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I
<br />BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE rD/srG.COMMENTS
<br />Se't Backs \IY'N,'t4
<br />Forms/Steel/Holdowns u l1 fi{u tt+
<br />\Erection Pads rto lr1 l/,li A
<br />UFER Ground
<br />SLAB Floor
<br />Subfloor/VenUl nsulation
<br />Bqof Sheathing /
<br />Shear Wall 7/S
<br />v.Lil\
<br />lnsulation/Energy Y,x wilt*-1 6W
<br />Extlltnt. t-atn 6 -24:Pffilr I t-l
<br />B-rown Coat
<br />Masonry U '\J
<br />Pool Fence
<br />T-Bar
<br />Handica p Req.
<br />De puty Final Report
<br />Engineer Final Report
<br />Flood Zone Certif /t'
<br />'12;114
<br />FINAL lc q t+ItLJ *'
<br />Certificate of Occu pancy
<br />Nqteg, Remarks, Etc.
<br />+I5z
<br />eLt /^/b kt 0
<br />V /,-00r-./ lW
<br />OWNEF AUILDI:R DEL('ARA'I'ION
<br />I ha.b_v .afm undr Fdiy or Fj@ ihd I d .rolpl fion rh. Contrriod l r.* lj\ to, rh. folksi.s r.rs,n (s€ 7011.5 .
<br />t\tsin6r .nd Pror6nn Cod.l AnyCiror Coudy $hEh E!,n6 ! Fn t ro m6rud,.116. 'mrio\c. dcimllh.r rqu xn
<br />rtruclur., prtu ro n! $uMc., rLr. rcqun6 rh. lrtlicmr ror !u.h rEm lo nl. ' risn d rartur rha! h. o. ih. . l'.d*J puRu!,t .
<br />ro th. FornioB of th. Contr*ror! Liccd.d lIs (Ch!pt6 a. Crnnn.ncinr $irh S6rion 7010 oi l)irision I of rhc B*indLr ed
<br />PrefdFn! Co<l.l or th.l lE( rlE udopl lrErdrom ud tn( t6i! tu rlE llkr.d.lmrxnn Atrr rkn.tniofs.ni,nT0ll S brM' -
<br />lppl(or 16, ! pdmn lubj(li rh. lrplasrro!civilp.Mhyotmrnor.rhelirchun.rldollue(t5ur)
<br />I.6otr6olrlEp.nFry.o.hymphrcwith*.36a$.rrn..omrEnr.rKn,$ill&rtE$o drj rlE sr'u1u. b mr ,
<br />ddi.rl tr ollGl lor sr. (sc 7(x.1, BBiI6 ud Pmt*rE Codc 1n. Co rxlort I rd* I js d.s mt q'?l! k, in 0$6 ot
<br />rh. FnFiy *lr txill or inF.o\€ tlmG ri *h dE uh $nrt hmslf o. h(*1, o. rhnhsh hk or lH os n dDl ') c.
<br />,rovid.d rhil such inFnvmdl!emr in!6ddl or ollssl lor$k.ll hrwar. rh.h(rldinsor 'mlr6\ondr BsH$ih'no..)a
<br />oacontkhn.llE o\rE &ril&
<br />"'iU
<br />hr!. rlr hnd.n of F.rMs rht h. or.hc dil nn t k1or i'nlr$t rh. Fntd, nn rh.prFrof
<br />l. 6 oNn.r of rh. Ir rrcry,. m .tclusiv.ly co racti4 \rnh lic.tr,cd ontradoN h consh( rh. p.ojar tSc.70.r1,lns'n6
<br />,nd Ptnldld Co!.: I h. Co.lcrorr Lic6r.l.!s dos ml lllnlyx' !n ouno ofpropsl\ qh(, huldr o' trhpror6 rlENn,
<br />rnd u tF .omdi lor $.h FoJ.ds *nh. (iddonrl lkdE,.l ruBd o rh. (.nnelor'r l r.* lr\ l
<br />I anr.r.nrpt undr s(rionl'tt-r+,/rZ-*
<br />DI;CLABaIIIIN
<br />I h6.5r lmnn und6 E ahr ot FjuD- on. ot lh. follo*inr d(l{.l i(!B
<br />I ha\ c lrj s ill minr.i. ! Cdirkd. of (i,MIo s.lf-lNu. lu r orld (o rFM io.. 6 tro1ii.rj l b'S(ton1700ofdE
<br />L.bor Cod., lor ln. Ffomu.. o f rh. soik for whrh rh. rEr.'r is isu.d
<br />I h.E !d q ill n!inr!i. qort6 .of,FBntur iIMk.. 6 r6l.r.d b Salnn 17(xr of
<br />'h.
