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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNER BUILDER DEL('ARA'I'IoN
<br />I hn.b lmrn utrd6 Fully of FJur) ltli I m .tmrl nnm rh. (ndrrloR l-r@ Ii* aor rh. followiry r.en (s( r0r l 5
<br />Ba'nRr nd Ptuts. Co&) An! (i!l or (budt shrh r.quic r Fm'i ro coldru.i. dtr. inro\.. d.tslnh d ,q{tr }rrlru.luc llilr 'o
<br />tu istr.. rto i.iiut6 rlE +dkd lM sh Fd !o fik. rrn d {dffir rhd lE 6r rrr i! lr.EJ Nmli,
<br />k,
<br />'h. Fr.rE or tlt co.triorr t.i.or.d |,tr (('luF. 9, Comtros u t sd{'n 7fi(} of Drispn I or 'n Blrlns lnd
<br />ItofRrirN ( o&) or rhli lE or slE ir .(dF ihd.fr.n rtl th. b6a a6r rh. rlks.rl .rmrrFn An! \.lini6, 6f sdli.n 70!r t h inr
<br />.ppli(&l tr . Fn( subjdls lh. apphcul to r ci\ il p.Mhy o f not mor. rho liv. htr.rlr.n (n)lld (t500)
<br />l.$o$noofrh.F.Fdt,6rmtmtloyhtrirhtrDs6srhcir$l.smF.ernn.*illdorhc*o dnrh.nnxlu.3nor
<br />'nrqicj or olIs.J for slc (S* 70t4.lrusin4i ind Proleci]B coJ.: Th. Gdrdor. l-i(ns. lr\e do6 nor rpdr ro an o\n6.r
<br />rhc pn'lElt wh. rldeor improv6 ih6drn, &rl who do6 nch \orl hins.lfor h6clf rrhn{8hhirorhroM.npky.6,
<br />p(!vt!.d rh.r iuch iml,orffirr tur inraxlsl ff or6d aor elc. lt ho*66. rhc h,ildiry or intrwt is sld Nihr on< ts
<br />ol$mpld$( rh. ()*fd au,Ud { ill h.\. rh. }xrd.r otFn\ina rh, h. or nE dn ml h!'U or rmFo\ c rh. Fapdry aor rh. purF,e oI
<br />L a o$ffi of rlE FoFrr, m .r.bn.b co, ,xrurs * th licdE d cof,r&1o6 ro codrud rlr r.lrcd tsa 7o.lr. &!u<
<br />dd Fotodi (-o&. rhc Cotu*rorr l.ic6r l.r* do. hr rp?l' ro eo$n6 orFotEI trho hu!r& o. inp.or6 rhda'n.
<br />lnd sh. 6dd! lor sh Fnrcd. {nh. ( ont*lo(, lraE d p{Nd hrh.( onrKm r Lic@ L!\).
<br />l rm.enp' und6 Sdiontl*ltT ,<
<br />D[llaxaua!
<br />I hdcl)tillnntr ddpdaltyoIpdjunon.olrhcrollnvin!d(larations
<br />I i6r. ,xl * ill @i.r!in r Cd ra(ar. ol (i,n6r h S.lllNurc ior sorle' coDnqlrll ion. d rrorid.d for by Sdnr" 701)otrh.
<br />l,tltr (i{.. ror lhc pqlo.rMc. of lh. sorl lo trnth lh. rqrnn b isucd
<br />I ha. .rd snl m.inui. \ ort6' comFNrirn 'Burrm.. 6 ,.qurcd t! s<l ior !7r, of lh. ljtF, Co&. ror dic Fn,Ir@c or
<br />rr. rlrl ,or qhah lhir Fnn ir isld My sorld omFldirn ,e@. cnid ,id Frr) n,nrE c:
<br />I(d,h rhd m rhc p.rto,nuncc.rrh. tr.{ fo. \hiLh rhn Fmn is i.su.J.I ill.or 6nplu r.y Frion inanymmn6
<br />s, a h &(o,n. suhjd to rh. $oltd' .ompdstbn rlr s of Cllifomis. aEl !{re rhir 'f Lh'uld h€rotrr. subjdl to rh.
<br />{ort6 compds.rion povisions of S&1i,,n l7morrhr l-ahr Co&- l shsll.Ionhtr h couply $
<br />'lh
<br />rhos pdirionr
<br />wAIrNlN(;: lailur. to sur€ worl6' comFn!.lion covftB. is onlo\rltrl. nml slmll ruhjd M dnplord ro dminal lErilli6 {nd
<br />.trn fin6 up k' on. hun&.d rhoMnd doll6 (t1u).00o), in 0ddnion lo lh. (osr of.omp.tr$rio.. d"roA6 as poidcn nn th.
<br />\.rrrr (r7(.f rh. Intrtr Cod..'nh.< 3DJ dt,nk\'s li$
<br />J .L
<br />DE(JAAAIIO!
<br />I lEcl't rlTm !n<ld Frny o( F]ur] rhd I m lkd!.d u.& Frttn ofor4r( e ltumn@ins $nh s<rio. 7(x[, .f l]ir 6h. r
<br />of rh. BBilB md Pr.fd6B cod., a'd ny lrc ir I tull tore &xl.lIrt
<br />L .rr.. \! nt\r
<br />(AIIItrUCIIONIEND.IIC-&CTN(I
<br />I hd.ty.rnn undd rarlry of Fjuo rhd rhd. i!, conrrudion lcsdds rsdcr aor rh. Fto.IMcc otrtu N* aor *ni.h rhis rnnir B
<br />Btu.n (se 1097. Cn C )
<br />APPI I(-A A Df,CLARATI(IN
<br />I hsd, rfm undd p.n5h) oaFjury on. of!h. folLqint d(Lnrio6
<br />lhnnnion Pdf,nsAsrBros Norificdion li.dd.l Rqulal
<br />'onr
<br />(Tillc .10. Pan6)
<br />R.ltun d Ldrddf Norifmlion
<br />lc6lilvrhd lh. f.d6olrquldions rcrddiir.rlEtr rdo\aldc nor iprli.ihl.n, rhn I'i(id
<br />I.d'h rhni, Mv. r@d rhli 8!pli.$on Err dlr€ rhd rh. atn\. inforftr,on 6 (otr.d lnf,rr r..ompl\ \'th all(\r) od (i,unr\
<br />ordiMB6 rnd sur.l.*. Eldi* ro tuklm* cNrrudntr rn hs.it ad -W:orltn Cil) lrd Counlylo 6rE uFrn llE
<br />tb\. mdl$n J p.oFn) aor i6ldFn p{rIFG
<br />'tpDli(.nr or,\Edr Shn.ru..Nf)t*hq: I 2a
<br />,,,,ff 't/ r 7
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf Ioor/VenUl nsulation
<br />Roof Sheathing
<br />Framing
<br />lnsulation/Ene rgy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />!!asonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />lgpqty Final Report
<br />E ineer Final Re ort
<br />Flood Zone Certif
<br />D
<br />FINAL h*l'l-l /vt,wlt
<br />Certificate of Occu n
<br />Notes, Remarks Etc
<br />Shear Wall
<br />I
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