|
BUILDING- INSPECTOB RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />Rool Sheathinq
<br />Shear Wall
<br />Frarninq
<br />lnsu lation/Enerqy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enoineer Final Report
<br />Flood Zone Certil
<br />FINAL
<br />Certificate of Occupancy
<br />Notes, Remarks, Elc.
<br />(r\t\tr lt( ll l)l.R lrt:l.( ,\RA I los
<br />I lsrhy .rltm unLr FBlry .)l Frrrry rhn I s cr.qi ln'm rlt Colrr*tB Li..n. L.w tu rh. h[.vns Es (9. 70] l i
<br />aunn.r( .d Pnna$!|n Car.): Ary Ciry or Counry vh.t tqotrn . Itmr r,, d'tr{er. rltd in{mYc. d.@lirh or iclry v
<br />nf,Etur. rntrlo rr\ surnc.. !n. rcqum! rh. altlrer tur<kh IEmn 1,, riL r r8n.d d.rcmnr rh.r ltor {E is lLtnql tiul\Mt
<br />b rh. l'olr$nr ol thc Cooll!.rd r l-rcnEd llq ((1rpid 9, Conmfrm3 w h Sdodn 7(m ol DrvFon .l .f rh' Bunmsr J
<br />!h{.lr.n\ CcL, d rh.r h. or rlE ! .r.n{i rtftlton !r.l rh. hltn nr rlE rlklal.rmdnf, Any viiLlrnofselrr 101I 5l,v rnv
<br />$dMd rN r Fm'l rul'Fl\ rlt q'd...t b r('Yil FNlryof r m,E lhrh fivc hunlFl dousr (!t{x,).
<br />-t.
<br />a! own.r or rhc p.,tEny, ,tr my .nlploy..r w h qu.\ rs rh.u v'1. $mFns.r nn. v l d' rlr *st dr] th. rrtur@ n
<br />dftIri tnnfl.Gl for !k(St rua4, Bu{tr( rnl Pn'Idronr Cqt Th. C,'.h.ttr'r tFnt lir tl&s nor rfrlv io & owt 'lrh. tn,tdy *hl h{ildr q !qn,B rh.F).. .rl whr JtB uh h{t htmelf or lEEll dr rh^rfh nr ri h., o*n ..q!t"e!
<br />nnrvddl rlur lurh mlln,wmnk e d id.dal r on.Bt fot BL li lbtrw. tlr tlrlinS d ,r{mEmnt ir $! wl}s uE Fa
<br />o( co,{lcrnn. thc owmr Bufii.r slt hrE ltE bunLo ol lF,bf rhzr rE or sh. 'jrj n, rtu'! ot r{mE tn. I'nlltn! tur r PUrPE I
<br />t. .s .wf,r ot rh. oottn y, rr .\.lurkly ro.trrttr9 w h lE.tr{d .o rr.in. L) (,nslrucl rh lrl,r.r ( s\.. 1}r4 Buurs
<br />inl Pn,kr\rD(iiic Ih.(i'nrr!.!tr't l-'r.n\. 1-!e docr tror {tflyn' rnowi( dl Pnlp.ny who hu'll< or rmlovci ihcr.on
<br />.hl uh) lutrrdrl,tr \khtnFt *nhi(tnrnrn,n! lx.nqJ lNru.nr r,rh.Contrr, r l-f,cnt Lt*l
<br />I anr.\c6plunJer S.cr[n-. a &Pc ldrthr.crun
<br />WORI([R'' C(IITPENSATIOI\
<br />ITESITBAIII]!
