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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE tD/srG.COMMENTS OlI NER BtIILDfR DEL('ARATION
<br />I hE tr dflim undcr r6.hy or Frjury thn I m crm from
<br />'h.
<br />ConlrRloB l.i.ffi l!\ tor lh. rolli'trina r.e\n (sd 70ll t
<br />Busin63 .,i Phfdion co&): Any cnr or (-oudt ehrh r.qun6 r p6nh ro .odtucr. !ha. impoq d.nolth olq$t ul,
<br />nrudm. lrnr lo its 6u're, !!. r.l]lrn6ltr. lpdEat lor iuch r.mn lo fik ! t|,rEd nn6E rhn lE or nt i! li(ar.n oloMr
<br />ro rh. Fo\itio6 ol rh. ( onr6cr(,'i I-ic.nral Lr{ (Ch.fl( 9, ( of,nmin* wi'h S..lion 7m0 of Divirion I ot lh. Busin* tnd
<br />Fmf$iins C.n , or lhd lE s rh. i .rmF th6.6om od rh. bsi! for rh. .ll+.d .ktrF ion Anj_ rioldlion nf&.ii.n 7011 5 (eL-t
<br />lpptcul for . Fmn suhr.cls lh. !pphc!.1 to ! ctr rl p6.lt)- of mr mrc th.n fir. hun&.d dolls! ( l5O0)
<br />l. a o{G of ih. FFny. d n! orpld)6 *nh *.s6 a tld $L comFsidn. triI dr llE $rrl dd dE rME i d
<br />inrdr&l or offEal fo. nL {56 70,1t. BsilB &d ProfdkB Co& TIE ('od.xl.rs ttru t:e d.s mr q,rly lo rn n\e ot
<br />rh. FnFry *lkl tnild! or nprov6 thdon, &i wrh &8.!ch s& hims.lf or nelf or ihmu*h hn .r lE o*n .nplolc6.
<br />F.ri.hl rhlr kh inrrerqEr3 E d indiL.l or olH lff -L r[ lsr6q. 'lt hildllg m,tFuqEr n rnd s.hh w )6
<br />ofo,r{'Llia llE O"M ltuildc r ill i.r! llE hrda or pmrtB rht lE or shc di, m' txiH or inprcE $€ Fordy ror rh. IrrFs oI
<br />I, ero*E.llln. F)psly- d.rclancly coorEding * h li.(!€d conrdoBro connru.l ttE Fr!.cl (Sd 7O{1.ltusms
<br />i,i h,tunir (hdc Thr(ontatu s l.i(ms.l,s do6nor rt l!- to eo*n6of nRr!.ny $ho boil&or imnov6lh(Nn.
<br />!.d rkl ro r.ct lor.uch F.j.ds trnh, CodE !o4i) lroeJ plEui rorh.(idrdd'. Lkrerj$)
<br />I tun.ropr unds Sdion
<br />D.r. Orn.r M,[ttss:(l]ufttr rat
<br />DTCI.ATATIOX
<br />I hd.hv !ftnn uad( p.nrlry. f p-rury on. ofihi r,,llos'nt dtrlssn.ns,
<br />I hrr. id *iU @inle . Cdiftd. olcoel ro S.ll-lBur. ru *D*d @6FBron. 6 Ford.d for bt sdion !70o.f rlE
<br />l$or Co<L. aor $. p6lol1rm. of rhc In,t lor strth thc Fn ir isu.d
<br />XE*.,a "'r'.."." *.*6'omFMion,ffiq6 r.{qir.d b sdhn:rTcD.rtlE L!bo, co&. ror rh. Ffollre. or
<br />rh. mrt f.rqhi(hrhiiFmr ir isEd. M) sort6 ompcaroi 'Ndm. ffir dd polic' numha e
<br />cffi S]aL G- z
<br />"",n,n"^n lha);>1anh ' r.\pc to/tl/,s
<br />I.cnrfylh.l rn rh. p.rloman(. orlh. Eork tor $hichlhisp..mir is nsd.l sh.llnol oplor.ny r(sJn in tny mannd
<br />$ a ro ttom.ut ftr 6 rh. $MI6'comFMhh lN* of Cahn,m6- ed +E rh, rf I rt ulll b.em subr.d to rh.
<br />$rl(6 omFerion frD\ii66 df sdbn :l70o of
<br />'h.
<br />lrlry Co&. r {Mll, fodh$nh.ond) $nh rhlrrrorsk'6
<br />WARNINC: Faihtr.lo surc so dl .lrmposotrn covdrSc k uhlawful. Bnd rhall suhjd M ot'loys lo cridrisl rEu,r'6 and
<br />cnil lin6 up
<br />'o
<br />om huEn.d rhousrd (hl16 (lloo.(t)0,, in *llnirn ro rlE co$ oa comrm'ion, &ro[6 a rrold.d nn rh.
<br />rn bhr cod.. mr6d aEl d'oE* s
<br />DF'LARATION
<br />I@.lTmunddF hy oa FF:_ 'ht I M liG!.d u.da F.r ition ol ('fi4ra 0 (omnE*ing trIh S.ciin 70qr ) or DririD l
<br />of in IIBill< d Prnl6eionr (\d.. ei ny l(.@ n '. rull lora rd.lfer
<br />Itrd.l'lN 4
<br />,,.,. 6/rl't
<br />/L
<br />ca!$alJ(llottllDllI;Jctlct
<br />I Hry.rm und.r Frhyof Fjur, rhd ihe ir. odddio. lftln8 .Btrr 6r rh. Frolruc. ol rlE $rrk hr shth rh. Fnn n
<br />isNd (s< 1097, Civ c ).
<br />d.tfll(aNfo[ct aadrlo!
<br />I nddry .fm undcr Fn!h) of Fju.) oE ot llE follo( in3 &(ldd 6.tr
<br />l).ftoli$n Pdmnr-Arb6ror Norriic.tio. l,.ddrl R+uh .. (Tnl.,10. Pd6,
<br />k.itutr.d I dr6 of rviilf, ds.
<br />I (Et iry rh,l rhc tql6.l ,csuLrirB Eardirx 6b6lo3 rmo\ d s. mr al'I,liclhL lo rh! Itsr..l
<br />rc (6 ify rhrr l hi'. ruJ r hi! anpl'(.hon &vl nrdhd rh. .invr i.rt\mal o. 6 cord I rgR b c.hlly *nh rll ( y rnd ( ounle
<br />,;|d'n66 dd s'dc lsr,.lrtrq ro b'H'.r.nNtudFtr lrd hrcbr trurho,u. r.!r6snair6 of rhi! (-iry 6d ( ounlyto dls oF,n tlE
<br />alr,rc n6'FEd l,op.dr [! itrsp.d "W /zu
<br />Kt /^"/",
<br />,\lplic.nl nr AAsl Sipnrlnrc
<br />n*^U. ,".",n.-,,, 6n
<br />r;y't/, t
<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/Ene rgy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />FINAL gn;lt4 ML4{1
<br />Certificate of Occu n
<br />Notes, Remarks, Etc
<br />I
<br />I
<br />Engineer Final Report I
<br />Flood Zone Certif .
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