|
BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNF.R BUILDER DEt.(]ARATION
<br />I hc.by rlfm ui<tn FuX' ol Fjury rhr I qonpi nom rh. aolifuo6 ti* L.*,orll* folk*'iA ..&.lS<TOllt)
<br />&!in6r .,n Profaion C.d.l: ,rsy Cny or ('ony \nrfi '.gsc . Fma lo orBM. rha. imFoe ddmlih o qi .tr_
<br />rruduc Fn
<br />'o
<br />rrt i!.lft. .ho EquG th. +pltd fo. Mh Fnn ro fiL ! 3ign d r.dEn ftr l.. or !h. a [G!.d Ffi4r ,J
<br />b rlE Fr 6hE of rlE Co.rrrd r Lia!.d L.* ((llcid 9. Coffiis rih S<rion TcDo ol Dirnion I of llE BGix! rd
<br />PmfdioB Co&) o rh.r li s ,r is ddpr rhs.from !i llE bd6 for rlE rll.e.d .rdtqb. ,,sy vbldi.n of sdrbn 7Ol I t by i)
<br />lFpli.sr for r Ft r sbjdr! tlt @gltdl ro r civrlpouhy of @t mE lhm fiv. hun<H &116 (!500)
<br />l. N own6 of rlE proFnr, or my mplolE $'ilh s !!6 a !h.n r,k .omFsrio.. *ill (t) fi. sorl irl tlE rrulG a m!
<br />rnrdrlqt or orld.d lor ..1. (s- 7044. B$ilRr ud Pn,ldbB (-o& Th. Conlhcloir l,icd€ llw do6 i6r tpp! !o M omd of
<br />lh. FtrIElt * b huil& or trnFov6 rf@r nd slF &6 $ch *!* hims.la or h6.lf ot lhmuah hit or fi6 orr .dPloy€,
<br />!.ovidql rhd ruch mlrovomrs e ml inrd&i orofli,ld ft,r $k I[ h.sa6. E hlildii* or iqntrttFr n sd whhin on. )u
<br />ofNntki)l\ E ONn6 Boil&r wiu h3\r tlE hrdo of prtrvru $e h. or !h. dd 6l hild ot imF.rt th. F.Fry for tlE Fipo* of
<br />l. s o$m oflh. FoFly. u dclBndy colrr-tuu *'ilt lic!6.d conrraioB ro 6dtud rlE FtrF {Sc. 701,4. BGiE
<br />dd holrin( od. Ihc Conr6roar LsGe t..* &6 mt .9plt ro e oErc of popaty *ho t{il& o, idprclBlha@..
<br />ed trho 6dtu! ftE Mh FoF3 rnh. (-ondo(r)lEqE d puB{rn b rh. Codrdr'.Irru t.*)
<br />I e. ctmpl u.d.r Sdl[n
<br />zO Ar2ot1
<br />!rg.a8auQ!
<br />I hd.t^ linnn unds nqulty ol pqjury om ol rhc rolbs'iq d.rl&rr tJtu
<br />I hav. od will msinr.in o (Gn ifEalc of( oroor ro s.ll-lnrur. ror uork6' .o6raMio.. a pmvid.{ fo. by Salior l?00 o t lh.
<br />kh* ( d., ntr rh. rsf.mdnc. ollfi. wolt for uhi(n rhc rs'nir i isu.d
<br />I hA. and $ nl n.i .in $ortm comFMri'n iN6x.. s r.quiEd by Sdrion 17m of dE ltho, (bd.. fot th. pdfolM. of
<br />rh. $orr td *hth rhit Fmn ir isxd M, *ort6 (mp.dion iBurm. (fir tid Frliy nuobo !c
<br />I .6llt rh.r in rhc Ftolr]e. olrhc mrr lq shrh rhn Fntr s eu.d. I sbll ml olPloy uy F&. i. &t ,nl,jG
<br />$ B ro b<aoc tlt*ri ro th. {odra omFdion L*r ot('.lifomn. od rsr lh! if! Jhuld b..or sti$ ro tlE
<br />*'0116 orFEtion FnvilioB oasdion i70o of th. L,b.r Cod.. I drtl. fonhq ilh o6plt snh ihos Fo! irioB
<br />\dARNlN(;: f.iluc lo Ku. sorkm'comlrn$liotr M 6npl(,to lo om'nal FBhi6 a
<br />err lii.\ trt, r, .n. htrn.lrdd lh.u$n(l Jrlli'\ (trr, (latr S.\ ,Ls pri\ .rl lin rhc
<br />s.erkr 1o7n.lllr I rlrtr ( ,odc. inrcrcd rn,l rr
<br />Zq, oLr zotq
<br />DECIJAAII@
<br />I hdrb, .mm u,& Frny of pGjury rl- t e li.oEd ulird Fovnion of c'Epr6 9 (sI:mug
<br />"nh Scrbn 7000) of Dnnlbn l
<br />ol rlE tkilE -d Phfdioc Co& rn mt lioE a b fult foc tid.ll..r
<br />(alilxiJgllllJ[NDlrcicfr(f
<br />I h6.1,) im . u.ds Fnahy o f Fju.y lhd lhdc i! a tunslruclinn bndins asocy lor lh. toaomM.. ol rh. *o,k for *hich lhis pqnril n
<br />issu.d {S( 1l)07.( 'r C }
<br />ATIIJCJILDICII8AIIO!
<br />I hday .fiin uidn !d!hy of Fju.y @ of rh. hlLr* i.g &(lrii,N
<br />D.mlihn Pdmn}Atb.3o. f,rorifKdbn F.dE l R.ruLriotu lTirlc.l0. Par6)
<br />l.quir.d t!r6.ltlorifi .tio.
<br />,.dil!rhi rh. Ln6.l EAul ioB r.8rdins stEtrB ranotll ir. ml dpplic.hl. ro rhi\ lroldr
<br />I (rl\ rhi I l'r\. '.rJ rh s rkl nxr. rh. rlHli,\. trnnrnrriL ,s con( l r!'Nr, (.n't 1 r' If il] (\t\ md (ir v
<br />.d'Mn.$ in,l sr, .l xssr.lilnsnf auttrrt. r.F6orsr ir6 ot rnh ( iry rd ( oory to 616 uFn !&
<br />.$\. marn'n d popdy for
<br />,r.r, i(,fja;ff,\ppli..nl or 1t l \l!n.lo
<br />Pdmlra n.n. I prinr ):Ln Sh rlll
<br />aLT zdl
<br />Set Backs
<br />Forms/Steel/Holdowns I L a I JEF p\€l rn ..
<br />Erection Pads lrD wiw
<br />UFER Ground tlrlvqr. +t/cr8€b
<br />SLAB Floor
<br />S u bf loor/VenVln s u lation
<br />Roof Sheathing
<br />Shear Wall ?-\
<br />Frami ng
<br />lns u latio n/E nerq y
<br />t?"\7-t
<br />\7-\Vt1
<br />Prywall 2-I \NL1t)\
<br />ExJ)ltnt. t-atn t V[Nil
<br />Brown Coat t2-23-t1 ft-11&i
<br />+,q$of,,ry JCAI.)Cfi
<br />Pool Fence
<br />12-l&4 \Et4l)!
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />FINAL
<br />Certificate of Occu anc I
<br />Notes, Remarks, Etc
<br />6w
<br />Flood Zone Certif.
<br />IA
<br />l -'r 'n \N*JT
|