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BUILDING. INSPECTOR RECOHD
<br />SITE.WORK DATE ID/SIG..\ COMMENTS
<br />Set Backs
<br />Formsisteel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />Subf loor/VenVl nsu lation
<br />Rool Sheathino
<br />Shear Wall
<br />Framing
<br />lns u latio n/Energ y
<br />Drywall
<br />Ext./lnt. Lath
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />flaod Zone Certif I I ri /-o
<br />lYbilld*E WA\4 q A ib
<br />tl t, t A
<br />FINAL I btu[u fru
<br />Certif icate ol Occupancy I
<br />Noles, Remarks, Etc
<br />-t
<br />OWNEI BUILDAR DELCAT TION
<br />I h.rhy .Iltm utrl.t IEElly oI FrJUry lh.i I m.rr{'r fi!,o rlf G,nrrrn' ll.n( Lu fr dr nnh*in8 r.$n (Sa ToJlJ
<br />Bunnc$ a lkof.s!'n C*L): Any Ciry or cl,unry whrb r.qutrs d Fmt lo Nn(Nl, .116. rr{iot. &mnBh o, Ei{! m,
<br />(ru$rc. Frtr h) irs niu.k!, .tq' Equr6 rh. ry,liur tur luch lf,mir h lik . r*Nd n.hmnt lh.l l* or dE i. l'(ned [N.tr
<br />b rlr F,v5i!n! of * Conr*(ri lr.ni.d ti* ((ll.l{cr 9, (tl'mBnf virh ScrFn 7t[lr t, DtBrrn ] of rlr Bunrn ...i
<br />Pnr.$,,ns Orj.) or rlEr lE or str ! .r.q, rhs.6on .d (h. hrsB r rll .lk!.d .r.qitun. Aryvr)Llrrorsdru?011.5bymy
<br />rpPlkrnr ntr. Fmr suhJ.ers llE 0lplnanl lo r.ivil I'.Mlty or nol m,crhrn nv. hu lrcd loll. (isUJ).
<br />_1. r! ow. ot'ri lhFdr. or my.nVbF! wnh vr8.s a 'h.r $L NmFnqtrn. * i&' rlE *(i lrj rlt gdr@ s n
<br />dcfttii or olllrcd lor srle (Se 7(,14. Busfts ind lhnasions C[]c TIE ai, n ntr r Liucnsc hw &'cr nor lptly t' in o*8, of
<br />rtE In,Irny *h,lDi!]rflrlI)Krlmar 1*h,d-uns fi'ns.llo,lEell or rtftugh hs or h.r ovn cr{'Lyc.s,
<br />F)vrLi rh.r rkh ryn,wd! & ni nrdri.l dd0dql [r sE ll l$w. rh. hotllrE q rFoErtr I r*l *aho lF Fr
<br />ol ..r{,lti4 rhc O*Er Buius * l luE Llr tuLtr ol In vnA tlu tE d sh. drl tur{ b! d or ul{roE tlE |nIsiy nr ltr orlrls or
<br />L !\ owrcr .l rhc F1xny, .m .t lu$Ely conkalr DI wnh lr.n{d (onn{nr b d'ndto.r rtr F)Fr (S.r. ?O.trl. Aulm(
<br />a l i)rssi'n Cqjc: Thc Conrr&ttr s l,ic.nic l,r*,lG: nlnplyb n orn.r or lhFdy vh. hu,ldrd rmJ'ruv.r lhcrcnn,
<br />rh,t rho odEds tt! r!.h Frr(k vnh. Cr'nlr..(fin Ircnql tu.\uilt' rlE Conrr&rr't lr.n( Irq)
<br />_l am.rchfl !nd.r Sc(r!)n ,!.&PC tltrrh!(r(,h
<br />EAEf,IXS:C9IIIAIAIIQ!
<br />DECLiIAAIP!
<br />I h.mh, rrrm undcr FmlryorFJ!r, o* I rlr nnbwtr3 &.Lr.lhN
<br />I helc arrl s,ll mht.m . C.n,ri.rc of CdnEht t) S.ll.lnsurc lor sdql .r,mp.tr{ri,n, ss tmliLJ k, by Sfrh,n l7(x) of rhc
<br />llhrCulc,li'rlh. pct,rDLr ollh. vo linuhrhrhc Fmrr i\ i\rucd.
<br />-l hrE arl *'ll msru worl.B drmFn:.rno uiur.B.- r\ Rturql h, seri[ :lnn ol tlE Lrbr OxL
<br />li nsdi)n
<br />'nsu.rtuc
<br />.r,cr lrn F,hy numlE u.:
<br />_l r.drayrhrr 'nrh rtnnrfrft. orrh.pork t rhrh rhr Fnrl ii tru,1. I r
<br />!) r\l,)h(dnk{,Ucdn,llrc*,trlrF'con,Fnini,rL,w\ol(rJhlrtrtru,r,r[tc
<br />$rg,ly * h rhx In,!L\D.\
<br />rn{irerrr co6f. 6 unLetu th.ll ol,Fr 6 cqtloF ro rrrlrfrl Frl
<br />{ivul.l,'ll, \ rSl(xrrxrr}, r rd,ltrk)n I ron nr .onFn\rr(rn. tla
<br />Ftulryol r--r,!ry rh.r l.m li.ctr<d 9 (o'rftrm! wnn Sald rgnl of DMm t
<br />Dl itu Busnr$ rnJ Plr.sNni C,xlc. n, my licnr
<br />73?Eo
<br />I trrct t irrm u Lr Fuhy of Frrury rhrt rtft i( . ..d n, rE Fnrllfu^-'c of rtr
<br />D\&al rSLr :l(l)7. C'v C )
<br />knlcrr AJ&rs
<br />A.EELISAIiLDECIdSAIO!
<br />I lrrti,atti ud.. Fnrlry otFarury or of rtE foll'*nl8 &rlrlrnn!
<br />O.ny'l n'n P.irn FAih. orNol'l'(ribn falcnl Rqulrlons {Tn1..10, Pin6)
<br />-R.+r.J
<br />lir.ror t{{ i:r,n
<br />_l rcn'lyrlEI rhr laJ.ful r.luhri,ns E8ldtrr8 ash<^rcnlvrlrc noi Jlplrrhh n, rha !n'r.r,'.
<br />h!ftn,ry,h{ r h.r rc..r 'h! ,nrr.dF'tr
<br />Uikmr^rd ,nd s,dc L'{rrr,hs hh,rLIr
<br />:der I rire r,, conolt ,rh rll Cr y.,rr C,t.
<br />ol rhr C,ty ud Counryn' cn
<br />I rblc mnrhftJ,hFny n, hsF.xon
<br />Appli(rnl or iE trl SitMlor
<br />I ftn r( B&rpnno:kk-''
<br />ENIil,VD,,
<br />UFER Ground
<br />Brown Coat
<br />llLt
<br />Ihl.
<br />-I A
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