<br />L,t , ( od.. tu lh.,xrfotu. of
<br />rhc erk lu shi(h lhd Fnn ! i$.d My s t6 onFrBdio. rBurftc ffF !d rFlEy numb( e
<br />I c.ditylhor i.rhcpqfo,Ile.of rh.tro.k lirr rhich rhis D.mir ir i$u.d.l ih.llno' ontlo, M, F*rn in.nr tr'intrd
<br />i a ro b.r.m sotii !d rh. *$*d' .omFM ir. l.*. of Cditumr rnd +E rhd if I rrsold iEror 3u\t€rt ro rll
<br />s.rt6' .omFsrionF.dri6NolSdion 17(Doarn I rh,r Cod., I .ltrll, fodn$nh con'pl! *irn
<br />'hor ror 6nB
<br />W RNINC: kilur.lo Kuc wrl6'conFs.lion co\6.s. is unldrvful. ud rtill subt l u otl,'F l. oinrinql FEht tnd
<br />lo otr. hund,cd lhousod dollffi (ll(l().(xxrl, in .ddinrn to lhc (o$ of comFrsnn. danEsd .3 pNid.d lo, rh.
<br />s.clior 1076 ofrh. hhor Co&. ints.r,nd nhtrr
<br />o".,'l-}q-l?-
<br />I H'.m.m un& Fmll' otFjury thd I dn li(dej !nd.r t'o\BFn of ClEfl( 9iNnn'Em'ns u(h s.dDn 7l](ol ott NBion I
<br />.f lh. aurinNMd ProfBiontr(od., dld hr lk6!. n in rull aor( r .rdr
<br />ca!fl4r]([otr]:N!IN$lriI!cr
<br />I hed, dfim @d6 porky of lEjury lld lhc. i! a coBrruclio. knJinS !!tr, fur th. DqtunMc. oi lh. \a nn \hichrhnFni a
<br />i$ucd {Sc .!0s7. Cn ( )l..n&'r Nm.
<br />attll(jxlDE(JJaarl1l!
<br />I hdd, dfi'n u.dd !.nalty ofp6iu', on. olrh. rolb*iis dcltirbh3
<br />D.eh6n Pmlt+&tEtor Norificdion l:nj.El Rcruhtirn!{1 1.40. Prn6)
<br />R.qurcd l ald of flolifi.dh.
<br />I cd if, rhd rlE f.Lr.l r.luld ioB r+d 'jin! ab6ros I m\ .l !. n r ippli.dbL ro
<br />'hs Inqd
<br />Icslilylhdlha\.r.dJlhisoprlic.riona.dn.r.thdrh.it{\.rnn,m ionn(nrdr l+rrro.on,d) tr h.ll('()and('ounr,
<br />od,nanc6 lnd Srat.ljs! r.hrins ro buildr! conlrucrion. Md hrlhr rurh.r,! r.rrBorarns olrhs ( irt atrd counrt k) drl6 ulln d.
<br />itF\ c mmrion d pnrFn! ntr
<br />..-/-,JL,-Amli.rnr or.\gdr Sign'ru
<br />Jess,uu !a(e n q ,-
<br />r- 2..l- r+
<br />?
<br />Framino I't+o:-h-t7
<br />I
<br />c-17DAwall
<br />I
<br />//4
<br />-H t1
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