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<br />BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNf, R BUII-DER DEI-('ARATIoN
<br />I h6.i,y lmnn und6 p.ruh, i'f Fjur! th.l I an.r.mpr tom th. conlrldoE l-icaE lj\r ntr thc aollorin8 i.ar,n (Sd 70ll?5
<br />0uein6 !d P.ofshn CodG): Any Cily or Coud, *hi.h r.qur6 r Fmi h Ndt'!n. thd. nnpror.. domlkh ,{ EFn Ey
<br />rto.lf.. trnr to iri i*uec, d.o rqpt6 rh. ,rpli.Mr lor such t6nir h il. . .iB6. .r.rdn6 rh tr or sh. n li(dr.d puean
<br />kr rh. FovilioEi ofrlE Conrrrroir l-i.m!.{ ljq (('lE 6 e. ( urmncins tri'h S*rkD Ttxx) of Diri.hn ! .lrh. ttilind ed
<br />Pold'oN Co!c)or rhrr h. or in. n.rdrr rhs.ftomand rh. b6B for rh.6lLs.d.rmt rn An, \shrnrnorsdnn 70!l.t byuy
<br />rppli.d tor a l6nii ihjdl3 rh. .p?li.rnr r. i civ il p.mlrt o f mr mor. rl$ fi\ . hufln.d dolld s (t5&l
<br />Lsowndofth.tn,Fnr,orntmploydvilhNiE6Nlh.tsl.comr€nslion.\'lld.thc\ofirdth.sttrds.nml
<br />'ln6d.d or or.!d a{ sE (Sa 704d, BBind lnd EsrdnB Codc It ( odknn-3 I kle l,$ d.6 mr rf'r,l! ro .n .\a or
<br />rh. F.Fry $ho hlil(lror iqmr6llEron. i.! sho do6tu(hro him.lf or t@lf or rluouAh hir or hs o\r. .hpL).6.
<br />p.uvilqi lha[uch inr,l!\ drE$ m d hldrLd o. olla.d tu sl ll lFtr 6 6. ltE lxilliu or inworsrHr is $ld \ irhi', nn. )rofortldbtr rlE oe6 Boilld trillh,\!iElddr orFD\iits rld IEM JE d'd d, trild or inpor. ft. I,nrdt rd lh. ruF& ot
<br />l. ar os ns ofr h. Fopqly. m dclulivcly c.nE ring Nir h li.ard conldclod n, cannnd rlE rmJr.! ( sd rrll1, IrGn6
<br />.n'l PloQsi (id.: th.Conrktor'r Li(6.. rls do6 nor srplt h $osn6ofroFnr $ho huildior inflo\6rh-Nn,
<br />.nd rh. codEdr,or sch Fojclt * nh ! Co,nalo(r) ladE d
<br />'^'Ruarn
<br />hrh.( odralo I f,e I is)
<br />I &n.rcdfl utrds s<lioi
<br />l).te: Orn.r:
<br />\r oRxrxs ( (,\rPfr\sAil{)\
<br />D}:(IAlllttlAI
<br />I hd.bumn. undd lEdr! oflrjur! on. oiih. aolk\ring d(lturiuns:
<br />I havc dd sill tuinriin ! ( cnificd. ot ( onsr k, S.lf-lmurc [tr lvorlgr u,np.d!d i{r, a In]vidal for by sd nrn i 700 oath.
<br />l,tiv ( d., for rh. Fa()'l1ft. of
<br />'h.
<br />r ort for $ni<h lh. Fmn i B,.n
<br />I hlrclrduillmrinrain so d comFdnlior itrwan(., s r€qon.d h} Sdr i{n 1700 ol
<br />'h.
<br />LrFr ( i\d., tu rh. d nrmEx. of
<br />rh. $nl ror shth lha Fn . eFd Mt norld omFudio.'curffi . (,fu !n rini) numt( o.
<br />,^. '4ad-*s*A -tla
<br />",,,,",*,,*'ail^LeqTg6i:l ,\pr6 , 8/tvf l7'/l
<br />Ic.nifyrh.tin!h.Frfom.nc.ofth.sorlforshirfilhnFm n i!!u.J.Ilhellno! GnlloJ trn) r,ren 'n
<br />i.) minno
<br />x' 6 io bdo'ft !tir' !o lh. lolld .omFMio. h*! of ( ,hloms- rn{,{E lhd if I sh.uB h((m ut dr r.lrE
<br />so*d.omFadhnprsrnhBolsdion:17(loorrh.titncoi.,Ilrtrll,fonh$nhco'r'bsirnlh*I,.\n(N
<br />wARltlNCr ldlw to su. no 6'comrtern,n covcrax. ir uobsful. Md rhr]l suhjd m npld)( to (iNtr.l rmlir Md
<br />ctril find up ro oE hufflrcd rhoued ihllE (ll(x).fi)O). in !r['rio" ro rn .o{ ..tu'nFMr'otr &h.t6 a Fo\ ilcd tu l,lE
<br />SarFn llu76 ofur t rr Cod. mradi.ddblB'rfd
<br />-,,' 'l/lzft/ ^n**,* -T"t+;t*- -Jtz-/ t LILI!.iEL(AIAAqoB, DfclJa6rlal
<br />I hod! arfirn unds r..!hy ofpdju.yrh.t I u li*tu d und( F!\nrn or( hrfio,) (..nnrftrn* trith sdi..7url olDirision l
<br />ot llE Buina.nd PmfdioN Co&. ad 'rylicre t i. full for.cnl.r(r
<br />l(ft.('l,s 6,r.rr?zDf u
<br /><Le
<br />I @r.rfm undn Fsxl of FjuD rhd rhn i!.
<br />itncd (S(.109?, Cir (.)hrling.*d! ({ rh.IEfomfu. olrlr trorl ftr trh{hrh.Fma ir
<br />ATIII(ANfI)TII.ABI1IO!
<br />I hdd'r i,l"m unr,s pcnlhr ol Fj!r) oR ot lh. folh$ ing dc(lmr mB:
<br />l)6n.1irion Pcnrits.Arb6ro!Norindlri)n fclddl R.suhn'n.(rilc.l0, Po16)
<br />Rcqlt d l-dr6 of Notifi..rion
<br />I cqht thd thc f.J6.lEsulalrG rcsddrns atEstos rmo\.1a,. nor ql''lic$lc b rhB l(!<r
<br />I .dif, ln, I tar c idi rhii .pplk{ion !i 3rd. rhi rh. .tr\. inforMi'n i! .ond I rl:'c ro rurph \ i'h lll (- r anJ Coutil}
<br />ord'nanc6 dsrrt.La*3chrinsrohu'ldrn!i{,n,DdhE.b,ruria,ril.r.ri6d .rn6DlrlnrCir}.ntl(i)utrlyloo,l6uporth.
<br />rh,]c 'n6tion d roFnr- aor iNp.dn n
<br />Arplk ,lsr sifin trft K
<br />p"-,i,- ."u'" r p.in, r, K o,J tf oltt
<br />Set Backs
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUl nsulation
<br />Roof Sheathi ng
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall a -/{'/7 UJdh&)
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />tlandicap Req
<br />De puty Final Report
<br />Engineer Final Report
<br />Flood Zone Certif.
<br />FINAL 6-7-tt "//eSrtz '4
<br />Certificate of Occu pancy
<br />Notes Remarks, Etc.
<br />a
<br />eFf )' '
<br />-)
<br />Forms/Steel/Holdowns I
<br />Erection Pads I
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<br />Ext./lnt. Lath I
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