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BUILDING. INSP CTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS
<br />Set Backs I --l')r \ (.iL,
<br />Forms/Steel/Holdowns 1-L',c*K o -\ . t Pr /vcllal)
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor S -2s- t1 v) O.r , tu S geahurJ
<br />Subf loor/VenUl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framinq '7-C- t7 ,@
<br />lnsulation/Energy
<br />Drywa ll l-L- t1 Jbz9r(,a
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lrila so n ry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />FINAL a ,qa
<br />Certificate of Occupancy
<br />Notes, Remarks, Elc
<br />fl.t-.,n-p1(a7
<br />c'
<br />a// lz
<br />OWNI:t BUILDI'R I}EL('ARATIoN
<br />I h€.t^ rllrn un& Fr.lly ot FJun rhd I o .rofl tti rhc (..nniloR Lkce l.!s fo, !h€ folhuins r.en lsd ,ol I I
<br />Bulndr and Prcf*ion Co{.) Any Cny or (.!d! (hich r.qui6 i Fm lo coneruci. rho, impror( d.mlih or qff mt,
<br />srtud@, Irkr(' n! sur(.,.ko r.qun6 Ihc E)t'licd fn such p.mil ro 6l.a !t..<t srtrool thi',Eorsfi. it licoBl ptrBurd
<br />k' rh. 110r*,06 or rhc Contkroar Licas.d l!* (( h.pr6 9, c.nm.Nins *ilh S.ction 70(x) of l)ivisiod :1 ol'.i. llulina\ and
<br />Pmldrnr ('od.)orrhd lEor rh. i.(mpl lh6.fion !d llE h6is tor rh. !ll.r.d dmp(nt. A.r\iol{ionofs.clnn 70115 h) !.t
<br />Eph(rnr tu rFmh subj6tr lh. lpplrs lo rcn,lp<elr] ornol ooErhs n\. hlNlr.d dolh! ( tt00)
<br />Laosk.lrh.Ir.Fn).ornr.hph!6nirt*.116srh.irarkcomFM$n.{1lldrrh.{ttlsdrh.9nrlEnrtn
<br />inrddd.l oi.fid.d for sL(SN 7(}1.{- BBrG Dd Pn,fdionr Co& nr ('odr.do.s ti<mF lr* {h6 rot qrly ro .n o{nd of
<br />rh. I'rFny sts hikt! or inlril6 rh6on. md $h).t'6tuch$!rl himr.ltor hdxllor rhhu*h hr or hd o\n drl,lo!6,
<br />prorid.d lhal su.h improvomr3 m mr inraddl or olfs.J Lr el. It kJ$6 d. !h. ttrildin! or imrovdmr i! $td kirhin n( \fl
<br />of(ompldhn. rh. 0"16 Bnitld *'ill h.\ c lh. t{rd, o[Fovins rhd h. or rrc dr, frn hlild or in{ror ( th(
<br />'lrFly
<br />lu lh. ri,lrrr of
<br />l. c orE oflh. Fopd!. n BchBr.l) colnciinA *dh ltda.d.odrdc ro odrud rlE Forcr (S< 7otl. 8sIK
<br />!d rhasi{ codc Th. contxro.s Lica* t * 66 mt 4pl! lo u o$ n6 olFoFr! $ho hliLb or imptorB
<br />'t'sd,n-&d $fio co Eds lm luch F.irl.q,nh. Con!(lo(!)ltdE d ru6@' 'o
<br />rtu C.it6cloi3 l.ic.e li{)
<br />lm.r.mpt undsSdion
<br />!qIlt!85:-CA!rfl:MAnA!
<br />DES.ABAITA!
