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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS o*?{I{R BUll-DUII DIi!,C-AI(ATION
<br />I llEby .lf!$ u'rj.r p.Mhy ot Frrr.y rhd I D .rrpr fDn rlr Cbd,*r6 ti..M t * Is ih. follolh8 Er$n rsd.70rl.5
<br />Bu$*$ .d Prof..rhn C.d.)r Any Cny or CN y whrh E{!'Ei . Fm. r. oNB. 116. inpr.v.. &ml;lt .r ,qrr my
<br />(ur@. Fer b irr isu., .la, EquiE r,E .pplau' ,or $ch FmI n, 6L ! rtEd i!.m rhr lE or etu h liltN.d puDd
<br />r. rh. tFvtimi.( rh. Conr-rd'! t.a.nad lr* (Ch.t..9, Collwrin! *ni Ssrn. rdr] of Dlvnbn I .f rll BoiB.nd
<br />Pnftsk,N Cd.) q ihlt tr tr {r n cr.n r iFEtlmul rlE h.i! f.r E rltS.d.r.rqrirn Alt!iJLri'.ofSdb.703l.5byuy
<br />!f'?lsN fq ! Fmn rubFB rlt lpprr.nr ro r civil pcBl y .f mr mc rhu iiy. hutitd .iollar (ttfi)).
<br />l. a n*6.,rll p..Fny. c my.mpbF.r iih *.!6 r. rh.r ek on+.diri. *iI dr rh. stt( rn rb r'rfu. d
<br />iddLd or oil.6d nn {h (S- 7Ox. BuriBr ud Pri'rc!'n, CqLr TIE a.rrreroar Lt nE llv dE d .pPly lo .n owr ol
<br />rh. FIfi, yto hilli 6 inFDE dEEr !n *io dc irn klt hirell d lr.rlf or tLDorlr ht q lrr oM.rploJct,
<br />,r6yi,.d !h.t such !,poErdr e d ht.,n d eolf.Ed rm s.L ,( bEE it ttr&iis or !,FEe ir$ld vnhinor rt
<br />ol.dqrt i,\ rh. oqE AorrE *iU lIE tlE hlnl.n olporrt lL rE r dE tlil d boi! q itFE 0t F.Fr, (' r F,!G.ol
<br />I. .s orEr of rh. D.opary. u .rluiEly oddi4 *.h li!trGl d.d6 b on{rEl rll FDF (Se. 7txa, BuiilEg
<br />!d h,asi6 a'od. Tt Co rtn ! l.i..ns. tr* das d .pply ro r. owE oI pot'.dy *h. bdildt or inrtuw. rh4on.
<br />M.l vt dd, l( trn Ftrit3 w.h r cdrd (, lidE d F{]d ro rll cdd i tirE be).
<br />-l
<br />m.r..ir ur,. Sd!.-, B lt PC n{ln!r.s
<br />uaxf,I&r.caul[dlaDo!
<br />D}'CLAR T'ION
<br />I h.r.by riliro lnds n Mfty .f Frury o* ol th. li,llorr8 dtLdrtB
<br />_l hlE .rn *,u drr6. Cdrfrr. ol C* ro s.ltJBm fir !trrt6r' rlhFdEG .3 FDvit( lhr b, S41br l7m or itr
<br />!.hor C,rd.. Lr rlt FtutlluE. or rh. eod ror *hth !Il.mir iirsu.d
<br />ZI h!v! tnd *'ll rumhh hrl.tr' @rFNdnn mruhE., re ..q!iEd by Sd irn 1700 ol irE trtor cod., ror rrE FfomE. or
<br />rlr srt fd,hrhrhultrd !.rEt My r,{taB' tutr+.M.i llwmtrE rnFk, ntE n
<br />(dH skJz T")
<br />Ulo| /zo z->
<br />_l difyrhrr i. rlr lErformM of rh. work for *hrh rhi, p{rBjr ir $Er, I !h!ll nor.opt r ry p.R). in tny Mm.
<br />e 5 h ltoE,ubj.rr ro rrE H.I6 .dr!.Mi@ Llr olc.hloru. ,rl *B rlq
<br />'r
<br />I nhlld b..om {n d r. rr!
<br />tud.c enrlEn$rsnprcvirbBotsdpr lr00ofrh. tihn ccl.,l dEll, fonh*nh!.nplr wnh{b.tmvistunr
<br />WAININGT hbE r. ru. NL6 @np.Mh! coEnt B llLatuL . nul ubj.d &.npbF ro mi.rl F.EI6 !n
<br />cMl firci up ro oft h{.drcd rh.ur.id 'Lll.h 1l,n0,Ull). 'n rddlion ro ih. co, oI corlP.Miid, d.m3.' & Fovd.d r rh
<br />S(r.n l{176 of rL Uho. Cdt , idfte .rl
<br />Zo2o
<br />, *.nri(..DUCIj8A.rM!
<br />u,n r Fftair oroqxd 9 i.m fti4 vih Sdhn 7fitr) .f Div!.. ludd Emhv nr rsjurv ih, I rm lE.<d
<br />ol rhc Ilur..sind lRn ssi,,r(i r. nl.,ylr.n\. n in tulll,tr,rnl. rcr
<br />357 oC o
<br />"", 7 /'l -/ /zota
<br />I h.rby dffmr id.r FMhy.l Fn,ry tlDr rhr. s ! u.n{ndflr tdr8 d!.Ny r{tr r h. n rfol]rrn-. or rh. *dI n{ vhth rhs Fmlr ir
<br />nr*d rse :1.1n7. C,r C.)
<br />AIfLICINLDECI.AIdIIIIN
<br />I h.6y rnm ud.r rEur) oa p.+ry oE or rll rolb,inr .hL riohs:
<br />D.n.lir'on P.rmir*A'b.sui Nd,f..rD. F.d.r.l R{uldion\ (ln!..1o, Pan6)
<br />RquicJ l. .r of Ndfrrrr-
<br />_I Grify rt r dE f.danl E8ulaiB Et{d!| ah6rot mrj e d +?lr.bl b .hir FoF.
<br />Dlqnir, u I rEE Ed dn!' +dirlih -d o. u. E .LlE 'rltub. it c!ra]l, t .sE to onl9l, yti .! cl, rd co t
<br />orJtrrtr.\ rnLl Srrr. l-rws r.I'r'tr!nu.o^{rucrxrl fll lEcbyrurhrr. r.pEsnrlriEr drrlll Ciryud Cotrtrryio.nid ulr)nrh.
<br />.h,r. m.[B{ tDFny n
<br />A pplirhr or Ardr Saluruft zhz/z"za
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Roof Sheathino
<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 />Enqineer Final Beporl
<br />Flood Zone Certil.
<br />FINAL NMftO v lYlf tt v.4 >-/
<br />Cerlilicate ol Occupancy
<br />Notes, Remarks, Etc
<br />Rev. O8-0 /-2015
<br />*'"yu."*. 1O3Lb9{ r+*.,
<br />Sublloor/VenVlnsulation
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