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BUILDING- INSPECTOR RECORD <br />SITE.WORK DATE ro/stG.COMMENTS OWNI:R BUILDER D}:L('ARATION <br />I h6ch .llm ui& Funy ot Frur] rhil I m ctmpl fion rh. (bnr..iod' l-i..@ lrs for 6. lollo$in3 r*!. (.^L 70r I 5 <br />llGin6s !,'d hoaBi.n ( od.) An! Ciry or (nu y *tth rqur6 ! Fmi h codrud, rlrd, inpm$q &mlish o[qtir rnr. <br />3rtuciu., Fmr $ ns i$um... rls r.qut6 rh..aflrut for su(h Fmn h 6l. r ri8n.d sdmdt rh0r hG or rllc n h.o..<t Neid <br />ro th. FrsioB of rlE Co'tlturore I 'cdr.{, l.r ((lqitr 9. Conedra *iih s..rio. 7000 .f Dnbhn I of rhc A$m* and <br />Pmf*rion! Cod.) orrhar h.orrh. is.rmrr rh{.no,n Md lh. ii*!n lor rh..ll.p.n darplion Any violilionotS(1ion 7011 5 by lny <br />.pplici Lr.Fnisbjdrth..pplrc.ntro!orilp...hyolmrmi.tndfir.hundEddollB(tt(x)) <br />l, a 0*16 ofrhc Forant. oJ my mplotd rnh srs6 a rh.n sL comFciion. $iI {h tlE $1,1 !d $. rnf,lE u mr <br />irrdrldl or oII6.n fs sL {Sc 704.4. BsiB Dd PrcfdtlB ( od.' llE Co'{rrcroir l-a.e l!$ d.6 nor 4ply to u o$B ol <br />!h.Frdry srr hil& or irprnrB dEqn dd *ho &6 och *r't hior.tr., telf or fi^rleh hi d h6 o$n oDloy6. <br />Irolid.d th.| sh iftp.olgllfu e d ndi.d d ofid.d for sl. I[ tn*66, lll hlildilB or qm\ffi t $ld *ihin oE E <br />oaonpkhn. E(xffiBl da$illn!.lh.hrdarof[r.\in3rhdh.o.nEdildhrldorFp..$fi.FtrFyforltEplrFEof <br />l,6osFof rir pogarr'. m Grckn.! codtsrinS $irh lic.6.d .oirrldoR ro odrrud rr. rrcJc.i (S< 701,1. B6i,B <br />tud rhi3rMCod.rTnc(o r&ror'. t.ic.nk l-.* do6nor.oplyro anowna.la,opd, who build.or istrovdths.on. <br />lnd $h.6dd!613*hFsj.drsth.Co M.(r) ltded p!B@ rollECo'nrdor3 Ltc l,u) <br />I m.\mF !.dd Sdiio. <br />Drr. Oi.r <br />.\lJaxr85:(arENAt[a <br />IIi(lJAAUOii <br />I hd.l! !fnrn undd tH.lr\ ofFrjrr!.n..rth. nrln$inr ddledrioN <br />I hi\. ad r ill tui .h . Cd ifk{. of ( oMr to S.lf-lBur. fo. $nrld: omFsl ion, s Fovid.d for t4 SdiJn uot, nf rh! <br />lrbor Cod.. ror rn p6foifu.. of rh< *.n fo. *tth rh. Fi( n Bu.d <br />I h.E rnd wil I m.rnrrin *orl6s' compdEaiion iBuranc., 6 rcquir.d by sdi('n I7uO or lh. I rb.r (id., ror rh. Frommc. of <br />rh. rorl fM *nkh lha Fmn b isxd My sorl6 snpdsion iBlrffic .uir td !oli) nudha &. <br />I cdi6 tll.' in 'l' Frormft. of <br />'h. <br />sorl r \tut lhi Frnil ir is.d. l .h.ll mr dpt t tnt Fr$n 'n t meE <br />$ s io bdom iubjd ro ih. *rrld .omtEns io. h"! of calin,mi!. Md 4r lt'd il I should tEcoe tubj(l io <br />'h.solt6..mFMriotrForsioBoasclhnl7m.rrh.bhrCodeIJEll,fonh*nh$mplyrnnlhorFrkioB <br />WARNING: Frilurc to kur ulrld' cohrsEnion cor(ls. ir ubutul, ina rt ll rrbjd e dnplots lo gihinal Dqth6 ed <br />citil 616 up lo orc hun&.d rho6&d dolld {t10o,000), r jd ion t. rh..on oa.omFNrio.. d.fl86 B pro d.d for rh. <br />s.di.n 1076 of lhr I itfl ('od.. int.rcn ,rj rnonErir lc <br />G.71-,t K <br />LICENSEI) CONINACIOR <br />DlicllSauox <br />I h6-,r( amnn und6 F.rlty of Fjury rhd I m li..nGt und6 lrovisi. of ( 1!116 9 ( comrmins w h S..lhn 7Um ) of Diltion ! <br />of lh. BNiEs dd Pol6s6 Co<k. tld ny 116& n in fulr forc. ed.Ild <br />r.icru.rs 15 <br />Drr. G-1? - tr .;,..".. 1**'*41t r trcW <br />co!$ar(rorL[lDlNc.AcliBtr <br />I hd.hy rftum und6 Fnahr- oIFjury <br />'hd <br />rh6. b. $dtudion lddinr.*acy for lh. p6fotrM.. ofrh.uork n r shih rhis tdnil is <br />Bscd (56 109?, Cn C.) <br />attucAallrcuSAllo! <br />I hodD' .,rm und.r p.nlhy ot pajur) on. or lh. fouos i.3 d(lrEliod <br />l)snolirion P.miis-AllEros Notifi cahon,:.ddrl R€8ulalnrm (rtr|. 40. Pan6) <br />R.q!t.d 1..r16 olNorifrrnn <br />I c€n'fr lh.( thc l.dc'd re!trlirn)ns rqtrrdLn! rb.:n)sfurnoln!rrc nor rrnli.il,lu r, rhis I'n, d1 <br />I cditrh.r lhr\.r.5d rhi!applicdhnondsrsr.lhsrrh..h)v. rnlolnElion is.otr.cl losrEro $frdy wirh rll(r!and(ounry <br />oditw6 $d Srrr. ties r.hluB ro hrldins coMrudiotr ,! lE.t'y adhort. r.Fsnd tr 6 .r rhir Ci! r_ lld counrt ro nrs r'I[n E <br />!nr,. h6,i ,nar emp.nv ror iBtxn nure'q <br />appu..nt or A16r shnrtrre Y u ,l;t fior[,ry <br />G -11-\1 <br />Set Backs v tl ,<9 <br />Forms/Steel/Holdowns a tu )1 L ll <br />Erection Pads n t1 l,t 4t <br />UFER Ground x t)'4/ <br />SLAB Floor k ,111t I t'\ilt 'q-t <br />Subf loor/VenVlnsulation m t?, <br />' l',e4 <br />Roof Sheathing ll t (t/l 1b" <br />tl tv I t,3\ <br />Framing I t1 t;ll I,3'4 <br />ln s u latio n/E nerg y 7t \)31 <br />Drywall ),0 bi Y1 <br />Ext./lnt. Lath I N tx 'r./ <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 />FINAL <br />Certificate of Occu pancy I 7 <br />Notes, Remarks, Etc <br />I <br />A,(- <br />a/---.- <br />Shear Wall <br />I <br />I <br />I <br />I