<br />I hE.l,) ,mm un&r Fuh, ol FJu., om ol th. folhs in8 &rlsd ioc
<br />I hrv. ud will mintnin o Ccn,fi.rt. ol Co Fr r. s.lf lmuE ror tr 0116r' Lomtq$lion. s porid.d aor by sdr i,)n 17(x I o r rhe
<br />ljh.r (-od., for rh. FaollM(c otlhc wolt for {hich th. p6nir i5 i$ud
<br />I h.r. .nd tr rll oainr!'n $ olrd' omFetirn '6ur.ft., 6 ..rtuiEJ ttr sdr i'o 1700 of rh. I ibor ( od.. for
<br />'h. F
<br />rh. *!rt t, $h.h rha Fnn a so.d My *.,td- .omFMion imrN. csng an Fltr nuntit e.
<br />,,^ t ZQquel.r? ( c;,Su.lt- (6'.- ff> .t .,
<br />^,,o^,.*, H* - 98 .8D t 8{ql4 -i6,,",",'. D / { n
<br />I (difrth{ i. ih. Ftollrff. otlh. u'orl for uhichlhis pcrnil ir 6sGrl, I rhdl nol mploy lnt F$n ina.yru6
<br />s B ro t(m sl'i.cl ro rh. $it6'.on9.rsin l,*r ofcdifoni( rd.*c
<br />'nn
<br />if I .n uB lrroft tuhirt ro tl*
<br />u!rt6 @hFsrirn Fn\.b6 of Sdio. !70O of rh. Lrtd Co&. I Jull. fodh\ (h onply * i!fi rh)r Fnr tio6
<br />WARNIN(; F.ilur. ro m. trod6'onFE{lnn cor6!s. ! unl$tu|. ai tlEll 3ubF d mI'hts lo miMl tHsi6 tnd
<br />cnil nnd ur ro om hudtBj lhoNnd doll6 {ill{,.1no}. i. tdd ion tu rh. con of mFMrmn. drnrr6 rs lro ddl nr rhe
<br />SNkr 1o7o ofrhc LrtFr (i\lc iarF6rand*",5/E ,-
<br />DICIAEAIIA!
<br />I holb ifimu ]aFulyotpsj!ryrh,I m l,eBi rdd F.rirhn.l(try c (onnffiins tr(h s.dbn 7000) of Drts6n i
<br />of rh. BBi,B.rd Pr.faths Cd.. rd dy lr@ i! n tull torc. d.{l{r
<br />4/a/t7 *-
<br />D ca! a!(ftQrr,[!!Ml$[rc
<br />I hdrh, llfm uo(b Ftrlhy of Frlury rhd rhc. ir . otrrdrli.n knding .aocy ror lhc pdfolrrmt oflh. $ orl tu tr hah lhn pqmn is
<br />isu.d (sa 1097. civ. c.)
<br />AfTU(AEI.DES.6AAIIA
<br />I had, .rm ur& pqlhy ot Fjury oE of
<br />'h.
<br />folh$ine <lcclrdFnl
<br />D.roliriotr Pdmik-A3t6ro! Notilicirion F.dsrl Rcsuhlhns (Till. 40, I'tn6)
<br />r!a(.q!ircd tdl6 of Nrniltr.lbn
<br />lfcarir,! rhi rh. a.d6d Esuhtb6 r.gd,'ns sl'dd r@rrl -. n 4lPlf,dbt io thl! p$r.n
<br />Wz.ar lry rha t t*'. -a rr'; q'pli..rion dd !n. rhr ih. ib.v. hlotu K. ! cotrrd I lrrE l. Nntplt
<br />0d counr\ k, ol( !Ii,n rh.ord'nrncs rnd Srar. l-a\s r.lnthtl I buc r.Fsdrdn6 olrh* (
<br />"')hr. ,.r1trtrrrJ Inrrfn\ ln
<br />,\pplicrnl or ,l8srt Sitn.(
<br />thE z t ull.7>
<br />E/8/i 7
<br />TIZTfrIIDEF,
<br />| " Ll"tlr
<br />\-<r4
<br />I
<br />t
<br />AV LIEZ
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