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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNE.A BUIT-DET DELCATATrcN
<br />t hr.rry rnirn uRrd Fndly,'( F,llry rhi I m cr.n$ ritn trE Conrrrtf' Ir.n. LD n [E tult *os Fr$. (S& ?tl!l5
<br />Buioc$ rn Prolcsx,n Cinc): Any Cny.r CNdy wh.h EquiFt r rmr lo mnrd.r. tlls. inlroB. &frnlh or EFr uv
<br />srrucrurc. Fxtr ro irs irsurtu., rl$ rcquiEs lh. {Tltrrnl li)r ruct IEmr n, 6L 1 sisnc! n .ftnr rh.t rr .t dE it listrcd I'o.tuur t
<br />ro rlE F vs|'nr ol rh. C:onrr*tr r Li..n$d bw (Ch. .r 9. CosExrn8 qnh scron 1xr0 oI Di,i!i,n :l ol lh. Burirrt rJ
<br />Pnn.{rur. (iiL} d rhd lr u itE Lr .rcqr 0E.rn,o dl rr. b8. fd ttE .lh.n .r.qrx An, vDLi$. o( Ssrrh 701 L5 hv rny
<br />{rplr.nr l . Fn,l suhj.rlr rlr rfltlldr k, r ov FMhy or mr mE rh:n 6v. hunJ..n J.Ut\ (t5O)
<br />l, .. owrr ol rlE rr.Fny, Lr my .n{thyc.r }'th *rs.! as rrEu vrl roryEnql $n. wru Ljo rtr ed* ,rl lrr (erE ! n
<br />inrcnjGj or.ii.rc.t 16. qk(Se.?0a4, Buctrs trl hnc$r,ns CBL: 'I h. O' ncloi! t,x.n* lrw dGr n.r {'r'lv ro owmror
<br />rh.pnFny ulx' Itril& or urF Er rh.6rn..r wh' dts sNh u'rl h'mtl, or h.rslf.. rhmuSh hit or h.r nqn cmplov..s,
<br />I,DlrLJ rhrr rkh mlnr\{*n! e rn inknhl (0116] ftn sh lllrrxkr,rtEl( 13 rqmEm !w lrnh6mF{
<br />of la,q'LirE rrr Owmr audk *Jl h.k rlE hnr!.t ol FDE rh, h. ,t rtE !i tEr t!'! d nqmE dE F lEl, n, th F,FE ol
<br />-l,lsnwfrr
<br />dl rhc F)I'ciy. !n.\(lonkly ronr&rur3 unh lcctr{J L.nrM^n) ('n{n(r rll nflFr (S( 7Or4. Bustr(
<br />uil t1 .snn C,xlc Th.Conrrr.ttr s l,iccns. lr* ,n,c: fr, ronlyn,.nown.rofrn'a.dy wh' hurldsor rmt0vc\ rhcrcon
<br />.nd wh{' .onrrr.kl,y\urh!.'r.rs*irh.Cin n'(r'n 9 li(n*J ttr^unr i' lhc Ci)nra.rtr r l-t..sc lj* 1.
<br />I mcr.mfl r*].' S..r.n-. A tPC ntrthNr.{'.
<br />D.r.
<br />-
<br />off-
<br />IYORT(FRS' CO]UPENSATION
<br />ITEIIIIMIIAd
<br />I hcrchy rlltrn, un,lcr F-mlry ol ttijmy om o,lh. rnh*rt Lt(llrrrkrF
<br />I h.E rn s'I muru ! Cdf.d. olconql r,, S.lalNuE nx *tr6 .o'lltEnrrnn. ar Fovrlal in bv Serbh 17fl) ofuh.
