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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS o\T NER A!II,DER DEL('ARATIoII
<br />I hsct'y .md unda Fufty ot p6JUD lhal I n .rofl non rhc CodrdoD licG t!* for *. tollos'fu.a$n (sft70115
<br />'l!,sin6s rnd Poa*n1n Cod.): Any ((y or Coum, $hich r.qut6. rEmrl r(' co(rto<r,6x6, ihrro\.. dd;nih or qFn dy
<br />slru.tur., Fior to ils isuM(., abo lcqun6 lh. appli.d for 3uch Fnn ro nl. r siln.d sl,ldar lh.' h. or sh. G lic6s.d puNarl
<br />!o rhc Foriri.tu of rrE (irnharor's l-i.6r.d l^ {Ch.prq 9. ( omtrins * h s(r io. 70u) of Dirirhd :r oa r h. aNin6s and
<br />Profdi.B C.dc) or rhd lE d ilE t dmtx rlEkfiom ,nd th. hcB for tlf, .llq.d .rnlPhn A.! \Fhion oI S<!i,n 7l)!l 5 h,y.n)
<br />4rl'(it aor r Fni rut ds th. 4pli(!nr trr 6 .ir il p.Eh, of mt mr. tha n\. hund.d dollas ( tsm)
<br />l, &r o* nd of rh. tmlErly, o, dy .DIrlo)G wnh war6 s rh.t $lc compqlrd(rr. ulll d. rh. urrl od rh. nnrB s nn
<br />int6d.n or ofi6d tu sl.lsd 7044.8osin6 dd Pmf*nrN ( od.: Th. ( onlr&1oi. I-ic.N. l-.* d.6.ol aDply to eo\n6 ol
<br />rh. tnldy uls tult or in{mv6 dtNn, rrlstnd€r(tso* him.lforh@lf orlhmughhi. ff hs oM. dotd,
<br />rro\ dci lhll ru.h imrm\ldr e mr iddrid orolYcal n{ $k lt ho$6(- rrE tliEine or qr.rffi i! eU tr i'h'n orc r@
<br />of oq'kiotr tlE (xffi lru la nill h.\!
<br />'lE
<br />h,rla! ofFo\ittr rh, rt o. slE drl nn tuld inp.r\t ih. Flrdr t,rltFIFEo[
<br />L a osE oa'hc lrrrdr. m cl.fusn.ly conrd inr rirh lkdsd .onricroG h (oo3rud rh. li. iR1 (s( ?u]t. Ilusoes
<br />atul lrhis$n Cod! I h. (i\nta.ior'3 l-i..ns. L* d.6 nor {T,lyto osnnorprop.ny$hobuil&drmp.o\.!rh6d'n,
<br />rnd \ho cod@1r ntr sch D.oj.ds * nh r ( onr.doni) li.ded poBd h r h. ( irdradors li.G ljr ).
<br />I m .rdF unad s<rion
<br />Drr. ()rr.r
<br />woRKrf\. (-on,PENaA I',toN
<br />[ES.6AArIA!
<br />I rEchy rmm u.d6 pc,!hJ- of pqu.,"oEolln folloqiry &tl[dnrB
<br />I h.\c dn tr ill flm'.h. c.nifEr. of ('086r h sr-lc!r. tu *0116' (omFdion. c F nd for h S<rFn r70oorlh.
<br />llhor (-qli for th. F()lrl@. oathc *oll for \tah rh. FE,r ! Bu.d
<br />I hr!. 0nd *ill nr.inrain wortd .omFn.dnrn i.sran.., i! r.rtuircd bt SNt ion ]7m of lh. I nhrr ( od.. for lhc pqfon.Mcc oi
<br />rhr \ort aor which lhir F€mil is iasEd My tr.rk6 compd.llon iBu.ec. cniq .d B'licy .uhiEr Ec:
<br />I (cnifythal in rh. r.rtormncc orlhcsnrl lor shichthk pd il ir issudl. l .ll.ol dnDloyany p.rso. inrny,n$ns
<br />e Bh hdom. suhJd k, rh. ss&a .omfdldi.n l.*.rf( lliromia, ed '[N rhd ilj sh.uld b.(.m..rbjrt
<br />'o
<br />rh.
<br />{$16 (6mF&r tun p.or loB of S(t nn I7{t)ofrh.Irtnr (.d., Lull- aonhtrnhomt[ tr h ilr]* fr.risirB$ARNlNc Frilur. u ftd. $st6 comFMit. ..16+. ir unb$tu|. lrl !h.ll rubi.{ x mph!( io mEl r@hB &d
<br />.Nl nn6 up ro oR hu.dr.n 'h.N.d .t'lla comFMio.. &nu6 a3 nrold.rl aor lh.
<br />S(rFn 1076 ofrh.lrtrtr ('otL
<br />2
<br />I h6t\ lIrm unld Frh) of Fjon of (-lEr{6 e lomffiins $irh S.t1ion 7l)00) otl)'\Nhn !
<br />of rh. BusiB o.d ftolsioG Cod.. d'd mJ- l,c;e B ,n full lor€ sn .,Iet
<br />./ -) c/
<br />L_ .2 _1
<br />I h..hy trflirm un d trnaht of IrJtr'r. rhtrl rh(r $a
<br />N\i.dtsr. !1r9?. (i\ ( l
<br />ins dldcy l,n rhc tGfoman.. drrh.\vork for shirh rhis pcrmil G
<br />AIIIIIANLDI:qAAAIIA!
<br />I tsd, iftn un'js rE.hr ofp6jur, on€ oflhc follotr in* d(ldrdhnll
<br />l).,R'l ion Pmir3.ArtBbs Norii..rhn li.l6al R+ukn)nr (1 1.,10, P 16)
<br />R.qur.d titd.r N({'f{d0.
<br />r.BularioN rcr din-{ 6h.sks rononlar. nor appl'( 1.loIhBIn,ld
<br />. r6d rhi! opplicintn &ri st.r.rnd rh. ihrc infomlrnrr !cnd I arEn, compl) s'irh rll( iryand( oun!!
<br />h6.$r .!rlFrn. r.r66rdn 6 of !fi'r ( n y od Counrt b or( upon dE
<br />o41.1\4 ^r,\"q
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />R oof Sheathing bfrn/O 5 DpflrrTH <s
<br />Shear Wall
<br />Framing
<br />lnsulation/Ene rgy
<br />D all
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handica R
<br />Deputy Final Report
<br />Engineer Final Report
<br />FINAL '/lt t l)1 n1'/t'/+
<br />Certificate of Occu n
<br />Subf loor/VenUl nsulation
<br />I
<br />I
<br />Flood Zone Certif.
<br />Notes, Remarks, Etc.
<br />I 700
<br />4-
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