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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNf,R BI]ILDEN DEr.('ARATION
<br />I h6cby rmm und6 p.n.lry oa p.rlury rhn I d .rmpr fmm th. Co.trdoB I_r.@ ttu fo, rhc tolowi.rr .@. t S( 701 I j
<br />BB'i*
<br />"t!d
<br />Pr.f6ion (it ) An, City or Cou.ry $hich r.qut6 ! Fnr to rnl(ruct. rtq. improre &frotirh or r+dn 6v
<br />dtu(tuq r,Dr lo ir3 isu4.. rlia rcqutrB lh. qDtihi (]r such Fhh t. 6t r risEd nd.lmr rha tE or 3lE E lirds.d pt&.n
<br />ro rhc provniod. ofrh. (-ontrrtois Lic..i.d Los (Ch.rrfr 9, Codm.Nins wilfi S..ti.n 7OO0 of Division I ofrh. BNin.s d
<br />PrnldirN Co&) or lhrt lt or slr ir RnF rhc.ft.n &d llE b66 for rh. rtt s.d .rdFon Anr- \irhhnotsdbn?01l l r,r,oy.ppli$ for ! Fmir strb.jdl! thc lDphcml ro . rilil p..shy ot nor mR lhm 6v. hundrcn doum (t500)
<br />/Ay' 1. 6 ."m.l th( F.Fny. d mr mph)c * h tr+6 B ihd $t onFMmn, \,,td, rrE trut d rtr<M@. n{' 'lro(H or nfid.d for sl. (s( ?04a, Bunn4 sLj ProtsioB cod. Thc C;lirrctois t-ic6j. r,w &6 nor mpty ro o otrna .r
<br />lh. FnFry q lF t!il& or inlroE tlEq dn $th d6 *h $* hilMtf or h6*laor ttvouSh hn G hd o*n .npb) B.
<br />pro\ dcd lh.l such imFo\66nr m mr iddld.d.r dnqld ror sL lf. lb$nd, iE b,ldns ot mlmrdFn a $td *.nhin on. )6ofr.npho( fi.()*n6 B lla*ill h.vc rh. hrda oaFnrin* lhd lEor!h.diltu buildor iftprov.th.F)Fi! forrh. Fj.r{Eof
<br />+rFsoqffiorrh(Frpd).m.rctBn.t'conrrdh8Eirhlic6Edconrr.roElo6Nnr.Flja{rrsa7o4il.&u,6d{d hDkm ('n<k Thr ( o.trsor'r Lrru LN &E .ol qrl! ro m o{n6 of Fop.nJ- dF ttuitdr or mFo.d lfissn.and who conrEd! aor.u.h Foj.<rsuirh o Contmctod.) hcm.d puBud ro rh.(rnrr(oas l,icffi.l,$)
<br />I m.rcoB u.<L. Sc!'on .B &PC turhirren
<br />D.,, -7 )Z/ ')cl/ *,-><l.la.--) /6 12{!t,,:--yo
<br />$ oRto f,s' col$ rars{rlol\
<br />I hqcb,.mrm un&r Futy of*ruoo*.rrr. ^,n*.*ffiHq
<br />| fi6. at r.ill rointlh . Cdif{d. of ( onsl to S.lf-tBr. f( s!.t6 omFMion. 6 rmvd.d for by Sdrion um of th.Ltfi Cod., tor lh. p6fnme. of th. ".d for $trh tlE Fnn i! isu.n
<br />I haE 6nd sill ali.tain $ ort6 .omtEBril. 'dunft.. G Equir.d t'! S€thn 1'7(x) of rh. t.hor Cod., for th. Ffo.rlec of
<br />llE hrt for shrh lhE Fnir is iskd Ml rdl6 omttu6n 6uDcc 6id ,n rsli., nuitEr s.
<br />Poli.y Nuntq Erpu6
<br />1Q4,*d,r,ot 'n
<br />t* e,,r",*.c. rrh.tr rI for {hkhrhk p6n $ u!u.d. r sh! noi mptoy !.y p.$on in..y mannr-:J E r. b.(R shrd ro rh. *nrl6 omFMdn L\i nI('dif.mE r.d.aR ihd 't I rtnutd h.roft ruhd ro rtr$ rt6 coEFs kr F.r sio6 of s.dhn !?00 of rh. I ltnr Cod.. I rldl. aonhs
<br />'rh
<br />6mpr! with rtre Fnvilion3WARNIN(; F.iluE to ku. $0116 corp.Ntion covd+c n unbwtut, od lhalt 3uhjd e nptorE to dihimt Futtis !.dcnil [n6 uF ro on. hun&.n thousnd &116 (tlm,ou]), in Njdnin to rhc.oj of ..nF&r,.n. d.ms6 s prc\i,l.rl fo, th.
<br />Sdrio.1076orlh. Ubo ( od.. i dd od rom.y 3fc
<br />^.1/izll<,/t
<br />Dgct.ASalla!
<br />I h(Eb rr"n u*L{F!lr of Fjur..- rhi I d I'c6E d uRtd F\.ioo or('baflE ctanmft,ns liih Sdrn 7(x[] o,Dri$n r
<br />of rh. uus,.s &d P6ldio6 (ird., rd my li.6s. i! in rull forc. dd clTar
<br />coNsTRuc noN I FNDIN(; AGttt(-\'
<br />I hRhy amrm und.r Frl( dlFrjurythd rha. ir. odrrudirn Lndins +mcy n, rh. pqn'm c.otrh.(.rrfttr*hththisFmi k$u.n(Sd r(n7. (\r C,
<br />A9PLI(ANI DE(-t-AIIA'IION
<br />I ndrry afion urdd,..6lly ofrdjury onc ofIhc fo,lotrinr ddldirn'N:
<br />Dsmlihn P.mh!.Aib6or Norificdrn r.cd.ol R.rular i$ (Ink {o_ p,n6)
<br />R.qut ! t fi6 o f Notiricrrion
<br />I Etitrhar th. Ld6dr.rulit'o6 r.srdin8 st8lo! roovatr. nor .prticahl. b rhis F ojcr
<br />l)! ,^'7,* ,
<br />^,,^,n
<br />.prtr.i'on rd era,. rhd rh..br. irotuion ir.oml r 'sE ro omp! snh,r c ) ,.d ( o!nr!
<br />n{nanr6 ed sldc l.{: Eldms r. hu'rd'ns (!6rud otr and hr.ht !ulhon,. rcFendi;B otlhi. rrity-a t.ooryro -ro upon r*.bor. lmrFn<d pmFny ar !r$.di'n ltrlrE
<br />rpp,lcrn,or^r.,s,*,D,urr 7:/flf) /ecrr{c-utrz. _,},,.r"-r,*-..,pa,r,fu * R / / o u I € u t R Qt 7 tz 4 'zafi
<br />Set Backs
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUlnsulation
<br />Roof Sheathi
<br />Shear Wall
<br />Fram in
<br />lnsulation/E
<br />D all
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonr
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />De u Final Re rt
<br />En ineer Final Re ort
<br />FINAL ) a.>4t
<br />"-14t
<br />4,
<br />Certificate of Occupan cy
<br />Notes, Remarks, Etc.
<br />IForms/Sleel/Holdowns
<br />Flood Zone Certif .
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