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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS O1INER !}tIILDER DFJLCARA'I'ION
<br />I hcrchy lrrtd uid.r ltrtrrlly olFiury rlu I n cxcnll ftom rhc Cnnrrlns l-icci'c t-rw {or rhc inLrsiis rcr\'n is'c7l):rl5
<br />gusinc$ lnd Pi(,rcs\n{ Cdle): Any ciry or (nunry *hich r.qtircs . Fani h .oi{tu.r. tlicr. imPr.orc dc xnsh or L-Prr tnt
<br />{tu.rurc. lrxr h nr n\uonc.. aho rL'quncs rhc rrnlicrnl lor \u.h [rnn i,l-rlr I vE'kJ Jrrntnr rhd rt!r tu | hfP{d rtrFurrr
<br />hrhcpn,!i\ntrnrrhcOnrrmcioisLi.cnscdtiw(Ch(rrcrvcqn\c! EtrihsccrittnT'txrorDrk[nl"l,IrBu\incs\aid
<br />Prolcs ions Codc I or rh3r hc or shc kcxcnri rhcrdlro n d 'hr hrs \ itrrhc Jlk,rc'ltrrnlron An) Ltrtlrtrtn"rScy'n70-ll5bvrtrv
<br />,,tflicrr'r.{rrc"itr\uhr.Flhc.'I'nltrrirL,r,tr'l|{n,.lrti'lnr'nr"irh n\.'nJ r.J'lol...'1ir,n. I
<br />l.rsosncr.Ilh.,n,!.dy.ornrycrnpIrrr.switrrwngc!t\lhcirvnccoll{tr\nlidr.!i1ldorhcworkutllE(nrlmnrr
<br />inr.ndcJ orollarcd ntr srl.lscc 7l!.1, Busiricrs rtrd Itolcsions Cdc: Tl[ C-onnmr{tr \ l-i.cnsc titr docs nor rll1lv ni itrowmr of
<br />rlrc lrp.ny *hr htilds .r i'nnrorcs rhcmn, r qlx)dit\\uchsorkhi'n{lf.rhc^cliorrhn!8hhi(orh.to*ncnfk'rccs.
<br />povid.d rhr su.h i'npft*tnEtrhucmt idctrd.doroll.tu{ i,treh ll hoscLr. rh. hril(linSoria{rorcrErrs{rds'irhinonc }t.t
<br />ol(o.Dlcrion. rhcOwncr Buiklc! *ill hr\c lhcburd.nof[ovi|-t rh lEor\h.dilrr luk]or inl,mvc dr pmFiv
<br />'nrrh( PtrrFJt'r
<br />l. *owncrolrhc Drorcny. amcr.lusnclyc. riclin8qirhlic.nscdc.dr!.rnski.otrifl.tthcPr'r..rlSc.70'T.Bn\inA'
<br />rtrdLltlasin,Codc:Thcc.raclor'sl-iccn\cLwd(sn.rrpplvb!no*icr.lPoNnvwh(,buildsorinPiovc\rhcrcon.
<br />rid sln ..trrrucl\li,t\khprolccs qilh rCoflrrnrG)lic.nscd Putslrtrr n,rhcCotrr .ktr s l,iccn\c t N)
<br />DICI.AIAIION
<br />I hc!.by amnnundcrFralrrof t rjrryotrcorlh. tulnrtriosdccluiiors:
<br />l h.vc.rkiwillm0i rinaCcdiU. colCorscnln,scllln\uElnr*orkct\'ro'hPtn!dirnr.a\ Pmvid.d lorlirSc'rnr 17in'lrh'
<br />LrtDr C(xlc.ld rhc |Elbnnanccofth. trork lor whichlhc pcrn,ir h nsucd
<br />rhcqorkhrIhirhrl'nEflnirrshsucnMy$orLrh-(nn|[nsrioni'Nrrc.''ie.)ItPli.vnrn'hrrc:
<br />_lixtir.\
<br />I.cnilirhrr h rhc rur,nnirtr.c.l rlE trork tr *hi.hihA Fnnir i\ i* dl l nrlli.rctrrl.tanylr^otr irr itrr_ trf''
<br />\r isroh..nr. suhic.r k, rhc$.rkcn conrn{nuri lr$soiClli,nnri .rtrdll.qrNr[nifln])uldbcc.nt\ulEdhlhc
<br />!ork..i co,tc srri,rrtrovi!i.nsofSccti(,l?00olrlt l;'hn (i r.l dhll.l.nhsl(hco rllr_ $ irh rhot nrtvi\dN
<br />::,::' :"; )' i' i"/':;."j } {-("., - ol etu f* [,t 1 "I ra|NsLD (oNTRtt loR
<br />UTChSAI]QN
<br />lhcrc'v |i]rnl undcr pcnallyofp.ljury rhd l m lic.i{alUMcr Provi\i(jiofChlflcr9(.omnEn.li! wfhs(lin 700)).ll)ivisi.n ]
<br />ol rhc Bu:ircs\ d Pnrtcsi,,is Codc. nnl myliccnsc i\ in full for.c rl.llirr'
<br />Li.cn\r Ch*:-
<br />(](tNSTRUCIION I FNDIN(; AGt'NCY
<br />l-c cis A,ld'css
<br />A.TTLIIANLDECLASAIION
<br />I trrby iilirmund.r pc0rlr, ol Pcrjury onc nfrhc n,l[^\ trrg dc.lnnrr]ns
<br />l)ctrn,linr1 I'.ntri!Asti({los Norificdn lictlcml R.3!hri{n,\ (Tirl.'ll). Plna,
<br />R.quful l.rr(J !,r N.lr-f,ri(n,
<br />l.drilythd rlN lidrrrlrclrhn {rca!kli',x r\lano\ rditr)vrlrrc D.rrl,ph.rblt ri rh \ nnid.i
<br />ordi',rtr.c\ nd Srnrc l-r$\rIrinAb hni
<br />$ovc nr.trr otr.d |xr]trnt tu iifc.lion
<br />lditr! ..n(ru.li,nr. rRt hc'.by xr hori/c rtP' csc irncs o t rhis Ciry dM (,rrl! rr cnro u|rtr l
<br />,\pr i.! lur,\,rnt Si8nnn,m ;a.., (t(^1i2ut-G
<br />f -7"ct//o
<br />,.'".2/t/ t8a7li lrs
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />SublloorVent/lnsulation
<br />Roof Sheathino alt,il t y 2*l*;tt>'/ct-
<br />Shear Wall
<br />,u( -
<br />Framinq
<br />lnsu lation/Eneroy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />l\4ason ry
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Report
<br />FINAL /ol>//t 6rtoz*/a
<br />Certif icate of Occupancy
<br />Notes, Remarks, Etc
<br />4
<br />Pool Fence
<br />Flood Zone Cefiif .
<br />i",:"a"i ))V",--. iAilo';n{' -P"+Ub
<br />1l oRK!: R\' (',1)l\l PCNSA',I',ION
<br />is\ucd (Sc..1097, Civ C.).
<br />t nJcr'. \D'nr
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