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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNER IIUII,DER DI:I,CARATION
<br />I lErcl,) rinn lndcr n nolty oI n rjury rhll I m cictrri ts,m rh. G)nbNk,F Li..nsc bw lor rlI lollovin8 Msn (Sa.7oll 5
<br />un\ircs ffil l'(,fcsi"n C(xlr) ny Ciry or Counry whrh rcquircs a Fnnil k' con(Ml. drcr. imfiovc, &mlish 'tr klun My
<br />!rB1urc. [ini(' ir\ ir$ur. uko rcqorcr rrr q'drr n,ru.h,f,in h nEasi8.cn nalcmnl lhlr lxo. dE ir liccnrd puBuur
<br />k, rhc Fovnio!\ ol rh. Co rtrcrq \ Lic.n{d liw (Charrd 9. ftmmminS wilh Salion ?un ol Dilision I oI rhc Btsits dd
<br />lrcltlrnn\('od.rorrhnr lror \hc n crcnpr rlrcli.n .nl rh. blsn lor lh! ollcS.d crcq,rnn. Any vn,hri'nofSc.rhn 70ll.5hysy
<br />ltDhunrli)r0 pcnn $t'tNlr rlE lpplic!trr ro !civilF'ux,Dln,r nbnrhd ilvc huftlEd dollur ( 3500).
<br />_ l, !i o*B or'rlE tFFnr, (, n, chpk,yR: uirh Mg* 1i rh.n s,h NmFnslFn. wil & rlE sqt !d tlE strdm ( rur
<br />inloisl o. orlcEd tu sL ( S( 7(x.r. luift3i dd htra6rbN Co& Th. cl.t.dols Lt.nr L.* do.s ml {rly ro 6 owrcr of
<br />rh. Dn'Fny wh hri[t o. lqnEr LrEro nt slE .tB sn kfi hid.lr or h.tulr d thru8h hi< c lE ow. cnphtt6.
<br />phvildl rhltrsh mF,wN m ncnj.d n ofisd |i,r slc. lt lrrrw, rlt hitinS or .ttmEnd n dd wahin w )Gr
<br />ol.or{,hhtr th. oqE Auils will IEE lrr h!d.n ol povins lhd h. r rlrc dd br htiu or i'rlmE ttE FttEly for E purporof
<br />-1.
<br />er owe of th. F,Fny, !h ci.turnrly .onbd inB wilh krnrd conr.dmto connrud rh. FoF {Sd 7014. Burimri
<br />N,n h)i6ri C{dc'nE(i,ilrrrol3l,kco*1,*dE\mr+rlyroMowEolFmFnywhobuildrorimppv.rrh.mn,
<br />rtrtl uho ontmk lu sct rmr<!! *ilh. contExrn9 uan-d Durur tu rh. c(rdftrm r Lirrc l,w)
<br />-l
<br />.d .Enql !n&t 56l
<br />]IITBf,E&I:C1&TIBIAIIAB
<br />Illql.AxAlllru
<br />I E.chylltimudcr Fnllry l Fjury oE of llE roll,*i4 rk l,tariDnr
<br />I h.E !n will 'Ei,r,.in r C.niar.r. olcod ro S.lf ln@ tr hrr6 onpcnldio( B ,rcvid.d rc b, S<li'n l7O0 of llE
<br />t lrr Cdta fr th ldfm of tlt *rt fd *hin tli Fni ii iso.d
<br />Jrl l'll arxdrtr, uorlrr\,.f n,Fn\rix n\ur
<br />.J2,'-111/./aeK
<br />aE.. d rdtutrol hy Sshn ]?tf,) ofrF.dir. insumc trir .rl poli
<br />\t, r., r*-c e
<br />rh. utYtr or&. td rhr ncrinrorr of
<br />Co- P'q-l
<br />or/rs /z-z(cg75ol -l(,81
<br />I cnr(r rlll r r,E F.f(itN or Esrl aq *ntnrhG Fml is i!!u.d.l3hll d.rphy.nyFls in uymnF
<br />r ar b b.ftm onF< h tlr *dr6 6,tEnd a,n h$ or Cr$fom* rn .sr |n.l ia l rltru bdoft s',bF b dtqr*6 oitENrion Fovii,B ofs.clior ln o,rlE L.lrt crn , I arlL nlnnwnh ordy wnh rIE FoEbN.w^lNllcr FrillE ro Bm q,r6 dnpcneh. oE & n urLstut .,n adl obFl D 69loF b dininrl FElar.,n
<br />civil fiM. up ro oE hundr.d rhoBln &,[.8 (!lm.m). h .ddirion ro tlE .or or on9.n!{ioo d,n+|.3 a Fo*Lil for E
<br />\t.ri, rrtnt r rrr.l, tr(tird .r!{
<br />u,,", . to(ze /2"76
<br />IICEIEEDSINEACtrIAD&lllf,arll!
<br />I hdlrry rrlm uL|.r FMlt, ol Fdury lnd I m lilEd urld Fovbb. of cllprd 9 (olmth8 *nt Sdrb. 7m, of Divtri,. l
<br />of rt BaiE$rd PiDf.sn6 Cod..,td nr litE i\ intu rlre.d.lld
<br />I R zaza/"r6;
<br />gr$uan(:Ili}iraIl$lclNlJ
<br />I hr.ny .r!n uniLr Fdy of F rury lnr rlr it . onrtuli'n lr.lnE r8.fty rq 0E Fflre or dE rci for ltth thir Frtrr it
<br />n$d (s(. I)9r, civ c.,
<br />-l
<br />cd't rh.l rli tdcnl t,uLlionr ts.rnfu d! 6 tmv.l G d lpglrtbk ro lh. FoFl
<br />W,*rr, * , an *,*rpplnrion rit irr. rhrr rlE .bk hf.mriin i! cdr.d. I {r t
<br />'
<br />onpl, enh d c., .!n ciury
<br />od,rdrr anl Sr.r.lres Eltrg k, h.rHi.t c rhtr r,n tE.ty .ul,ri. qr.srdiEs or
<br />rtiNc rnnomd IrDIin, f(r inl\--!nn
<br />AD9ll(ur o. A16r si*MruE
<br />L (<"xo\:'_":';)ru
<br />Set Backs
<br />Forms/Steeli Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Sublloor/VenVlnsulation
<br />Rool Sheathinq
<br />Shear Wall
<br />Framino
<br />lnsulation/Eneroy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certil
<br />t
<br />FINAL 7/tqt 72, --?x/r/
<br />Certif icate ol Occupancy
<br />Notes, Remarks, Etc
<br />-D
<br />Rev.0B 07 2015
<br />AII,.II:/III.DECIJSAIIO!
<br />I nodt .iEh uni,.r Friy of Flly oE or tll. rolt,*in! &.br.ri{r]
<br />D.mhi,n P.rnila$.rr6 tlorirr.rbn kil fi.ruhirn! Onk ,o. P.n6l
<br />_R.a!i,!d llrrd ol Ndaf'.ti{
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