yrh.r tr rlE FrtorELt ol rtr worl ln whrh rhF Fmr s r{kd.I sh:ll r m9tl!.n, F.s. tn.ny lMrr
<br />ar nrl&od hjcd n, rlt srt r ofr!.nqlfn Lwr "i c.l nmi!. rd a8d rhlr rl l rh,uld h.eom luhFr nr rL
<br />q'rr.i\' drmF.\trx,n on'rsrons ot S.{t$n lTlro ol ih. llhn (ixlc. l {ull, tunhw h Ltrmnly * ilh rh'E pn'!trxrn\.
<br />I{ARNINC: r.itur. t. sR *)d.^ .oqtnsrx,n !rrtE!. ,! !nl,*lur. .nj Grll sutFr r .rrfhy.r ld.rlllDl Fml6 &l
<br />.rvrl likt up tt' om hudr.tl lh,uifl dollr\ (!lul.(Xt)r. o d rr t, rhc.o< ol .odfFnqron, Jm3.r * rn,!rl.d ir rlF
<br />S(r!!n ll,16 nl rh( Lrh (irL. d.'c{ aiJ ri,my'\ lac\
<br />LICF]\SED CONTNACT()N
<br />lECL6SAIIll!
<br />I lEEhr.rltm und.r IEMlryotFrIJryrhd I 1n l(h(t uhd.r ln,$.n o16.F..9 (coEtuEm8 *.h Sernn'701)0) ol r)rv,ri,i l
<br />of rh. Burftsrnd Pn,fc$k,ncC,rL. $rl hy licn(,\ n tulltuRt rnd.1L.l.
<br />Lic.nr.CLs:-
<br />calslagg&!.LE8DD cElq
<br />I hcrby.llimrd., p.Mhy.f Frury rM lh.rc Lr. Lurlurln Ldins r!.L, fitr itr Frft)ll:Ilt ol ih q*l tu wh.h lhs Pcrha 6
<br />AIILIIANLIIECIdAAII9!
<br />I ld$yrlimru .rn nrltyo,t rjuryoncdlrhc hlkrwD8 d.cllrdrdnrl
<br />Iktu)lr$nP.rmilArh.{oi t{or *.ri,nf.!.rrl R.tuLrrrrr'Irrk{,, I'd6J
<br />_Rcqutrll t nciof Ntrrllcali'n
<br />I ..n'1, rh.r rlE r.&r.t EluLrx,n. E8.rJmt .{Erkn rcm,v.l sc nn {plr.bk tt lhri FDFi
<br />-I
<br />rdrrtrh.I h.w r.rl rhr rlll,l..t $n Dl rrri. rh,r rh. r Irrftr,r$n{ ywlh.llC'ry.d(i y
<br />,f,Jlli*6 rnl Sr.tc lrvr Eh!E ro h[lu3.on{tui-n. .il h.Ftr.urhtru. rqt.Elrdr6 of thn Cry rd cl'udy io chrc uF,n rrt
<br />ah,w minortl |oI.dy l rsFri,n puFxcl
<br />,tpplicrnl or A*dl SirmluF
<br />P.6llc mm. rrrlnlr:
<br />Set Backs
<br />Formsi Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framinq
<br />lnsulationi Eneroy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif .
<br />FINAL bllltA 1 wxrqat (ea )
<br />Certificate of Occu nc
<br />Notes, Remarks, Etc.
<br />r\n'cd rS... i(19'1. (iv. (' J
<br />lr kir Nam
<br />Pool Fence
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