<br />bbd Co,.. lq llE Fri,lr'l|G of rlE wt td *tBh llE Fmll ir !.eJ
<br />I hry. lll w'llnrmr!6 slrt.rr.omocns i,n NiL,(c, r\
<br />rh. tri r xr *htrh,hr n rnnr,\ r!r,l MLgo,lfl ! !'intn n.ir
<br /><-6-€/ -[t^v^..r
<br />rctluft! hy Sdrr)n .u(,(l ol rh. ti&r Gxi.. tu ih. Fnolllet ol
<br />k'n hstr.Bc .dir dl Fn., numhcr el
<br />)--cfr
<br />l.cniyrMr m rhc Frfortunc I rh. *ork ntr *hrh rhrllcmr tr 6ru..l,l sh,ll Bn .hfk,, !n! Pcron t.{y mrR
<br />* *r,h.$N slhFrl Iolh. worlGi or{rn.ar i,n ldwsolClhtlmm. sn.l aSftrhdt I rhnrLl **om srhl.rr!,rh.
<br />soit.r."n{En\.lhnpN!Ni,i\nfSeronl?0O.llhaljhorC,rlc.l!h:lltudhwh$mliy*irhthd$Pn)v!tr)n\
<br />WARNTNC: Ijrnt( k, <cw vft.r $qrnr.rnn $v.o8. n unb*ful. a.l.lull .!hr(t .n cmploFr k' l:mml IEBlEr.nl
<br />.r lirt un !r r hudrcd rh'ur8l Jolbri lsl(x),(l()(l), r rllnin r, rh od .l ..6IEnerD.- 'lrE!c<.r Frv .J iix rh.
<br />s(ri,n lrrh or rlE bhtr (,rj.. Dr.m{ ' r[ff]'rl(1
<br />DrL,- {!orlol:-r-rcnrsffi
<br />IIEIIJEAIIA!
<br />I rErcby.lrsn d.r Fn:lry ot Frjuy lh.r I !n ll!.nsl uELi lnrvs.n of Ch+ra 9 (conn.Brs rirh Ser i.i nxl(j) nt Divtrr 'n I
<br />or rh Au!trs !n Pmfsrirr CcL, rd my l..nt N o irl ro^t,rl.ffer.
<br />_L,ccn!c Nun'lrr \ tE-.\5 C
<br />CONS.TTU(]TIoN LEI NG AGFA(-I'
<br />I h.Fby rlltm unl.r Fully ol Flry rhi rlrr. 6 . onrlnrlD. kftlDS rtdy fd rlE F.litu! ol rlr qrt [u r,tEh rin Fnr u
<br />n*J (s( :1097. crY. c ).
<br />Alg,llANtDEllllarlt!
<br />I hdlty rllim unticr lctr.lry ol I'.ttryok of rh( !,,11'!rn3 J(lrlti nr:
<br />D.mohrrrn l,.rnnrs^slrnot Nor't'orirn Fcdcrrl R.SuLronr (rrlc 4r). Pd6)
<br />_R.{tr .(l Ir(.rdl NodiJriB
<br />I rdr!! ihtl rlE lGi.r.l Eplrrirr rElsJh! .dFtr tn)v.l m d {rlr.t lc t, rhr. FJ.(r
<br />-l.dilyrhrrI
<br />h.E rcrl lh!.ml({rn lrl {rrcrh.rrh.abvc rl,,turi,n rl(,lBt I rrNn,ror9lyI[hrllCry.BrCurnry
<br />o uHtrr.\ rtr.lSrr. Lrws(1, m,r L) hu,U r!hcrcl'y r rhn,. eFcsctrr.|v.i ,n rhn C yrn,lcountybcnr.ruF,nrh.
<br />rhtrr r rlnKl fn,F_dy l ntr.r()n
<br />,\pplionl or A*.nl Si*Mluft
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Sublloor/VenVl nsulalion
<br />Rool Sheathinq
<br />Framinq
<br />lnsulation/Energy
<br />Drywall
<br />Ext,6{, Lath /7htl r rtTL
<br />Brown Coat
<br />Masonry
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Report
<br />A.
<br />FINAL L-A 9InUn
<br />Certif icate of Occupancy "\f
<br />Note marks
<br />Shear Wall
<br />Pool Fence
<br />Flood Zone Certif .
<br />tJdc,'\ a tr.s
<br />*" \^r/;41,
<br />t-
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