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BUILDING. INSPECTOR RECOBD
<br />SITE.WORK DATE ID/SIG.COMMENTS O\TNER BUILT}EN DELCARATION
<br />I h.rd,, rilnm uLkr trElty in F nlry rh.r I d crcry{ il,m rlE Codr*r(B lr'f,( Ir* lor ih. tull,owx8 E.yrn (S{.7Ull 5
<br />Bo;ikr! .,n Pn csi,n Cftr.r 4., Cny or C.unry *hith rcquu$ ! Frtur t' Lonrltucr, .h.r. intnnvc. &ml!h or EFr 6y
<br />neru..Frro 5 6rll*., s rcquer
<br />'rx
<br />rflrrm' for *h Fd b liLr nlEJ,r.lm h.r lEd.rr i! la.n*d olmlr
<br />ir llr Fs,ltDns ol rh. Conlr(ktr s l-tcnE! llw (Chu! cr 9, ComcNin8 w h SclnB ?un ol Divn!'n I or rlE Bunmst ..d
<br />Ptul.sxrns CiiL) (, rhl lr d {x a rt r!t, rlE .6om ,rl rli lr.!s n{ ih nk8.J .lcqrM Ary vadldln .l S&rnr 7Ol I 5 by .ny
<br />.ppliL. tu i rrmx slht .lr rh. .FplEanr lo . civrl Fn.lry ol nol frrc lMn liv. hundral dolld. (iJo)
<br />l. $ o*rcr ol rlE pmrEny. or my cmploy..s wnb w.8.r rs rh.r bh .rmp.nrnrion, w l do rtl knl lnl rtl (uft s mr
<br />!'tcll6i or liAcJ ktr slc {Sd. t(}l.t, BurBs.&l Pn,rcri,B c,{.: TIE conr&ir'r lr.n€ L.* &.! n, q|fll!n'eorNroi
<br />(hr F,tMy wh' hrius or inlh'rs rlEc,a ! wkl dB surh q,I hmiclf o. h.rclr ot rl8,urh hr o. lrr o*..r{'li,ycd.
<br />nrolrLd rh.r {kh hFrwd.e n d.ft*J dofr.rEl fr,.lc ll,lbk€,rlrhl sEd,4neftd sa rihinoF F&
<br />ol Llr{ihri4 rh. O*xr llurl&r w l hM t}E hml.n .I ln v'n8 rhd tE or nE Jn o, b!t! {x ,qmE rh. FId} nr dE lxrlr,. of
<br />_1. a1 owrr ol rh. ln,ncnr- rn .r.lu!v.ly .onrrrr03 * h liectrfl .odrNnm n, ..Nru.r rlE F'j.\r (sN 7tN4, Busm$
<br />.l lhfdthhCod.r Thc Conr(rr'i Lr.ns. tr* J(x. nor lptl, L' an ormr ol lroFn, *to hur[r trr,n{t,v6 rhda'n.
<br />rnJ wrr) .1 r&lsl'n rEhlrer\t!*nh.(odr&k,nO [cn..tl I'!^unr t, rh. C$k.!l,tr's Li(ns liw)
<br />-l
<br />.n.r.m uoLr Seliln
<br />raaf,Ef,troutElsallo!
<br />DICI.Af,AIIO!
<br />I h.r.hy all un unJ.r FMlry ol Frury or ol rlE l,'ll,wh8 ielu.r[nr]
<br />I h.E .ni *rll Eul.h . Cd,li.t. .l ConEnt ro Sclf-lrlu t, qfiq. (nFnsl[n, rs Frvll! lbr by sel$. ]7(xJ or rt
<br />lrhtr Col.. lirr rh. IErirm&. of lhc wort Iu wh(h rhc n rm !r atu.d.
