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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE tD/stG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />Subfloor/VenVlnsulation
<br />gRoof Sheathin
<br />Shear Wall
<br />Framing
<br />lns u lation/E nergy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />FINAL t-L-zn }N U-"u\'
<br />Certificate of Occupancy \,/
<br />Notes Remarks, Etc
<br />OWNER BUILDER DEI-CARATION
<br />I hs.hr.mrm u.da lci,Xy ot l6jur) rh.l I m.!mF 6on th. (onldo^ l,i..Nl,$ fuln aolLwi.s r.sn (5670ll.J
<br />BLrin* .,i Prol<i,n ( 6d.): An, cny .r C.uln) r'hth r.qun6 . F,on lo codrud. !hd, imFo*. ihmlisi,rr q.n dy
<br />(ruduq F$r t' itt suffic. !!o r.qon6 th. +plkst aor ru.h Fmn ro fiL . riSn d idqndr lhd lE o. ltE i! licdB.d Frud
<br />ir' rlE FoyirnN df tlE (b.!aror'! Li<.or.d Lr* (Ch!I,l6 9. Conn.min3 rnh s.nsn Il00 .f Di*ion I ofth. &!iB dd
<br />Profdpc ( o&) o. rld E c Jh. t dmF rh@fiom md rh. bdir for rh. rih.d ddFr. ,^., r hhlion orsdi.n 701 Li by mt
<br />,rpl(.nl for r Fnir .ubr..rr rh. rrrlkd to r ciril FEly of mr mE th!, ft. hurd.d &lld! (tJrc)
<br />l. a onE of llE FIrEly, or m) arplolE *nh f,!96 6 rlEt nL onFdion- sil &' llE rr* rn llE rErE a mr
<br />doxLd d ollald lo,6L (se 7O+4, BdtB &d &lfBnB Co&: ln. Colrrrrm r lrd& l& d6 nor Sly ro & o*c ol
<br />rh. Fqdy * lF t!'ll d inrm\€ dE@ -d {'ho rh6 sh kyt hmlf or h6*lao. rl&!3h hit or hd om.rpbrs.
<br />Folildl ttd sh inp.o\rxdr ft d nad.n o.oddrd 6r et lr.lbrtu, r triuiB or ihqsqrEr i. $ld $ihi. @ !6olon{'ldrlr dE O*E &iilb vill l.!E dt hrbr of F$i$ fir lE tr !h. dA r{ hild d inFow llE FrrErr- ft,,. F Feof
<br />L Eo$nd.lrh. FDdry, m.rclBi!.ly.odrdins *nh ficq*rj.olnr&ror ro.odtud rlE Fojd (sd 7tr,l4. adilB
<br />{rl E.l'in ( n&: Th. Co6lr.1of r Lic6c tiu &,6 ror Frly ro u or'f,( of For,.ny sho build! u impre\g rhFs(
<br />.nd f,llo odrd! for 3uch p.njclr wnh . Conlrdo.l3) li.d!.d I'ond 'o
<br />th. ( onlrdd r l-k.M t wt
<br />I n.!c'nl unds sslrcn
<br />l)rr. Osno
<br />]la8llIal:.(QuflilI ]lll!u!(tdtitllaalhcrh\ rmnn trnd6 pcnnl+ oltdjrry on.orlh.rollNvins d(lararions
<br />I hav. ind s ill 'tuinllin r Cglificrrc ol Co6ot lo Scla-lNrc for so.L6 snp.Mnrr, a pn,vid.d for h, Sdrhn 1700 of rh.
<br />Ijny (ird.. nn rh. Fforocc of lh. & for $tkh th. ponir i isu.n
<br />?h.'. .nd will m.int.in $o d'conFN,rion ireulrq s aquiEd b.v s<rrn r7m or rh. lih.r (t d., ror rrE Ffo'rffi. ot
<br />rh. *oil fo. $ hkh
<br />'hn Fmn i! is.d My *ort6- .omFrdbn idsra. (Mir erl r.li.y numt{ i.
<br />,, .5"n(/7 z1/.4,'.^. I
<br />P*oSrat t
<br />(o.t-.1/7 C
<br />I \rtrr!
<br />-P
<br />/^ /^) o
<br />I (d'ry thi '. tlE Fforna. ot E$.rtforrhahrhnFhni.ecd.I.h.l!mr@rht&y,E$n$aytrDE
<br />r 6 lo b<nm sbat lo rlE svr6' omFsbn L$! olcrlibmia arl +r rtr if I ltruld tEom .utljal lo th.smt4 mnFdi'n prc\ inB orsdiln !7@ of th. Lltor cod.. l CdL 6nhs nt oq,ly rirh 'lrE provi]nB
<br />\,tAR lNG FlluB k' G@ mtd @.pa6tbn (rE!s. ir uL*iirl, rd ,t ll obj.ll D @plrtq rc oiminr! FrrB dd
<br />dvil fi.d !p ro oc hu.rb.d tho 1m.000). u ddnFi lo 0!.o! of ..EFEniotr .h6,e6 6 Foti.d tu rh.
<br />sa1-n t(,76.lrh.lrhtr cdl.
<br />9-ts
<br />I nmby rmm uftj6 rE llly of rErjury thn I m licducl lndd F.virion oI ( l[plq 9 (comnftins *nh S.(ion 7000) of Dirision 3
<br />oa lnc Buli"d bd PNldi.B Codc. ed my licos. i. ifl tull foR. md .ftd
<br />0 37o t7r
<br />tt-s - t1 L-^J CI*--L
<br />I h6rty .miin oad6 Fnnh, ol !.rj!r' rht rha. t r oNtudion Ldin! .sft, f.r rh. Ffo.mhn.. ofrh. $orl tu $ hich
<br />'his
<br />p6nh i!
<br />6ru.i{S( rrr<J7, (i\ (-l
<br />ATIUCATIDECIASAIII}!
<br />! hrd, dm undr Friy of Fj!ry oc of fic followils (klr.l aoB:
<br />DnEli ion Pmig&h.n6 Nodfrdion F.dd.t R.suhioE lTnk {o. P.n6 )
<br />R.quncd Lc'q ol tlorifi.rih
<br />I ltraro Nmplt tr'rt rll( iry.nd Q'unly
<br />dtr6 olrhit ( iry Md (numt ro 616 uFn rlE
<br />,,,,1t 9'lq
<br />UFER Ground
<br />Flood Zone Certif.
<br />1a
<br />\y aair-l
<br />cL-.,(
<br />Clo, l"
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