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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
<br />I h6.try !ffm und.r p.adly of psjur) thd I m cicmg &on rh. Con{B.lon Lic.M L.w for lt. follo\io8 ,q$. (sa 70] L
<br />Bunld a.d Pnf6s.i Cod.) Any Cn, or Cou y whi.h rauic . FEi lo a.nru( ill6. oFovc &hlirn or lq.tr my
<br />iflln& FE. ro rr! isleq.L rqr@ lh. +?tiar tu*tFr lo fik. t'i".d riorEn Ot lEo. tlE it lic.lE n FElr
<br />ri rh. F.vtbB ol E ConFrror'r l,aq!r.d ll* ((rlprd c. ConlljkE3 wnh SalDn 7000 ot Dirubn I of th. AailB rd
<br />Prcl6'o8 Co&) or thll lE d 3h. s .rdF inq.non !d dE b.ri! for lh. dLs.d 66ngio. Any violdion of Selbf, ?011.5 by uy
<br />ippli.et for r p.mit subjets lnc lppliclnr lo r civil pmhy ofnor oorc rhe 6!. hu.dr.d doll6 ($500)
<br />l. B o$d olth. p.pdrt. or my dpb)6 utn s'.96 d lh.n sE.ompoBrF( tril do tlE *dr !d dE rirtR. ml
<br />idoid.d or ofis.d an sL (Sa 70r,1. ltuiB ed Prcf6joE Co& TIE codd('t Iire ls ita 6l {?ly ro - oqE of
<br />rh. FDF!y vh tukh or i,q!\6 dEo( r'd wl'o dc sh wrl hiMlf or h6*laor rhmuSn hit m lE ou ripbr6.
<br />Irded.d rhd su.h imFwuEml rrs'.t d orolIald ftr$k.lf, h.wM, dE trildry or ihFo\€Ei Eeldwihiioi.)a
<br />olconplrion, $E O*nd Buill6 {iU hlr dE ha&r ofF.vi,g $r lE or ,'. did Dl hiild ot inPiov. fic FDFiy aot LIE P4oc oa
<br />L s ogc of tl. FoFry. m qcluiv.ly codrrllls wnh lic@.d .olftt6 ro @tu rlE FoFl lsa. 7044, D'ti6
<br />.,ri PFto imCod.: ThcCo rrolt Ltoq lr* d€ rcl pply ro s ohE of FoFl, who b{il& ot inFDtd llEon.
<br />&C who .6fln $ for such Frjdr wirh r Co ndo(i) licd*d puau.,rl lo lh. C.ntrdoa! Lkru U*,
<br />- -l o.rofl uld sdi.n-, a & P c lor th6 @n
<br />Drr. __ 0'16:_ _
<br />]!OAf,ESiI;OMfjNIAIP!
<br />PEqJAAIIQ!
<br />I hd.h, .faim ui.!a FEly of Fj,ny oE ofllE folhwirs d.ih.r6N
<br />I hrv. rn *ill i .h . Cqrifrca. orcoelr ro Sdf.l6e fd mrl6' of,pddi,E ! Fov'd.d tor b, S<t6 1700 onlE
<br />t bo, codc for th. Ffolrffi. ol llE wort tor *ti, E Frnn a is.d
<br />I hrv. ud sill midrin wortd codpcadioi iBuruq d r.qun.d by Selion 1?00 of th. Llbot Codc fo. lh ,rfo,rje. of
<br />D
<br />DqDn i uEd Mt [ortd cofipqasEn vuu. ffir d polEy.dbrtctv(\r/yr&.(K 1l+ Lav'- K
<br />c1* 6pk 17 rL Frpfr. . 6l / > I 7
<br />I cdit thd h rh. Ffolrllec of tlE *ort tor vhih rha Fmn 6 au.d. I th.ll ml dpby uy F$. i! oy nmE
<br />b B ro bdoft rutidr ro dr *od6 otrlFson LB ot Cd'folu &d rsrE thi if I 3lDuld b<od tubd lo llE
<br />*0*6'coDpaqrio.provisioNofsdionl?00of!h.liborCod..IJull fodhsnh 6mplt wnt rhor FlvtiB.
<br />waRNlNC t_.iluE ro EW wrk@' coopquar'on Nvd,sc ir u.Lwiil ed rh.ll lubjd d o$loF (o oinin.l Frni6 tnd
<br />b onc hurdr.d rhousnd dolc {llLr),ooo), in addntun lo lh. cor ot comP.@xoi, d,h.3d a F"ovid.d aor na
<br />::l:"':"'i'?ii;1 L Y{-'zqla
<br />IECIJEAIIaN
<br />I hd!6y rlrm undd FEn, of Fjuy lhn I m liG!.d un<rd Fovi.(,. of Ch,p{6 I Goffiin8 wnh Sdbo 7000) oa Divilio. l
<br />.f llt BBnB rnd nofsi,6 co&, -d ny ltaE ir i tull foic..!d.{cl
<br />ror(EZ f?-tt{t tq;,IL **.K ar-^-?e-Z-
<br />(alirBlJcllolJ.llDllc.Aq[B(x
<br />I tsrby lmm uodd Fuhy o f pdlury rhd fi@ i! . .odntclion lcnding lsocy lor lhc Ffomft. of lh. mrt for which lhir Fnn n
<br />tru.tl(sE. 1097. civ c.).
<br />attllcAlr-lEcl.aaalra!
<br />I hdlbr !r!h un& Fnrlry or F,u'y oG 6a rh. lollos'nB dELrn bE
<br />D.h.hbn Pmir3'Arb6r6 NoiifK.tpn F.d€rl R.lulllm lTnL10. Pu6)
<br />R.qutrcl Ldr6 oaMtiftdion
<br />, I ccr'ry rh, rh r.da.l EBuh bN ESrdhg !tdn! mvrl !. nor @l(.bL k' I hir ptuid
<br />. \Lc/
<br />Y I (cri rld I hat Ed thir .pplrdEn td r.rc rhi rh. !to( 6fotu6h t o16 I t€E to @npl)
<br />ord'mn.6 md Srar.li$s r.Id'nt h bu
<br />atF\c rmrkrn.d flolEnr for inspdrrc.
<br />{ppu..nr u.Aaol stdum:X
<br />Pmnrune lprinO: K
<br />ildrs cirdndoMd hdb, .dhoM .!?.cn! tr6 oarhi! cry
<br />\P<rt-.-*--c2c< D,.
<br />\_\o c^ v^'---.LC7 c'.--
<br />!d Counry ro dr6 upor rl'.
<br />.t7 (G lt?
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />Subfloor/VenUlnsulation I
<br />Roof Sheathinq //Ao- F)
<br />"(Q
<br />)o *
<br />Shear Wall
<br />Framing
<br />lnsu lation/Energ y
<br />Drpvall
<br />Ext./lnt. Lath
<br />Brown Coal
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif .
<br />/\
<br />FINAL 1-v-74 \]TLI(I
<br />Cert ate of Occu n
<br />N arks Etc
<br />lrd
<br />at
<br />0
<br />-t
<br />UFER Ground
<br />//2dJiln- n,/. *1//,^il . ?-/.t,t*1,'n 'tb tbts ,
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