|
/
<br />BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq
<br />lnsulation/Enerqy
<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 />Enoineer Final Report
<br />Floo!. Zone Certif
<br />aJar 31512fl0 JIWTA @66
<br />II
<br />FINAL lqaat we/(,'11<{
<br />Certiticate of Occupancy
<br />Notes, Remarks, Etc.
<br />OWNER IiUII,DDR I'IILC]!i.ATION
<br />I rEEry rrm uDl.. FNly or Ftlr, tl,r I D.&,+ frDm rlr (bddB' lire Le lor r folb na E s {Sd 7olr.5
<br />auiid's !n PsfBri6n C.d.l Any Cny.r C{N y whih r.qlirr . p..mir h o.ntuct. .lrs, impr.E. &tutnh or EFn ry
<br />si . t rr r. ir, a$.8!. tho Elnlftllll +fL.d lor kh 0.mit ro fi!. !Br-, nr.ftd lh. E q CE ! I..tr!.d Frid
<br />h rh. Frvish* orrlt Conk-rr't li.n*d lrw lctrp{.r 9. C.mmEi.B *(h S..rbn 7(XXl or rrivirion , nfrh. Burims.nd
<br />Prof.srN C,xl) 6 rhrr lE d rtu a .r.irr rhdrtud rfil rtt ha!6 fd ih. rlhg.i .rrtrE6 ly DLrio. of Sdih 701 I t by e,
<br />rlrlt nr lor r p.mir subFG rll .rtlK.nr ro d civil p.Nhy or mr mE rh.tr nv. hurdEd d6llei {tJll0)
<br />l, a .rE nr 0r ImFny. o. m) .,q'loy..r *irh *t3.. $ rh.i, e\t NrytMrhn, *ill d. rtt v.rk .nl rh. {de i! mr
<br />ienldl r oll.rd nr qE {Sa.7{x4. BunBs &d ADlai,m CaL Ttl (idrld! Li.qE t r dB d ,ply ro u orE of
<br />trE Ft d, wrn hi,llrr,rFoE rh.@tr !n sb dcr rhsd h'nsro. rE,kllor rh,truthh( or h( o*o.rpby..r,
<br />proriLd rh.r ru.t urFnmtu ft d ir.i.d (dlrn 16 sl ll.t r.w. rlE hlillra tr urFEBd it $ll *ihi! c l.!
<br />olroqillir\ ! Ows Builla will hlr d! hnLn uI Frtrr8 rhr tE or sh. dil nn hilll M i'frcw tE pnldy au rlE p!rF'* of
<br />-1.
<br />D dwE orrlE F.p.ny, 6.rclBiEl, 6ddin3 qh lirrel coftrB ro q{d rlE F,jd ISa. 7oa,l. BusiEv
<br />rd Prrl{ir Coa. Th. O).hctor't Urnr. L.* da! rcr rr,rly t' h owftr ot pmr.n, *h. t'lildr M ,nphwr rtson
<br />rd vtn sdmr rr tch Flrdr rlh . Cdrddn h.^'.d Fr]d b rtE Cdrddr lire trw)
<br />-I
<br />m.r.f,ri uliL SdDn-. A lrtC fdrhir t.q
<br />t&4f,!&r.c0!ll!!aaM
<br />AECIAXAIIO!
<br />I h.rchy .nirm u.dfl pcdhy ol pcriury oe or ih. nnh*u! dccLr&'trl:
<br />z-a+ci*.'il+di .in. C.nan c of C.lrnr b S.lf-tEc t( ldrtd' on+.Mbr a F!*Ld tr l, Sdid rTO0 of lh.
<br />L.ruCda t rL Fl6l:w or rlE *qt rd ehkn rh. IEnn i iro.d
<br />- -l h.E rn srll Ndrh sort u @Rp.NrEn Isld., i! Fqui,ld b Sari.a l70O or rtE bborCod.,lor rlE Flm of
<br />tl* *dt tr rhah rhL paoi u B$.4 My rqt(r' otrldds! !@ ffi d got , NEa.. -:
<br />I dify lhr m rh o.rfornE olrlr ro fd *nrh ihir pc.d n BEl, Ltlll d .lrphy my !.te! ir &y llw
<br />$ 6 ro b.sm tuhl.cr to rh. ro*cr'6nD.M{ion h*! ol C.lifon[ .d |ar lhd il I .tnuld b...r obf.t r. tL
<br />E ta' 6np.nds ps6!N ol Sd.. r@ ot rlr f.tu CcL, I dI]]. fffh*irh Nrply *nh rbc prDviiitu.
<br />WARNING: F.iluE ro Eu. vort n 6qE6nirn 6Eni. ! unl,vtuL nn !h.! {bjd & c'rdoF b cidnd p6.li..d
<br />cril fi6 u! b oE hmdr.d Gd!&d &,ll,r (tl(Ir,urJ), n .dd{t'. to ih. or or coqrNriD.. d.rra.r 6 pDvn.d fd lh.
<br />s.d()n .ro76 0lrly l-rhtr (icl.,
<br />'nr.r.{ rnJ
<br />LLI$II,4.!2NIAI1T8lrDrtdtaM!
<br />I h.rbt .fltm ud.r p.Muy.f Fju.y rhr I d lilnia, uid.r P..vubn .l Chl,,ta 9 (smmminS Bnh sdhn TIID) .l Divnhn 1
<br />ol tlE Eutrics rrd Pnf*,N c{xk, !n Dy lr.e t r tull foN rnl.lld
<br />q6 7z28r-.2
<br />SI}ITIBI]qrc!.IEPIIEIGEICIItEEbyrfrmu.rFmiyolp.riurylh{rtfti!tc'dBlml'rEa.!dytrrlEF.IllreofrlrEt6rrti{trl,itFdi
<br />iarErl rs€ 119?. cir c.).
<br />AITLICAU[OECIASAIAtr
<br />I hr .trm unL. p.Mry or edju.y oE ol rlE rorbwo! (h Ln'.6:
<br />O.mhion P.mirsAst!.nor Ndif(rrirn F.d.nl R.tuLrih! lTih .lO, Pd6)
<br />-R.qr@d
<br />krl.ror Nditu.rEn
<br />r lE ftJ.ral rcBuhtuE Gtid'nx {linor tn$ul . nor .ppl.$h io rhh pnf.r
<br />I
<br />Rev. 08-0 /-2015
<br />lrtuhr'r Addrcs
<br />!d Counry ro .116 uI.n rlE
<br />,'rr^. fnrn'nnl trr)jx'rY rrtr z-
<br />L ,rrr 4, \'-'
|