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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNES IUILDEN DELCARATION
<br />, lErcby .ntE unl.l Fdry oi F,rry rhi I d.r.q{ lNo rrE Co,ralin L'N L.u fitr r|E tuilowo8 r&,n (S.r m]l 5
<br />lllsncs r,rl Pnrr.sn,n CGk)r An, C y or Coonly rhkh r.qtriEs ! lfrd'r i, odrud, rlrd, imJrtrrc, J.nrnh nr qEir .ny(u@. ri, b i( E\xa.. d$ Erluftr rh. rJrLrdl inr rkh Jrrml tr fib u rqE1, sr.r.mr rh.r lE or nr s l.dtJ Frsrnl
<br />ro rh. F,vsi,N or rrE co.r*u \ l-rcrEJ tir (Ch.prcr 9, Cdnftn'n8 * h S-1rn nu) or orvtDn t ol llr 6urms r.J
<br />Pnrf.$h'M CoJc) or rhlr lE .. sh. n .i.mpr rhcErron .n i th. hlns ,.r rh. rlr.lal .r.hl'lu. Any vn .lion Df S.ri6n 111 I 5 by rny
<br />$tlKr ntr r Fmr rubF*r llr .ppl..nt l,' . .ivil Fdlry of mr mE rh.,,it. huBlr.J ddllts lltm)
<br />L rs .*rcr of Ihc ,,o!.nr. or ry cnPloF. wnh *dscs .! rh.tr sh !.mFnsron, w Jo llE wqt.rn l&ntulrs,n
<br />itr.nldi oroficEJ n, et ISe-, 71x4. Br{ar anrl Pnrl.sod Gll.r Tlr Cont&tt'! l-].c.{ l,w&Etn +d,r..noltrur
<br />rh. Fyd, ph tllt.lr d rrtnrs rh.c)[ !r] wb tlB qtr qtt h,relr or lEmlld rh^rah hls r lE ow.trI|tloycr-
<br />tovnc! rn{ su(h mltr\iftnb eftn dr.nlAl oror.tul n sh If. hogtw, tlE hlrurB or u{n&ftd n s wnhn(tr,sr
<br />ol $rlolcu,n. rh. O*mr aullkr sd ha€ r hiJ.n olF)ruu lhrt lr 1r rlE lrl [r hitl or q&E rtr F'tEly l llE Fq$rof
<br />_1. rr o*r.r ol rh. Fop.ny, rm.x(lurivclyc..rr!ctu3 wirh la.nrJ.oohrrnrnio onrhd rlE FrFl (scc. ?o44. Buimq
<br />rnl Pr)hsrrCGl. fh. C.nr&ttr r l.i..ns L,r ttrt .p?1, t' m o$d oI FoFny *h' burlll! or !,D^!kr rhsdE
<br />.Bl uhl lnnrr.lrr nn M..h tn)Fk *nh ! ci,no,ntrlr) l.meJ Flrur bllE Ci.rn.lqi lx.N l-*).
<br />-l
<br />m.rhl, onr.i Sari'n-
<br />lhlt _ ()sn
<br />WOR{FtLS' COIITPENSATION
<br />DEqLAtA[q!
<br />I kr.by rlltrmundd Fnllly IpsJuryrB olric n'll)*int Jelmronr:
<br />_l hrE dn w l md.h. C.niar.r. otcons ro S.lr-ln@ fq srtd .$ntEMioa .r FoyJdl tor by Sals l70O oa rlE
<br />L.trx cln., lor rh. Frfo*-_. of rll wt fttr *hi:i rL Ftui E lrsual.
<br />_l hrw.'i * l m'nl.r ufiqi .o'qEns.rrr rur.t.. r r.ludl hy S.t';D. lnr or UE L.bor Cql. in r& Fitu! nl
<br />l,E srr l,* ehrh lhs Fmr E BnE{ M, n ts LrnFNr[n Ellluc ffi .,n Frty ruf,rb.r e:
<br />Cuar:-
<br />-Erfe!:
<br />-
<br />-l
<br />r$rr, rh.l h rlE F lorNEr oa rh. vort I(n whrh rhB Fnn r dskn. I ndl u, .rqtt'y .ry Fr$n h rn, mF
<br />s, rsb h.Llrm.uhj.(r ro rh. w rtftr .lhFnr.rtrnr hwr olc.lilirmu..nJ l3G rhrr ifl shrlt t^uom.!bj.t! hllE
<br />*olt6i dhr.nqrir rn'vBi,.s oa S..ri'n .l?tx] ol rtt llht Grl., I drll tunhr(h .l'llllly *iih rh'{ F,titirnr.
<br />WARNING rlbr nr su. wtdi !r,n{r.srbn .ilvm3. r unLwtul. r,n ndl tul'Fr r. .ri{tl,F h daurl FeIs r,rl
<br />!* 6n.! x! b om hunlhJ (hou rl doll.h (ll{I).0(,(rr. m nldrlnn lo rh.
<br />S&rirn l(,76 of rh. lrh, (irj., i .rcs rnl drtormli l(r
<br />.ston, J.m8.r .r lhvrhl ntr !h.
<br />r,,d., o\ .Lo,Ll
<br />I)tgla.I.I!
<br />I ncr.lry rrrtn u4Lr FMn, ol Frrury rhl I rn lkrr€l uLl. Frvsnn.r ClI. s I Grllllll-os w h S&r$, 7(lD) o, D,vNon :l
<br />ol .h. Butms .nl Pbrcrnons Oxl., &i my lt.ns n h tull lnr( utn crl.c!.
<br />(.-?@ 1l
<br />o\ '7-D 'Ll
<br />c0lsralJgrraB.EdDlutilgE!.9
<br />I lErd,y.tltnu lcF hy.l Frrury rh.l ln* !. Lrndturion Ldhr rlcMy tur ttr Ffurta. ol'lE wrt tu !'luh llB IEnr !
<br />i{.x.d (S& r(R7, C,v. C ).
<br />lr' .i ! A.l&.s:
<br />-
<br />AI?IISAELD&CIJSAIION
<br />I hdrt?y .tlim undcr ncn.lry oI r,ury o'E ol rh. lilll,wm3 JRl,d krsl
<br />lXturltr$n Pcmtrr^lb.ttr M{fL:rrr F6L..l R.SsLr rB (T L 40. Pd6)
<br />Rcquftd II(crolNn icilbn
<br />l.dnlrh.r th.lcdcrrl Fgulali,or rcBarJrn3:\t nor Ed)v,l,c e inJ'lf,ahk !'rhB|n)Ft
<br />_l .drly rhj I h.E r.d rh! rmlurrr lrl n.l. rh.r rlr .hr inn mri,n tr cmr I .!G b .or{'ly wlrh rI C[] .,n CNnly
<br />oilDe.r .fl Sr.r. ljw! ELrlB ro toilrn! or li,,r, !,rl h6rhy .uh,E EF(r.liE ol lh,! C'r, .!d Coury ro drd lFn dt
<br />,",,ol,LD'21
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />Subf loor/Vent/l nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Enerqy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />FINAL J/-4
<br />Certiricate ol Occupancy
<br />Notes, Remarks, Etc
<br />UFER Ground
<br />T-Bar
<br />Flood Zone Certif .
<br />7-ZC2l
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