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BUILDING- INSPECTOH BECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDER DEI,(ARATION
<br />I lEEby rliim u.'d.r Fn lrt of FrJory dul I d d.npr lirn rlE Cdidm Lie t r for llE rolt)rtl8 lgsn (Sd.?Ol l.J
<br />B6iBi .rn PDt*:bn C.d.)r Any Cny or Coun'y snih EquiEi. Fhi lo @nrd( !16, lrpioE. &tulilh d Er.n uy
<br />(Mr@ Fir to irr n!l)e, .!o '!q!io rli .pflid fd.nh Fmii b nL. riSrr.d sl.llmnl lltl ll or CE n lietrrd FrlMl
<br />ro tl! FovihB of tlE CdE r6i Lih.rl L,p (Cl! ro 9, Col@EinA rlh Scli,n ,6, of Divirb. I ol lll AutiFs anl
<br />Pbfc*bns Cod.) or rlq tl or dE is .r.,pr rlIrclrum ud rh. h$i for rtE nFs.d .r.nl|,{i{ Any viol{ir. or S4rion 7011 5 by -y.p?lar for.FnnobilcrlE.fpltdror.iviltEEtyorrrmEfiqiv.hu'nEdd.,lE!(t5m)
<br />-1.
<br />s owF of llE FaFry. q By.rqrloF.r wnn *116 r llE -k onrp.di,.. w ld,0E wt!dllt $ER ir mt
<br />i.rdri.rl or or.Fd for sh ( Se ?044, Burix, and Pr.f6sbB Cdc: TIE Conrsrr'r Lin* Lrs dB Fr +?ly b o owEr of
<br />rlEF0rsry,tntlil}diqffidEdrudwhod6Bhh.thi,MlforlEftlf,ftoui[hitclsoscrTlo!6.
<br />Fovi,.d rh.r sh lqrlftn! E d cid.n qotuld rq nt lt ltrE rtE hi!!B d in!6wd n !.id wthn m F
<br />or@.q,htioo rlr Oftr AuiBd will hr ir hldd 6f FoinS thd lr 6r .r!. dil ni hoju or h{rcw dE FqEly lor llE notpor ol
<br />-1.
<br />&ro*E oriE F{Eny. u.tct3iwly.qrr-th! wnh lit.id lfidm b od'rud llE .,oF.l lsd 7O!4. &!iEs
<br />.d h!6r,in Cod.: Thc Conxrror'i Li!!ri. L!, d6 ftn lPplyro m6w6 otproFd, wrh buildr or im?mEr rh.rcrn,
<br />nd lin onr.ds fm uh rmFcrs *nh I C. rro(, lt nEn plrlur b rlE Codftb r Li.re Lr*)
<br />-l
<br />!m.&niF uid.r Sdion-. B ar P.C rM lni rabn
<br />Drt.: oM.r.
<br />!rcaslilstg.DlfrN.tlrQN
<br />l,uicldaArl!]li
<br />I h.rby lfltrn und.r lEully oI Frrury orc of rlt ftnL,win8l^( l,r!, i,,ns
<br />-l
<br />hlr snl *iU miodn d C.nif.d. ofc6n.d b sdHn@ r.r wrl.B oEFnidion. .1 Fovd.d for by S..lnn l70o o( rlt
<br />Li&r Codc. fq tli F tu of th re.t fd rti$ rlE Fmi ii b!u.d
<br />-}r*.na*,tt-ruln**.n onFa$.rEn Nurft..8 cqlr.d bySdbn l?m of E tr!(tr C!dc. fd rL p6Im. of
<br />llE u fn *hi(h ltrii Fnil i! trrd M, k'l6 NnFd.i 'nrlllrm ffi .rn FlEy Nd$6 E.
<br />"* thrrx lz;t
<br />Lr'nfuaK1'a7,,**, 6 'L l
<br />-l
<br />c.nifylld in rlf FrfGflLr of $. e ftr*hthlhirFdr h iltucd I \hru d cnploy rny Fsn in sy lEE
<br />s rr ro bc<ft tubF.r ro rh. w(t6 onp.ndkrn Lws or Cdift,mi !n .8G thr if I rlDuti h..or enrcl
<br />'o
<br />rlt
<br />Mrloa conqrrqlhn rmvishB of S..l6n l?0o of lhc Lrhor Cod., I tllL fonh*ith d,trll)ly with lh.. tmvirimr
<br />W RNINC iriluE lo rm qrlda onFnelio. omrE ir !.L*r!L .,n lhx $bt{' r drt'bF lo cirin.l FrrB.tn
<br />.ivil tuB uf ro.nc hunnrcd r,r,usun dolhh ($llr).i)o). tr, rlirtr,n , rh. cod .r coryEns'on, damtcs r. ,rovdcrl for ltr
<br />!61i'n 1076 or rh I rhgl C.it . ur
<br />D'r': 111ol'"' Lr(:Frtsrrl clrNTRAcr{}R
<br />D&CIASAIIO!
<br />I lEEh, .lf,n undcr tEfllry of Frry lnr I m liu!.d ur&r Fornb. or Chr0rd 9 (enjmD8 rnh Sclion 70(Dr ol Divilion J
<br />ol rh. Burims and Pmf.r<iotrr Cod.. r,n my liccN. is iI tull for rin cr'rer.
<br />L- l"/roVI 6).
<br />l.),-rrnrrl'\a/
<br />coltlxugxlli.LB.aMJiBrl
<br />I rEElry afrm ud.r FMlry or F Ury rhd t,EE n. odMd Enins.scEy nn rl! Fforll*. orrh. krt fot rtih rht Fni ir
<br />n!u.d (Sc.. :109?, Civ. C )
<br />knrtrr Ad.t6r
<br />AELIQTNTTEIIJXAIIO!
<br />I Hry rtrm un&r Fnah y or I'.tJ'Jry oft of rli fDlheinS .k<Lnrbns
<br />D.mlnio. Pcmir A*.(aNdiltdiri fddrl IGg!,i irnr (Tirk :r0, Pd6)
<br />-R.{]uiEd
<br />Llt.r or NrifErli'n
<br />-lccniryrhar
<br />rhc ti.rrl rcll]hrlr. Es&ding astE{os tumvaldc mt q{,la0hlc ln lhn pmiiIl
<br />_l cdily rh|t I llw rcrd rhis appltaiion and ,!r. rhrr ltc sh,k anromr bn ir col6 I .gN lo orrly wnh rll Cir, !trd Coury
<br />oiliEN( rnl Sr.r. tl*r ELrirA b h{illin8 btr nn h.Er,, ldbrie EFrrdiB ot rhir cir y .nd coudy to mrd upon dE
<br />io\t mnriJftd pmFny ni
<br />tL
<br />App{ t or &61Sh.llE
<br />P.mltElm(Fltrl):
<br />tlu .-L.
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Boof Sheathinq
<br />Shear Wall
<br />Framino
<br />lnsulation/Eneroy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coal
<br />I\ilason ry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enoineer Final Report
<br />Flood Zone Cerlif .
<br />FINAL /-l '' /zoz./ -"4r1r/a
<br />Certif icate ol Occupancy I
<br />Notes, Remarks, Etc
<br />Rev.08-07-2015
<br />Set Backs
<br />Subf loor/VenVlnsulation
<br />D.'s l!/
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