<br />I luvc rn,l wrll mln {
<br />'n
<br />work.rr \ omFn\rr tr,n hnhR.. r\ '.qurcJ 6y S(r (,n :llro ol rh. Lhr (irk, r,, rh. FnnrIIIE-_. of
<br />rh. utrIl'{rhrhrhlFrh '\ tr\uJ Mt sdlo! !,.r{Etrurrin rnrurrrtc r.n.r.hl p'k} numkr dc.
<br />.--, 'Slak q-,not. qttrStr,
<br />-",",,"', -lol )[L\
<br />-l
<br />cn y !h.r r rh. ,Erf.rEBc .l fi. w.rk lnr qhi.h rhs IE hn N nruc!, I shlll not cndt'y rny Frsn h rny n.,mr
<br />a, rs tu b.{om tubFr b rlE k t(i $qEurnn L*! ofcilfi,ru, .'J '!N ilDi !r I n,u! hd'r lrhFr b ilr
<br />s,ll61 d,r{Eni.ti'n F)yNons rl4Lrb.l7(Dolrh.bh,Gdc,I3hru.,rnhw(h(imllyq hrh,Bn$va.nt
<br />WARlilN(; t.rlurc r, *m uyldi $nyx.qri,. (.rEF tr unLvtuL .!rl shil iubF rr .nltll)Fr k,6rurl FrlrA lil
<br />uivrl li..r up b oF hundr.d tlr'ugr dollrr (tl(D,000),
<br />'n iddnNn b rh. lds oa comFnsdon, drm8.r rr [ovrl.J n (lE
<br />Serrn .lll?6 nI rh. L.hf, C,rl. rrcEr .nl .n,fty', lc lr.lrtLct I t\
<br />lECtdEAUqg
<br />I h.tu$y !,lirnutuL, F.alry uf llrrury rhar I rh ldnEl unLr FUvsKn orCluO6 9Glljmtuht qfl Sctr,n ntt)J of D'vsx,r ]
<br />rl rlE Busms dl Pmfr$rrd C(iL. lrl ny lI$< tr d lull ntu rn c &l
<br />,-***ar.., '6 'r0 50 \-11
<br />e blL^l't-\
<br />(IINIiIBUCI,IaNIEIDING-AqEI.LA
<br />I lxrcl'y.llnnudci rENly or,r4ury rh.r rh... tr r ('n!klr)n LBlhr rlcmy tn llI Fri{rom. ol lhc *olk tur *hrh lhN Frmn L{
<br />,!\u.d rs.u llr7, C'v C )
<br />Afflt!$lt lctl&trM!
<br />I l-r-6y lim uiilcr l[trrlry of rr r rry '
<br />trrc or rhc ,',ll'rwmf Jcc hrar n\:
<br />IXnntrin, Prrm \ A\hr(o\ Norltrtrr$n Fid.r!llt.!uLrx,n\ I lnL {, PJn6r
<br />Rctuucti hn.r olN. i,rrm
<br />_l 6l' rhd rlr rdlr.l rcluL'ioB Ee.,{'n8 rrhstr rcfr,{l s. ftn {rl..hL b rh! |BrF1
<br />04 (6 y thi I hrE Eal rhs ltlrr.rbn nn srr. rh.r th. rlbE anfolmrDn r (mr. I +r t, Nn9ly e h rlt Cily rEl counry
<br />onlitutu.s ind Shrc tlw! Ehriry n! hullllil3 cotrntuxon, .tl l0.by rxrhro Etft-d{r6 or rhs Cr, rn Counr, ro .nr( ulbn rli
<br />rh^. m.nrk,ftJ Pn)Fnt,,n m\Fark,, Frtr
<br />lpllionr or ,\(ml Sismlu
<br />t,
<br />44o
<br />i1,y$ 1Ll
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulalion
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsu lation/Enerqy
<br />Drywall
<br />Ext.i lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />ll
<br />FINAL .{\ r ?\2,r.v*#f,
<br />Certiticate of Occupancy
<br />Notes Remarks Etc
<br />T-Bar
<br />Flood Zone Certif .
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