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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE OWNR BUILDER DELC-ARATION
<br />I My t,lm uds IEn Xy ol Frury rhd I d cr.,9r tom dE Co rdoE LluE L.* for rE folkrriu len Ise 70ll.5
<br />Butifts .rn Phtcrsion C.dc) Any Ciry or Cody which ErluiB ! Fm! ro @niur. 6. irfmw. .lmlih d rqn ry
<br />sldE FE lo ili ntu'N, llro e{uiE. ds.pplaot for rsh Frnil lo fiL. ris'r.d {r.nD rlEt lE or tE ir litn-d F,$ti
<br />ro rh. Fnvilr.s 6f r,r C6.tMd 3 Li.r..d t w (Ch.pls 9. C.trWring wlh Selb. 7m of Divnio. I of llE B$iEB rd
<br />PEr.$irns Cod.) or thrt lE or ih. is cr.npr tlscEln.rn dt b.ri ror rlt dhr.d.rdr+ir Any vi,blia ofSsri,.7oll.5 b, ey
<br />!pnlk!.r fo. d rEnir bj6B 0E rmli.el to . civil p.Elty ol ml tuE lnd fih hrdEd t oll,tr (!l@).
<br />-r.
<br />rs owEr of lhc FDFny, or m, .nlpkrjer! wnh e.86 ( drn $l otrFEt&G *iI 6 0E qri dd uE tuE ir mr
<br />inrc,i.d or ofrcEd for d. lsa TO4d Burimat.rn Pinf..lbd C.rhr TIE Cdrddt lj..e rl* d..r mr .tlpry r.6 owF of
<br />rh. ptr'pcn, *ho hril& or nwoEs rlErE !d slD ds sh w,r hiBlf d rEelf G llNoth hit d lE om.tr hy.d.
<br />I,mviL{t rhlr skh iniF.\era m ftn h.i.Ld dorErtd for r].. lt l!4q, ft tlaEilg, nrFw i!5BerhinGF
<br />otmnq,L1ih. tli Owrr Boldd e0lruh tr hlrLr ol FrvirB|lEl lEorsll dil 'nl tlild G i!t@ 0i FolEry fn r F4D-.f
<br />-1,
<br />N o*E ol rhc Iml.ny. m.rcturivcly.odrsrhs *nh li(ctr<d ..ddod b 6dM tlE PmFl (S.c 70,14. BuriBi
<br />rd Enftsin Cd.: Thc ConrEttrt Li..ns trw drt ml .rply to d owE oa phFn y *l$ hildi or inPrewt fidon,
<br />rnd who ont crr lq tuch Foj.tr: wirhs Ona'odr lirnr.d purq{lr li, tlr Co rrloar ti..M t*).
<br />_l rn c!.mF u,rld sehtr_
<br />.ul}8[!4,::c9MgBlAlr0!DECIjSAI0!
<br />I rErchFlfimo Lr Fndr,6r F,lry ux of rtr tullo* n8 d(kdionr
<br />-l
<br />h.k.rn,ill midri.. Ctniar& ofcon.nl lo S.lr'lnre rm eil6 6nlFruro., n ImvirLd for by Sctbn ]TOO of 0t
<br />L.hor C.d.. td rh. Ff{,lrlrm otrlE mrr Id *ni.h llE p6ml n Gt!.d,
<br />-lhrwandwill
<br />id.ins 6 @n{rn rk n i6u.Er, .r EqurEd by Sclnn lDo of llt Lrhr Gtd., ror rlE Fni,ffi or
<br />tlE sd nn *hih lhn Frdt i\ k .d My *dt6 sntE.si,n in$dre cuir md poliy nunrxr 4
<br />-l..d,ry
<br />llEl inltr F formr. of llE sqt for $ihlhir trnn il k kd I shrll m'.nploy.ny Frsn in d, tuu
<br />s tr to tEmB obrcr to dE sr6 onFndio.l,*..{Crlifomi.. rn lsr lh.l if I slblu t,.{oft rubFr ro E
<br />krl6 ortEMrbn p6vi.i,B olsdn 37fi of rlE L.lu An , I drrl. r.dhsrh d'ng'ly siih ttnr povtn,n!
<br />.ivil ljlEr uI, ro oE nundErl ilnrsd dolL^ rllm,tg)], h .d'riti,n ro lhc ;;W:s(iit,n 1076 of rh. lru OiL. irr.Er rn .rt(rey\
<br />-",:-2:l\:?l 7-trV
<br />trlglJtalllld
<br />I h.Eby oftun ! .. Fuhy of Frr!.y rhd I d liro.d unld Fovtirn of (S (commNi.g *irh Sdir)n 7UD) ofDrvni(,n.1
<br />or E Burirss lrd PiolcsioB Cd.. .,n m, ltffi t in hiu nrd r .fi-r
<br />7 -tl+-\2 tvl
<br />I h.Erlt rtli.r u,nd Frhy ol |Er]!ry lh.l lh.r is . onrrudbn lo.!an, rScry for dE F.foffi of lhc hrl fot *tlih rhir Fir b
<br />irrEl (sd 1097.civ.c.)
<br />lJ tas Naft:
<br />at?t r('{mnFcr AR TIoN
<br />I lExb, sJlm un kl Frlly of Flry oE of llE followin8 d..b.l ionr:
<br />I).mliriln ltmnr A.b6rd tldafi.ripn tudrl RcSuhrrN (Tir L {o, Pd6)
<br />-Rcquircd
<br />rnlcr ol N.rifsbn
<br />-l
<br />.stify lh! th. rad.nl EtrLri$ ts]rlin8 .s.ird Emvd G , lllllr.tlc ro rht In'Fr
<br />, I cdny rhi I lEr. r2r' rhs qrliorhtr .xl {rrc
<br />'h.'' rdtur.r Jnd sDre lil! ELriIa ro t. .l'ns(rr<d.
<br />!h,vc EtrriEnomp€ny l{r
<br />,lpDli.Mr nr At6r sitnlru
<br />lli .LE hloi io. ir ffi. I ryE lo orply wilh .I Cny .,!d Coury
<br />tr rn hd+/.dbrn! Errsrnffi or rhl C y.,nCounryloold uPon dE
<br />*,(/\: -",-tY'z)
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Su bl loorvenVlnsu latio n
<br />Roof Sheathino
<br />Shear Wall
<br />Framino i*#&
<br />lnsulalion/Eneroy
<br />Drywa]l
<br />Ex Lath I fN.!*,
<br />Bro\rfCoat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Beq
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif .
<br />I
<br />FINAL rtr vql*yl
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc. ,')7-
<br />I
<br />Rev.08.07-2015
<br />ID/SIG.COMMENTS
<br />5/
<br />'l-o\u
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