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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNER BUIll,f,.R DEITARATION
<br />I ha.t, rrm unda Frly ot Fjuy fin I m darF 6!n rlE (i)exId Li@ l,{ forilr folh$q la$n(S<70ll5
<br />BGind 0d PtuaBion Co&) Ar, Cny or Coutlr shth r.qun6 . rEnr ro co'Edcr, rhq. inForq rbFlirh or ED6n ey
<br />rrudEe Fs 'o
<br />irt iw.. .ho r.qdB rlE f'!l(or f& *h Fni h nL r !E..d nna6ll rh, lE 6r rlr b l(aBql Ftlld
<br />'o
<br />lh. p.otirio6 ofitE Conkrl -! Lt.n*d tr* (CluFq I, Comcus *nh S.(ion 7000 of DN!Fi I o{rtE Bu'n6 &d
<br />ftorBFN Cod.) or lhn lr d nE n dcn9l tlE.6om !i E hc! fd rh. rlke.d.r69lioo An, riohrirn.f Sdio. ?01| 5 byuy
<br />tpplicel for, Fhi !ubj61r llE .ppltan lo ! ciril FEhy otmi mr. tho fiv. turxH &'lls (!5@)
<br />I. a .sk of rn. FoFnt,.r n, dplord ( h *'r!6 B rh.( y,L conF&lion. sill & rh. *oll &rl rhc nd@ 6 R
<br />inlqxtrj or olTd.d fo sl. (Sa 7044. BBi,B sd Prolarins (itlc I h. ( o.racbrs Licru lj* dr6 nor .t lyr.ano*n6of
<br />rhc p.\'Fny $h, tlildr or in{rnr6 rha6.. &d *ho d(E uch sr"I hins.lfor h@laor thn ulh hi! or h6 o*n dnpkr}*,
<br />pro! .d rh.r ru.h imFovomE e rcl intqddi o, ofisal for sk I I ho$ d6. lhc hlildios or iryrov.'ndt ir slj s,ihin "nc )d
<br />ofconll)ldiotr ItE ownd Aoill]c wiu h,\€ lhc hn*n of IrN in* !h{ h. or rh. dt no' tuil1 or frlmv. thr rmFr, a.r rh. FtrIrs of
<br />l. a orE of rlE p$Fr,, a crcluivcly.6dr.crin! r h h.ns.n co ra.ro^ b oNtud dE FoF ls6 701,1. &atrK
<br />. nnrsrn (idc TlE Contrroi! Li.* Lw dE mr .!Dly to s.qM oIprcF ly $ho tlild! or 6pror6 lhgdn.
<br />ud {lF codtur rn {ch Foj.(! $th. Coddo(r lkdE dotltld ro rh. c.dr&oar l-tN tr*)
<br />*)"^'pfi+ *"-
<br />I ha.h\ nltnn utrdd lE,rl(\.fpquD on. ofrh. n,LL\\tr'* d(l nn$
<br />I h,ucu {illnEinrain a C.r1ificd€ of CoNor ro Sclr.lNu!.lor worL6 comFMrion, a providal ntrb,Sdtun 1700 ofrh.
<br />libor (inla fo. r h. p€n)nnffic orrh. *or[ lor whi.h rh. pdnir is
<br />'s5u.d
<br />I hlE rnd e ill h.inllin $ ort6 conp.Ed ion iBUr..(., a r.{un.d by sdion l?00 ol rh. Lrbor ( ird.. aor rh. Ffomm. of
<br />ih. so,l for shrh ltir Fnil i! NEd My s,orl6 &'mFuion iBurffi. cair ord rElay nunbs e.
<br />Icdi[rndinrhcp€rfoM.oarh.$o*for\hi.hrh'rndf,,rBu.d,IslBllmidlplot.ntFh.i.a.]noE
<br />$ a io b.(m rut <r b rh. $rrtd onFu{i l!*r of (il'fom6, nd u8d rhd if I rlbuld tr(orB luhi totlr
<br />uorld' comFNrbn For sioB of S.dion l70o of rh. I lhor ( ird., I .lBll, fonhwith comply wnh rhx F.viioB
<br />WARNINC: !!'lu,. ro suc \o.kd comFertun covsas. is unla$tul. ed lhdl subFl d ophF t. om'nal FEhB ud
<br />.i!il find up ro or hundEd rhusd dolld ($l(I),l](xr).
<br />'n od'j 'oj..Drk c"n or(um[,.Nrn'n. Jou*6 s rdid.d ldr rh.
<br />SN'un IU'o ol rhc Lrlx, ('odq mrd.s eddrom6 r 16 I -/D..:'-7f4/7 ^,,,-iXf*#@=
<br />I hq$, .rm udjd ps!n) of Fiury thi I m I'c!b.d u jd Fr\iionof ChlFa9Goffin8{irh Salior T00O)orDnsFn I
<br />of th. ttli,B md PtnadirB (-o&. dd my IklM i! m full ntrc id.lld
<br />(ox f,u(lraN.LlrDllclcli!(a
<br />I hlrc[] mn tridd Fnnhtolp.rlur^lhrl rhd.hi('Brtu(k,n ldd'nsdr ry ny rh. pdfonnddc o l th. soll nn \rhich l his pomit is
<br />Gsu.dlS( :rl)97, ( iv ( )
<br />AftU(AXLAl(lJSArla!
<br />I rEqrlJ .llm uLrr Fuhy of pdjurt oE ollh. foll,* 'ns &r L,lrDN
<br />Dmn'rtur P6mnrArb.n6 Norif(dnn F.ds.l R.BuLlirN (Iik 40. Pd6)
<br />R.qu(.d l.llq., fhrf.iDn
<br />I .d,fy rhd rh. fdL! rl r.eularioN r.Sddin8 6t6i(\ rdoval d. .ur epl(rl,le to rhn prcj.d
<br />I (sl,ryrlral I hnr.,a rh$.pplMrion e{lstlrcrhar rhcnh'rc rnn'nmlmn is cotr.d I olren'.{!nplysirhall( 'rv,nd(_.unryordinanc6 ud Srit. I rws rcl,rins ro blildinr consr rirc rcpr€glarN6 otrht ( yand ( oun(
<br />akl\€ rnqrbnal l]ftrldy aor iN
<br />Applicrnl or A*dl skn.lurc a/r
<br />Set Backs
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Frqming 9x,ll+tff/t7t
<br />ln sulation/E nerg y
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />Handicap Req
<br />Qgputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />I
<br />FINAL /c/rflt -r-*Vl-t
<br />Certificate of Occu Vpancy
<br />Notes, Remarks, Etc
<br />Forms/Steel/Holdowns
<br />I
<br />I
<br />T-Bar
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