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BUILDING. INSPECTOB RECORD
<br />SITE.WORK DATE tD/slG.COMMENTS
<br />Set Backs ct (r lxo bffiE 7
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUlnsulation
<br />Roof Shealhing
<br />Shear Wall
<br />Framinq lot bkt>2
<br />lnsulation/Enerqy I
<br />Dcywall
<br />/6iDltnt. Lath It)I? I-ZL 2A *'5t
<br />'B-rown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enoineer Final Report
<br />Flood Zone Certif.
<br />-,L-A/I It{tt 0
<br />Certilicate of Occupancy I
<br />Notes, Remarks, Etc.
<br />I)WNDR aUll,Dl:R DIJ,CA|i llON
<br />I h.aby .rhr utoLr D.Mly of pftlry th.r I m .r.npr trom rlE Collfurs lr.e L.r lor ih. folbliI3 den lsa.70!1.5
<br />Bui6r rd Phr.ahn C.d.) Any Ciy o. Cody ehah Eql,6 t F h c.nce, .xs. ihFt, d.mlah d .q.i m,
<br />ltlrfu,Frrbdt l!@..to Eqli6 E {lp[.d foru$Fdro 61. "ard cr.eri ihrhdrE.lr.rEi Fr'd
<br />ro rhc F.virhnr.f tlr Coit-rdi l-iLred l.* (Cll.Fd 9, Comftrin, qth S&rhn 70m or Divhb. I ol th. BaiEs Dd
<br />Pn .sionr C.xLl d th:r Ir or rh. i! .r.r{,r rhdtnln rnd rtr bl$ lbr ih. ill4dl .r.nFi4n Any vbhrion ol Sarior r0} l.5 br rn,
<br />lpplionr f.r ! p.mir iubFk rh. rppliod r. . cvil p.D! y of mr mrc iu fiv. h{ndEd d6ll$ (tJll).
<br />_1. a o*Mr.arlr ,rrp.dv. d 6t.npt',r.. rth *.36 a rlEn nl. srrtldD., !i[ &' llE xlt rn ii {dE i d
<br />ar.d.r r ofi.rd rn r]. (s- roa,a. B6i6r.,ri Ptot6ri.B CcL: TrE Citu.1r'r tiae r,*.16 d.ppl, ro r om or
<br />rhl ploIrdy slr, t{illr or uqroB rlEl4 ar, qho dd sun sit himtll or lEElf .r il@urh hn .r h.r oH.rployEs.
<br />provid.d rhI.u.h in+mEEdr e mr id.dcd nofi.ed Inr!.i..ll,lN.E r huittiq c Epll)tE hsld*ihiioEFr
<br />of ranpLlia tlE OwE Builrd *ill h.E rll hrd.n of Flvin8 rh lE m iE Jil d tui! or iI+.oE 0E Fr,ldly d rlE Frroc ot
<br />l, $ owd or ill Frodly, m .rcluriv.ly .$flrdins rirh lr.n:al Nddr6 !r !{.rM rlr F)ir (Se. ?l)4,1, BMS
<br />r l Ptstusihc.iL. Th. Contdor'! Lr.o( tr* d6r re( lprly !, !n owEr ofpoFny who I'o,ldr or inpbr.! rhd&..
<br />rnd wtF odrr's f.r 'u.h pr.irb vnh r o)d*roi{s) lieii.d pu6d ro tll cotudor'i Lt.^* Lw)
<br />I mr.r.n'F u l.r S(!r
<br />l).1.
<br />lrcaff[I:.(1rilu:ulalltl!
<br />DT]CLAL{TIoN
<br />, h.r.hy aonoun&r Fdnyofp..,uRor or rlr hnl,wn8 &rl,Irutu
<br />_l hrErn *,ll midrh. Cdf.d.olcre ro S.If-l6m ft, k t6 !rmpdq.^.r p.!vij.d lor bysdih 1700of r
<br />IIIU Codc, ln rtE pqfornIr. ol rlr ed Itr shih rlE Fmn ! is.u.d
<br />azlfuk ud *rll Ddrii *oAfl lorpcMrDn rolu.,.r Equild tt Sdrbn 176orrll L,hor corL. ror r,E paro.rc ol
<br />rh. rrt lq rt!.h thn Fd i! NJ.d My rrtal o8FdD. ltllllld ffia rn IEIiy mr'tE E:cmr q+c,fu f"/
<br />z-/- ?/
<br />z'*ily thn r. rtr F.fmoe of tlE *dl ir rhrh lhi tE.dr D EsErl I :hrlt d d+b, rny tq{n b uy lME
<br />s 8r.ti..m$hr{totlrr 16 6np.Mhn |lqr.a Crl'rmi.. .d t.r rh, f LlDuU h.oE 4bFr b rlr
<br />soam {nqEnsr. pDv'*,a ol sdFn l7m of rlE L.ts (ixt.. I llfrl. ldhvirh .lrply * h rlE. povilDB.
<br />WAf,NING FiiloE ro sc h.tr6 on rn$rhn cowet. ! u.bwtul. .od ihdl rubj.cr r .mphy.r to sillwl FEhi! md
<br />!'v'l {in.r ut h om hunlr.i rh\u$nd dollM (llrrr.rr(r(r). ,n iJJ xr (o rlk ({ oi
<br />ItdEn 1075 of tlE tr6o. Ciod., hkFr Dd rbEri fEs
<br />a^
<br />I ltEb, .llirm uda FdIy oI Fiurt rhd I .m lh^r.d u,n r Frdrim orcrl.tid 9 (amrrint sirh Sdb! ?fin) ol Divnhn l
<br />or rt Bu!c,! .rd Protsoo Coir.. rn my l.lM ir iD tull foc &d ctrld
<br />b o 3c 3(I - t- zo
<br />Ih.Ehyait tr .rFnrlryofnrjuryrh,ih.ftnr.onsn'cri k' in! !!.tuy tu rh. f.rlomtu. of rh. M.k l.r rtih rni.s Fnrr ir
<br />r\u.dlS...lrD?,Civ C )
<br />AELICANLDECIdBAITA!
<br />, hody ltrm ufttr Frhy ot psjory oE ol itE follorin8 d.(Lnrio..:
<br />D.mlirir. P.mGA$.ios t{drr.dDi FnLol R.Buhrbnt (Tdl.lO. Pd6)
<br />-RalunBl
<br />I.t.r or Nir'f.rrr.
<br />_l &nni rhd rtE f.rL.rl qlLr nnr EBt diry a\h.sros Ennvrl E tu lDt arbL tu rhx pDJar
<br />F**-,,,r,,rI h.E Ed rhtr rprl..ii,. rn drr. rh! rlE thov. rromrbn n .@r I .!E ro r-rply yirr !n Ci y t'n Ced,
<br />!k ljws Elrrl8 n, h 'ldml tb'@ rt .rd.trB of tlB Cny.td Cou y66rduFhrlE
<br />$xtrc m i,kl nnrFdy lo! h{EdM L)
<br />aatftrgl
<br />!
<br />Rev.0B.07-2015
<br />FINAL
<br />6 z ? /l tS se'z'>
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