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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDER DELCAI' TION
<br />I h6cb! !fliirn un'16 D.n.hy of r.riurr rhd I m dmDr 6.m lh. ( odr..1o6' l-'.ro ll$ nr rh..ail.hq r@ar (s.r 7lrrl 1
<br />tlulnd .d P.ots. Cod.): Anv ( il} or Coudv rhah (qut6 ! F$i ro ml{rucl. !hs. iDl{o\q d.nolith oi(Ft v
<br />!hdu. Fi,lo ik qrum., al$ R]!G r h. {'dkd lor lNh Fm lo fiI. i ersrc{ slaldFl lhAl h. o. 3h. t lic4*d prcuain
<br />ro th. provi3roB ot E (onlr.clo r I Edsd t,s (('t4ia 9, (omffiins $nhSthn 7000 of l)nEion ! na!h. B$ins ed
<br />Pmr*nnr Co&) or lhd lE or C. s .rnqi rl6.Con d rh. b..u lor !h. ,lkr.n .rmplhr Ary viohnrn 6f scrhn 7011.5 by art
<br />lmlic&l for ! Frn suhjcri rh. .ppliui ro a civil t.Eh y oa nor ,nor. rhe li!. hundEd &lld! (1500)
<br />l. .s o$E of th. F.rEn y, or mt cmployG *ith * rs6 r, lhci $1. co,nt.Nrion, will $ rh. sort md ltE nnf,rE i! n{
<br />i dd.\d oi oltd.d tor sl.(S< 7O{,1, t}6i,1* dJ Pr.l66E ('od. Ih. (nnr-ort Li(c lr}'d€ d <!tlt ro e.\N oa
<br />rh.
<br />'l!rd)
<br />u lI t!il&.r i,irmr€ thdFtun $ h dE trh *$* himsclf o' h@lf or th$rBh hB or hd own cmpkD 6,
<br />pr.vd.d rhar such hFvtur ft mr mtdld.d or ordrd t{ sk lf. k'$6€. tlE tliklma or inlro!ffi B sU {irhm ot ra
<br />oiol+kra ilE ()$E E{iltd $il hrE rh. hrddr ofFosrt rh, lr or rh. dd fr torld or mFnrt $. FstEly for lL purrrEof
<br />I. s orG of rhc Fdpqry. m .rclusivcly codmiinS wirh ,i.o€d .onr&1oE ro consruci rh. ImJ.d ( s( 7(lr,1. BNtr6
<br />sn hDtosn Co.!.: Th. Co.lrxror3 l.Ear. hI <kB mt o!91! to u os n6 d I FoFd r u h. t'{ildt or inpr.\ 6 lhdd,n.
<br />Dd tr h. o.'rE.r3 tor 3uch F,).(]1! *ilh r Codncio(r) h.d!.d poB6r b rhc Co r.dors Lic* lrw)
<br />I o.imF un<!d sdhn
<br />Ihr.: Oind
<br />woe(r Rlt. ( :oir PansAJloN
<br />DEOJAAIIAX
<br />I ho.hy amrd undo ro6xyoltqjuryom oirh. nnfuwing dftlearioN
<br />I h!!. erl will minrah a Cdr ificlr. ol( .n5r 16 s.lt lnru. tor *orkn omFn$ib., a Etrlid.d ntr by SdN. 1100 ur rh.
<br />l,bor ('od., for rh. p<f6mffi. of lh. trln am trtrh
<br />'h. Fnn it isu.d
<br />I hivr a.d wnl f,ainhin eoda- comFBrlb. iEunk.. 6 Equr.d h Sdmn 1700 ollhr llbo, Co&. Id rh. Faollffi. of
<br />$. *ot lor *hi.h fin Fmn ir isEl My wortd' 6nFsio. iEo,w. cei6 a'd Flrcy numbs a.
<br />Poli.y Nudb6: €tpn6
<br />I c.nifr lhd !nrh. Ffolmmc of lh.\o.t forrhrtlni3Fnn i! nru.d I null @r mplo) my Fren in lnyd&rs
<br />* c ro baor eubiar ro rh. {vrd' cooFElln llB of Cahfonir. ud,eErhd if I $ould tE orcsubj<t lolrt
<br />wo 6' compqurior FovtioB olsdion 1700 of rh. t.l'or ('o<,., I tull. fdh$nh onply *nh rbr P.ovinB
<br />wAR ING Fdlur ro sa m*a omFdhn .ovr+. ii unh$tuI, ud shdl shjcl 6 dplolE ro dimi..l ,Edii6 Md
<br />.ivil 6n.s up ro on. hundr.d rhou$nd doll6 {1100
<br />sdio. .1074 of rl{ ll|d ( GL. inrdd arl rbrE !
<br />n,n. drtrs3d 6 pro\ .d n! rh.
<br />DlClA8tIAts
<br />I hcE6r,mm !nd.r pdldry of Fjun lhn I m lic6!.d unds Fo\ LlioD olChafld e (.ommdcinS wth sdnr 7Ux))otl)nNFn I
<br />.l rh. Buiine lrd PrcfKioB cod.. eJ my lic.M G i. tull forc. an.fi(l
<br />-" c- 4
<br />(:I)ISIAIJCIIANIIIDINCACIACI
<br />t hdt, a,Irn und6 Fnahy orFjury lhn lh6. a, strrrucinn Ld'.s isft! for rlk Fft''rrun.__.. of !h. sorl i)r \hi(h rhi\ Fn, a
<br />isu.n tsa loe7, ( ir c I
<br />AfILIIAITLDECIAAAI]O!
<br />I 6ddry.fiimund6 tdrlty of prjury on..f rh. fotn,*in* d..ldrnrn3
<br />llfrniion PgnirvAstcros Nor'a(dnn f.dnrl R.*u hr io* ( InL 40. Pd6)
<br />Rcqurcd Lc 6ofNor'6( d
<br />I cgliry rhsl rh. lcdsal r.rll,rions r.Sadins atBt.s rmo\al.k mr a.rli.abk ro rhs rxnjd
<br />l.dii lhd I har. r.rd rhis dFpli.i'
<br />orJraft6 all Sr!r.1.$. Eldi,{ ro htu
<br />omario. ir.otr.( I rslr 16..mp\ *nh.ll ( nti Counlr
<br />idhrn! GFeniif6 of rh,.cn! d ( ountvlo 6lq uF.llE
<br />aln\ . rmrnrn.d ,rcpdv lnr iBF..r
<br />G-e-t>
<br />d
<br />n,*-* - nr-,.n-\"
<br />".-U--..,rn",,\,]F(
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subfloor/VenUlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framinq
<br />lnsulation/Energy
<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 />Engineer Final Report
<br />Flood Zone Certif .,( l /l
<br />}(r,"r ->'L ){h?'til.(LxT+i
<br />FINAL Ot rlohi iltt,'lh(1'l)
<br />Certificate of Occupancy v
<br />Notes, Remarks, Etc.
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