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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG COMMENTS OWNER BUILDf, R DIii,('ARATION
<br />I hcr.hy amrm undd p.nih, of F.ju,,- rhdl I d q.mrl frod lhc Comrtdo6' Li.ml. l,s aor lh. f{nl!triry rcdqli (sd 70lrl 5
<br />lUti.6s afll PmtBion C.d.) A., Cir! or (ir.rl $hi.h Equtd a Fini ro coNrud. 5h6. impr.r.. &hollh dr qE dr
<br />iruducFryh 3 isum.,.ho r.qln6r& {plkd ld ech Fnn lo frl.isrn d rrml lhdlEo.iEisnc6.d poed
<br />h rh. Fo\i'io6 ot r& Co.teroa3 Li.or.ii Ir* lchqrd 9, ( ommftr.r \nh S(lnn 7(r)0 or l)n 't(i :r of 'h. Bur$s Md
<br />P('fsr6 Codc) .r rhar tror!h. is cl.mpt rh6.6om md lh. hesis for tn..llcrcd c!otr'.n Anyrnni.onoasdnnT0rl5b}.ny
<br />.mlicant for r p.nnil subjcl3 lfiG opglicdl to a civil pmhy o f nol mo,c lhd nv. hundt.n $llds ($J00)
<br />l-.s o{E.rri. FoFr!. or dJ dprotc tr h*,!6&rh.r$!.omFMnn,s l&0E$stEn'&rurft6frn
<br />ddrlal orofid.it aor ek (s( ,rlll. B6iffi Md PNfsk,B ( od. Tn. (ndrdloii r.trG b$ d,6 noi q,ply
<br />'o
<br />d 016 of
<br />rh. F)p6ty s''l] hil& or nqhr6 rh@)n. dd Bho drE nrh trnil himr.lf or h6.lf.r rhnrulh hi3 or h6.\v. mploy.6.
<br />Fovd.d rhar tuch mForoEtr ft mr inrarldl or ofirGl lor sk Il ho$ 6'6. rh. boildin* or itrprovtut n oh s irhin on. )w
<br />of co,pldion. rlE (hE l,!i&r uil haE trE htr.t n ofFor r* lhd rr or irE dil d tdtt or iryrox th. Frasly tor llE Fqx& of
<br />l, 6 o*n6 of thc pmpsly. u, .r.lGrv.ly conkrdin! $ ih l'.ds€d tukNoa ro c.trnnd rlE p.oi(1 ( s( 70.11. uur.d
<br />!d Pbtisb. (ird. Th. (inkicro.s Li*ns. L6s do6 nor nfi,l! ro ofl oq nE o I ropd v \vhn buikk or irtrotcs th(&n.
<br />ud *ho (odr&ttoru.hFo)ds{irhN(i'd ro(,l'.nB.d puhud u'hcCod.rdo.5l ke< I'ul
<br />I e.td,, unjs Sdtr,n
<br />lr.t.r Or(r
<br />woRl(f,rls' (aMPr'\rsaTloit
<br />DIIIJIAIIAN
<br />I hs.n) afim und6 Fan\ ol FJUry oR olrh. follosinr tLrldarsB
<br />I nav. dd s ill moinrah o ( .n ificar. or(\,nhr k, S.lI lNuE ror sorlds .ompqH! i.n. 6 pmvid.d for hy selion 171)l) olrht
<br />Ith, CDd., tu rh. pafomMc. otrhc uorl loi snah lh. p6mil it i$u.d
<br />I h,\. .nd *rll o.'nt.i *orls- coDFrud Fn rMrakc. s r.qu,.d t'l sarren !?u) of lh. llbor ( od!. fo. ln. Ftulllffi. ol
<br />rh. sorr for *hich fii Fni ir atu d M, worl6 on{xdh. iEuiffi. ( ir a'd Fln} .uhbd et
<br />l.difyrhbr in rh. p6aomM(. of thc f,ork tuwhichfiirrdmil is i!rx.d.l3h!lln r orhte! F$n in lryman.6
<br />y' s to becom. rut .n to rhc *o*n' ofrFndion h*! ol ( rlilomi,. ud +rE lh.a if I Jhould bc(om rub.<i to rh.
<br />q1d6' mnrEEdrn F.\ EirN of scrin t70o oath. Irlv ( oda I sltrll, fdh$ nh comply I nh 'h* Foy6i,a
<br />wAnNNC: F&hi. ro k@ $.116 NmrEiEiion 0\6.*. i! uh*tu|. dd rhdl lubFr e dplord
<br />'o
<br />simiMl FEhb ard
<br />(nil fr6 op ro orc hordr.rl rhoN.d &llB ltl00.0m). rn rddnbn n' rh..on otconFNrion. d!h46 a I'..ridd aor rh.
<br />sdion 10?6 dfrh.lnbor ( orlc. irr6.sl .nd .lrorrcyt f6 C4U-'11 -rr
<br />LraFl[srp ( oNTta (-run
<br />DECIJAAIIAtr
<br />I hd.by a,lim und6 F.ahy oftnjury rhd I an |.dscd undd Fovirion of(-harl6 9lconmocins trnh sdhn 70m)oallnision I
<br />of lh. Bsin* and PrcfsioN ( od.. ad my li.e Ls i. Itrll nn.. ,rl .rTd3
<br />b-11-q
<br />(AISIaUCIIA!]ENDINC.AGB(I
<br />I h6.ty nmm ond. p.nah, of pdlury lha lhsc ii ! coNlrucl irn hndds !*n., for rh. FfomMcc ol lh. sorl for \ hEh ihis Frmir i
<br />t,u.d (sd 10q7, civ c )
<br />lddo'r Nim.
<br />Alti.IcaNl![gaadlla!
<br />I hdq .iEn und- pcnahy of Frur) oE oallt rollo*in! &(hrttioa
<br />l)o(nirhn Pm t'Asb6lor Norifi.d6n F..ld.l R+uldio..(l l.,10, Prl6)
<br />Rdtuncd l,.ud of N<nifi .^!N.
<br />d\ \trh nll(''rr iid ( 0unr\
<br />il! ind(()unirlu r rd ur{rh.
<br />I cdifr rh, rh. f.d.r6l rcsuhl oN rcsd'n[ BtElos ,mn d r. nol qrlktbk ro rhB tmj.{
<br />lcdiry rhd! I hn\. rad rhn nflil'orion &d r.r.rhd rh. rbr. 'nfomdon n cotu I !+ialooml
<br />.rJ'n.n(6 md srar.li$sEldrn*lc hurldmx c.NFF'on. mdho.h) au'h, u.,.Fffirirtr6 "f rhis I
<br />,tin. mor'onGlrn'n fl! ior idrdiq/r.tf.r,rl L:;,;:.;;;,;;;;- d ut-< D..-.;,,-....,".,; Cal, fr,A^.i
<br />(p"71-rl
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Enerqy
<br />Drylvall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Reporl
<br />Engineer Final Report
<br />-/t 21-/-7'',L'-/,V1 -/, ,a-
<br />FINAL Z/t/ 5,,/.4t '/ts/*^zaS ; './
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />Pool Fence
<br />I
<br />Flood Zone Certif.
<br />4taI(..Ndmh.r I I IK@
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