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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE rd/sTili J COMMENTS
<br />Set Backs a
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framinq
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath 1/r-/rq Dz.t /o,
<br />Brown Coat 'ri,/-y'tq d.aa
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />Etq?rb t**{r<At CD&4/dts
<br />FINAL aL/n W/o\
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />cn
<br />OWNrI BUII.DER DELCARAl'ION
<br />I hd.hy .mn. undq rsrlr] of pdju,, rhd I m .rm|, 6on rh. Conl6o6 l.tR l,* for rlE f.lhqil* ,.bn ls< turl 1
<br />B6'nd: d ft..*d. ('od.) An! Cnr or (ou,n! {hth r.qutr6 t Fni to odrud..116. ut{,o( d.,nnbt o9lq6t M:.
<br />sln'.iu., !.ir l0 its isuft.. de rquitd rh. epli., aor .u.i Ff,ni to 61. ! ri3n.{ ndmai rh0i lE or stc ir h@r.d Puru.d
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<br />Fr.fshN ( .&l or rhsl L tr 3lE i. .rdnF tha.6om tnd !h. t rit lor lh. tll.s.d .roqrion Anl Lioldhnof Sc.li..70rl t & o!"
<br />4l]li.ant for a FDn 3ubids lh. a{Tlicrnl lo r cn il p.uh y o f nol mor. rh,i 6\. h nd!.d dolld! ( t500)
<br />l. B o\6.arh. FoFnr- or n\ .nplo!< trirh tr.!6 s lh.ir sk comFslu.. { ill&' !h. No* .nd llE slnrctd. u ml
<br />i drdnl or oIIftd lor sl. l Sc 7044. B'Lrmc Md PtitcrioE Cod. Tlt Codr.<ro.t l.kre ljs dE ml 4tly r. o$col
<br />rt FnFnt $t hlikld irryltGrlEo". td ll$ dE*h trlit hin*lf or hd*ltor rhnush h'! or hd osn dnplor.6.
<br />Ftrvid.n rnll s.h nnFordmr! ft mr inrdidl or dr6.d for sL lf, hr$66. . t[,ld'ne or i,rir 'ffi ir sH rnnh @ !6
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<br />l. 6 o$G oarlE F!Fr). d .r.lBi!.ly.odd ins $ irh li..nrd m.ltsto6 to.o[{rud
<br />'lE Foj6t (S( ?04,r. BBire
<br />r rhis$n(.d.: Th. conkdor! Licds.l.o* {to6 rcl !p?l) r. u o$nd ofFoFn} $ho tD'ld. or mpro6rh.on.
<br />nnd qho sndi! fd Nh FFi $nh !coddo(r)lads.d l[msd lo rh. Codreo'sl]c@ L.$.
<br />t m crhpr undq s..tio. .B &tC torlh.ren
<br />D.r. o'.d
<br />&aaf,Ers:gluf[NtAlla!
<br />I lr.b .mm unrkr pdrX) or-r"O.,. r,n" ",o",nffiH*
<br />I h,\. ad { rrl m,nr.m . (-difr.l. of Co6dl lo s.lH6u,. ior $flln' otrvsEdhr. s Fo\ iLd for b, Sdtion 1700 o I th.
<br />htF Cqj.. fM rt tEa()rt]@. of th. rolt for u'hich lh. p6nil i Lrsu.d.
<br />, hrr..nd $illminrrin *ul6 cohp.dlion i.s.r.. !r ,.quirti b!Salion u00 otth.lrh.r (od., for lhc pdlomuc. of
<br />rh. {,trt fi{ *htrhrhtsps,t 6 isu.d Vy*.116 c.nFMrn '6urN.(.ro !dFlr} numhd R
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<br />I (d't) lh.r
<br />'n
<br />rh. Frolmm..frlE {o* for uhEhrhir Frnil i. i$cd.I3h.llmr oIploy.ny prvrfl '! lny 6mc
<br />$ siu rE<oe suhEr r, rh.qorl6 compdsron b$, of( llifomir..nd ryc rh, ift,ruld li.oE sli.s bih.
<br />\0116 c.np.rd.n F.! 6ioc of Sdu ! ?(xJ ol irr Lrh, ('o<L, l JdL n n h* nt comrb $
<br />'rh
<br />rlhs F.! ithN
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<br />DrcllxArlo!
<br />I hs.q .rm und6 padly of psjury lhd I d licosn on.l6 FnvLion otchr,'ld e (comffiin! $ nh S..rnn Turl)) of Di\ ition l
<br />na rh. tlurN Md Prcf6io6 (.or!.. !d hy lrccB n in full fora -d.fid
<br />g 9736 7t16rt@ar a
<br />CAISIaIIITQII.LEBDIdC.AqEICI
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<br />is.d(56. !097. ( ie. C )
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