<br />I h.r.hy rllrnnn&r Fdlrrdl lqlrlry oE ol rh. n)!k)wot JRhrdi)nr
<br />Ihrvc,I!wrll nui' rsr(-.nitL cof(in{ b Sclf lnntr. ttr 'drk.F' .$nqtn{t r{ {t Il rrLJ n, hvSelk).lTltlofrh'
<br />Itrtxr(ixt., tttr rh. Jl.nomnr. ol rh. *o* n, whrh lhcll.mnr R rntJ
<br />V4.f.* ,-, *r, .-^." *"*.n d,mFnur.n ns!,rn.. r\ rcquu.r h, s.(rr$ r7rx).r rtr rjrx, LGk. fttr rr. Fr(trmec or
<br />rhc work fitrwhrh rhr nen.r,l rru.J Myw k.i( ..ml'.nsrr( merd..{rr nl F,l(y nuntf, r n
<br />,*., ?lwtLv i LAm zsY\ Lt+r,,,r,y",-u-,-bJLSP4(rS---'-*. I t fr l2.ozo
<br />I( riyrh.r n th€ Frlllrtuft. dl lh. *.rk kx {hrhrhnF.mn tr r{'cJ.I rhru .r{'t'v inv Fron 'n .rv mnmr
<br />e, rrn'h.rom ruhj.lr tr,rh( xdc^ onfEn\.|!!. LtwsotCrhli}mir. lnl +r rrur.l I tbuu rhom llhFr ntrll
<br />*n*c6' (tr!p.n(d( Dn t]s)vr[n\ ol Scrri(,n !7(Xl .t rhc ljhtr Cnt . I \htrll, nfl h] h ..n'flt w(h rhr€ lmvstr'nr
<br />WARNIN(; l.rturc lo strc rortc .rnFn*rx,n $t.h8. rt unt *ful. .rJ \tdl ruhFl in mnl,v.' r' .nm,nrl I'cnrlrr\ lnd
<br />('vrl lrkl ull r) {F huftlkJ rh'uQrl llnlIr r3l(t).lr]0). ,i dJ iD t' rh. ..( ol .onBnr.rtr'n. J:ro3.r rt f vrl'J l0r rh'
<br />\.(rtr l(,76 0r rh.1Jhtr( !il. (rc(.'nJ.titrrt\'\h'.\
<br />lL'.,\ot ftr,e*.t
<br />a[Cla8allla
<br />I n.rcby rlfim unJ.r Fna[y ol pcr]ury (hrr I am lr$kl unLlcr lr'v5r,h ol chlltcr 9l.ommtu6! r(h s.et,,7(xx}) 't Itvtrk'n I
<br />d rh. Buerc$rrtl Pn,f.($ns(iiL. rd nylf,ci{ tr m fullktr(. lnlcll..r
<br />Cto
<br />,"* I I 4 | LL)'Lo
<br />coNsrRL,cl I(rN I lr:\Dlli(; a(rlll\cY
<br />I hcrrby rltu unJ.r t^..nrlry DI l(qtry rlBi rlrr r 1 $h<n( rr{r Liidurt rg.h! ii t rhc Ii rlonDt. ol rh. rolk it ehth rhn Fmnr 6
<br />trltLn (S<. tog?, ( rv. C )
<br />APPT ICANT DFCT AR TION
<br />I hdrtl} rn'mru cryEnrh y.a FrJUr y or ol rh. n,lh*tr,3 Ja_bri( i)nr:
<br />Ikm,tii'n Pcrn r^rb({os N.hfr K,. F.dcnl R(3uLli'n\ (1t1.41), Pd6)
<br />Rr,ltrtrnl t.r(r.l N!rLlL.itrtr'
<br />l.ot'lrrhzrrh. f.&rrl rcplt li'n. EErJ'n3 ashc.tx(fr'v.la. ftn {dr.hk b lh^ prx.r
<br />V1[., ,,- ,n, , n^" -., u* i,Nr.irn' I'rr {. .,h.n ,r'c .'rttr. ]r,rn!.'
<br />itrtltrLUn.\.mlSrrrc l-.itr\ r(l: 'U k' htr'l(1tr'g Lon! nrd' i l ltreh) nlx
<br />r\Lotr(r I rl(le n,crny'ly * hrllCnyn.J("rnry
<br />rF.r.nr LrcsnlrhrC[yddGrnlyio.nr$ur)irk
<br />.h'vc Enr[En pn,Fny t({ mrF
<br />Appftx r nr A(enr sirnatur
<br />Set Backs
<br />UFER Ground
<br />,.,., tl al lzoLo
<br />--,.,,.tr((Nun,,*,
<br />qaaV<1e
<br />,".,*,". V\vtlltaol4fL
<br />,,-," t [{ ha2z
|