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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Formsi Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Ivlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Report
<br />/..-..\
<br />FINAL ,'lt-z)
<br />Certilicate of Occu nc
<br />Notes, Remarks, Etc
<br />OWNM BULDER DELCAR TION
<br />I h.r.b, rtlEm uftr.r Fn lly of Fr,lry tlEl I m .i.trfl nln tlE Conr&roF Lk.e L,v lor E folhwinS rsn (Se?oll5
<br />BBim$ .rn Pmhrion Cod.) Ary Cny or G,rr, ,nth rquiB r Fni ro m(d. .rd. irv.oE &mlirlt d (F. u,
<br />3Ufu. Fii ro ilr i*ru.N..l$ fttuiB llE !ppli:,r fm uh Ffti ro 6k. !'!rd n&lld rld lE or dr ir li(aEd Frrrr
<br />b dE Imvirrns of rlE Co.rrs.iolr Li(ssd lr* (Ctrflcr 9. CoEftftins wiri s6!io. 7@ ol DivLbn I ol llE Burnts ed
<br />Pmf*rion. a.dcl or rhrr lE or ilr h .r.npr rlE ftd .,n rlt h.ri! for lrE dk8.d .r.trrBi,n. Any vioLlbn of S6lhn 701L5 by o,
<br />.pplkr.r to.. Fmr obirrs Or .ptltd ro..ivil FElry of d mc fie fiv. hldEn do[8 (l5m)
<br />I 8 .wE ofllE F,Fny. r my cq,lolEr *ilh *asd B llEt $k d'iltndb.. eiu d, oE *nr.rn tll ldErE 6 mr
<br />rt nddl or olfcEd ad el. (Se.7o44, Busimes ond PDfBsioN Cct TlE Cni!6ct.a. Li.cnk tre (,.l.. mt apply lo M owmr of
<br />rlEFr-ty elb tliLk or ilItiffi UE6^ .rn {b de. trh wt hiMlf tr lEElf n llhu8h tu q ,r o*n c@L"6
<br />pmvih 6.1 3rn iqmEEB elbr irdn d ddtu d fti.l ll hME rr hlillta 6 irr|Iwrn is tld *tnin ln rs
<br />ofrnrl'Liir rlE Oed BuiEr qll lrE E hnL.otFtrnlB rb {Edndt!i!nitvrDEdtFtrFi,rdt,tFlDd.r
<br />l, s o*E of rlE F,tdy, o.rc5liElr oturros *'nh lilosn oll|si6 ro srdM Lh FoF (sd ro.4,8urc$
<br />.rd hradsinC.d. TtE C. rro Lilna L.* dc Dt {ply to o o*Et of pmFdy *lb brildr or inlpmt! rlE6n-
<br />ind *hd 6.Ms lor sh Iml.dr pirh. ConrErorrs) li.uBd purlut rorlt Co,rrxnr\ tx.M t wl.
<br />I lh.rhDl un&r S€rDn .B &PC tdrtu,Es.
<br />l)or. ()e...
<br />rvontrru crrirtrrts,tturtt
<br />Dlrt t&u!.N
<br />I h.rrh\ rrnr$urnler llrlrv ol trrtLnvum rl rh nnL,r 'nr JNL'rrin}
<br />/ r rr.* "ra
<br />*
<br />'lr -,n- . C.n'fra. ol Conq! ro S.lf lB@ fd htt6 @nF6di,n. s FrviLd for byseri,n 37m of E
<br />/lx[.E Cnd.. rq rrr Ff6ffi ol
<br />'rE
<br />trrt lor whf,h
<br />'lE
<br />p6ni ! E$€d.
<br />( /"* - *r,,*... *rLn conp.Mhn imlr.. s Fqrid by sdirr l?lD of rlE l,Do. co(l. td rL Fr(r1lrN or
<br />\h *ur rd *hich
<br />'h! F,r d 6r.d My "dld otrtrdbn lNlrR ffs rn Pohy ru,6d e
<br />r l-"
<br />f,-,?7
<br />lzl c.nrryrhll in lhc FrfmnlE. oflh. wort for whict lhn F mn n !s*d, I shrll hr.nphys.y Frsn in xy nrnF
<br />s !t ro bc$r $t e o rlE wrnlsi ur.Fn!., io. bws ol Glitomn. .nd {r lhrl if I rlnuld tE oc obFr k' rll
<br />wrtd' N,p.Ntirn pEviiio6 of s.dioo ltDoltlE l,lxtr C.d..l ltlL ldh,iih 6q , *irh rhE FovirrE
<br />WARNINC: F.itE lo M qrtc6 onFndM d,@r. L unhwltrl .rn srlll rubFI & .nrloF ro sinin l Frlisr !n
<br />civil fiEr up to or hlndEn rbound &rllm (!lm,o(tr), r hn n' rlE cosr of corpc
<br />;::,-)/;/D*-',-^
<br />DtigJaafl]!
<br />utots F)viri(nof (11lfl6I (.ommmin8 virh Sr--rnn 7(xrD ofOilti,n JI h.rchyalltmunder FnallyoflErury rhd I r
<br />of E Burir$.,n Prof.$ioBCo&. an nr liffi ir in tull lor rn.lt6r
<br />I 27
<br />I ltrh, lmrm,nd( Fulry6,F,tr,Ihd rrE it !M'r,. bidi.8 .!cry for tlE Frftrur ol rhc h.L ro, {'tth rhtr Fni 6
<br />b.d.ir Nrm:
<br />-
<br />AELIiJTNI.DECIJSAIIO!
<br />I H)y.rm undd p.nllty oa pdjory otu ot rtr n hli.8d(h..!io.s
<br />Dcmllbn krnn+Arh.ic t{rxirEdbn l. dEit Rc8uLr hnr (Tir L ,10, P.n6)
<br />-RcquiBd
<br />Ldrd of Ndifdin
<br />-l
<br />csrily lhal rhc tudqat rslhrio.s Esdding locrr.s rctu,v,lrc Rn rmli.obk to tht pmr.r
<br />#x'ry
<br />fi, I l$r rc.d rhic {lplirri.. d{.r.rn t'Ert k oromrr ,.rffi I.!r botrplyw .ll Ci,.ntCo@ry
<br />tu EFs.tr.raE of lni! Ciry &d County io ard upon drr dBl Slarc Uw! rLri,E t t!
<br />k^,'**.,,".,,,k/AzaQfurc '*/<'/-
<br />D[r'5lI
<br />II
<br />Rev.08.07-2015
<br />Flood Zone Certif .
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