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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNf R BUII-DER DEI,('ARATION
<br />I h(.b.fiirm !nd( r.mhy of r.iu'] that I m.rdnra fmm lh. (tntDl1oE l.icoE li\r lor rh. follrsins rdk,nls(70ll5
<br />Bdi66r ed Pror6ion Codc) iy ( ily or Counl, \hi.h r.qutr6 o pFrit to .onircl, ahd. im8rve dmolish or t.t'.n an}
<br />sltu.rur., rtu 'o
<br />irs isum., a66 r.itun6 rh. al)pl{.d r{r .u.h Fni k, 6k r si!..d rdmr rhd h. or sh. i! ncoRl ,trNNnr
<br />ro lh. Fn\toN or rlE ( onrrrdi I (oEd ljr l( narid 9. Co,trmdrs trnh sd1x,n ?0O0 of l)r\BFn 1 .f rh. Burndr rnJ
<br />Pmf*krm Co&) or rhr! lEorsh. u!\mpr rhdcnofld rh. h6a for rh( ,ll.rdl .tdnF Kr O rFldmnofsdFn?lrrl 5h\a.\
<br />apol'.! tu.Fmnsuhj(c'h. lpphc! lroocnilp.Mhyofnor mor.rh&6\.hundrdl,iollssits(x))
<br />L E oMdol'h.FoFn]. or frynlplo\6 *nh *.N6 6 rhcn ek conFEdion. ullldl ri. *dt nx, rlE imd& ir n'l
<br />ddxbl o. ofrdrd fd rL{Sc 7Or1. Bulil6 m.l Pbf*irN Cd. lh. Coffi(i liw tle &E ml qplrlo u.nF of
<br />ih. FrEry vhoh'l'lor!qrc\6rirEtr,ns'hodE*tw hiBl, or hdltor llmush hB d hc osn cntphld,
<br />Fovr&l 'hd
<br />ru.h imFn!ffi!emr ddi.d d.lid.d ror sb l(r.*6i.rh. lklm* or nrpr .l1d!$kl*thinw!d
<br />ofcompkion, lh. o\ra arir.l6 rill h.t. lh. hr&. of prrnns rhd h. .r rtu dn ml hliu or inp.olc lh. tnIEI! 6r ltE rtrq{r of
<br />l,6o*EofrlE [iop6lt. m.r(l$tr.1), conr&1uB trirh lrcdK.{ $dr(.Elo oMrud rh. r.jra1(S( 7Ol-1. tt6'Rr
<br />dd Plrftsin cod.: t hc ( o.rmo.r l.'cmr tr$ J6 m! q?ly ro M o*n6 of rioFnr $ th b(ildr or mpm\6 rhson.
<br />and $ho codE r.lor sch Foj.ir! $'rh a Co.'lndo(.) licasd poaud rorh.Cont.icroir liGI!*)
<br />lncr.nrprundoS&'on
<br />D.r. (rin-
<br />MtrE[rla f,t t ra!
<br />DICIASAIIA!
<br />I hd.hy im.n un,js p@lryolpsruryon..llhc ldkNin* d.claraln'nr
<br />li,\.exluillrudan.Cdifrdcot(otErros.lf-lcur.ads$rldscomFr{k}.,aForiddlorb_!SdrnrTo0orlh.
<br />t!tr, (-dle fr rh. paf.llrjft! of lhc $!lt ror *hih rh. Fmn b isu.n
<br />lhxv.snd \rill nr arnsork6(onl{.saron'nrurrtr...asrqt(tr.d1\s6lionrr(()fIrh(l.txtr(irl..forrh.PIli),mr..l
<br />the \o'L li)r s hi.h rh's I{rmi 's
<br />iinRl My Nork6s' rnn,tHsat
<br />'on
<br />nBur reclrie' rnllxn'.) nu'ntrr tu.
<br />l.cniI lhat in lh.lEnrmam.oflh.sorl lor shi(h rhkp6mi is n3(.n.1shallnor dnnloran! po$n in an,- nanno
<br />$ a n) h.om. euqd ro rh. $.ondr mmFrdin I'*s .r califom'r. d +ftrhd if I llr{ld lrom. lutrd rorlE
<br />.n,m\iiioa ofsdkJ.17mdf'h.lrd Cod.,I a6ll, adh{lrh.ompl! $nhrtbx Fr 6io6
<br />\\ARNINC f-ailur. x' EE udtfl c.mp€dion ..\dis. is lnl.trful. .d slEll ruhr<t u
<br />(N'l fina up lo om hundr.d lholsnd Jollss (llolr,(xx)). in.ddirion h Ih. cosl ot(.mr.Ml
<br />Sdi"n r(176 "t$c I rlr('odc ifls6l
<br />".,., ,Olt.tllT
<br />I h6.hy.mrm undd foalryorFrury rh.r I m licdkj utuj6 rmvnbn or(.r\.pr6 e{.onrno.in! $irh sdiln Tuxrl oaDtr rnn 1
<br />ol th.llusin6s d llorsDN Cod., &rl mylicds. n m lull lorc od.ftd.
<br />',),'"'t'"J1,
<br />f t+-<11
<br />catslf,ll(aloNrEB[ltc-acl!(t
<br />I ho!t) rftm und.r Fn h! o t FrJuD. rhr rh6. a r oirruciion ladlB .sfty for tlE Flo'rj@. or rh. rort for snrh rh! tEDi i
<br />du.d (Sd.109?. Ci! (.)
<br />L.ndd r N,m.
<br />AffU( NLDfCr &lltQ!
<br />I hE lr.llhnundd pdtrhv ofps]ury.nc ollh. foln'qinr J(lararions
<br />l)otrohn)n Pmns-AstEnos Nolificarri I.d6.l R+trl.rtr,nsiIirlc,l0. P.n6l
<br />R.q n.n Ldrd olfn{iff,dhn
<br />I(drB rhar lh! tnsalrqulalons r.radin3 NIEst\rdno\alar.n.ripplicabl.tu lhs pror(l
<br />I.d'l! rhd lh.r.E d rhs rppli.atirn EJsrar.rld !h.rhrc in scDmr I asE ro.ompl!
<br />r.r.6ddn6o,rhis( i'r
<br />0'a.^. \
<br />;j;[;--
<br />Set Backs I
<br />Forms/Steel/Holdowns //tt/,2 !-*7.tfi
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subfloor/VenUl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywa ll
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif .
<br />,--- l
<br />FINAL J"tIg .r&7
<br />Certificate of Occu anc
<br />Notes, Remarks Etc
<br />o,dn.n(d !r Srd. l.sr,.Ln'n! r
<br />rbo\. lmrxr.d !.oFn ! ft,
<br />'\rDli(inr or ,\qdl Si!trNrtrrr
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