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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS
<br />_1. 6 orc olrh. FoFiy, d f,y atrphtG snh e+6 s drn $b mmFsrion. sill & rlE ust rld tlE irucE i! d
<br />i di.d or ofts.d lor sl. (SE 7O!1. B6i6 od Pmf6ti'B ( od.: Ti. codr.dd'r l-r6e t * dE d ,?ly lo x of,E of
<br />rh. Fotdy *lb hild d inqs6 tha6^ rn *h dE sh klt hrelf or lEellor lhrcWh h6 or lE om fiplryG
<br />Fovid.d ih.r luch inFo\q'Eu G mr ndi.d o' orI6d for nL ll h.Bd, $. hoildrB or inp.usE ir sld *'itfiin o* yd
<br />of conpkth( rtE oMd Au&k wiu h.w rlE hnln ol Fovins rhi lE or sh. did d hill or irp.ov. fi€ plordy fG th. Frpo* ol
<br />l. 6 o$ffi otlh. ForEry. e.tclBivcly conE(lins rn,, I'cEa.d contdm k,.odrud t,E Foi.d (Sc 7Or4- BGo6
<br />!d hDlsrn Co&: Tt. Conkdoi r Lk.e rls d6 mr qrly ro o oq ns of Fopsly [ho h{il&.r impror a rhao..
<br />sd \lt) odrEl3 fd rBh rrcFr wnh r Co'rrrro(!) t-q!.d p{rsti ro rrE Codrrdd ! Lt* L.*)
<br />I m.rmpi uffE Sdnn-, A &PC aorthir rsn
<br />Dir. Orn.r:
<br />W(IRX}lr(' ( dNiFENSA'IION
<br />l)lig,aaaM!
<br />I h.1ch\ rlii D unds Fuh) orpsjuryon. ofrh.fdl,\r'n! d( ltrartunr
<br />-l
<br />lI.!. d s ill mhr.ir r Cd'trrc olcoer lo s.lf'l6e tur wtss (mFul6n, s Fovii.d for b, Scrion l'7m ol E
<br />Lrv Co& for tlE Fftu ordE wt fq *fiah lt Fnn i! isart
<br />_l ha\ c lnd will na'nuu wortdr' .omFBdio. i uhk.. s &qut db,Sdion 1'7(D of lh. Labor ( o&, ttr lh. Ffollr:tr. of
<br />rhc sorl for rni.h rhd Frmit n ie.d M, w kdr comp@riion iBurm. cai6 dxj F,licy numbq 6.
<br />t_
<br />lrDi6
<br />_,..ni6 rhrr in rrEFaolilje.olrlE $orl6r ehi.h rhir Fmh n isu.( I $.ll ml oploy dy Fen n..t nME
<br />e at' b.tnft $bd lo lh. *!rt6' comp.Bdio. LBol( llitodil a,ld .*E thd if I ihool..l b..oE subel lo trt
<br />wolt6'comp.dslionprcvilirBofS6rionlT00ofrh.lrh,r(.d.,lJtrll.aonh$nhcomprywnhlno*prcvitioN
<br />wARNtN(; F.illrc io s@ $0116 omp.Balion co!a8. it unlavtul. ed $dl .ubjd dplor6 to aininal Fullis dd
<br />civil lin.r ut to on. nund!.d lhou!$d dollN lll00,00o). in lddnion lo lh. .or oa.onp.Mlion. dmlsd s lrovid.d tu rhc
<br />Sdnrn rc76ofrh. t bor Cod.. mrdcn6drh6rftr'. fc
<br />-*, ,'zlrll,&
<br />Df{la8Arro!
<br />I h@br .flm undd Frly ol Fjuy lhi I m lic!.d und.r FryisD. of (trFq 0 (ftffih8 wnh S.(bn ?000) of Divilir. l
<br />of rh. B6inB ed Pmf6io6 Cod., od my licaE ir in full forcc En clf61e 2-Gs40q
<br />rz-\,3 I r €1,r*-"-G;+^-.. \- ?c,* 9t=\L-<-'=-.iS^..
<br />(axsraltcll(Idrllutc GIilrI
<br />I hsrt t imnn und6 F.ohy ofp.iJury thn lhs. rs r srBltuclnn Lnding asd(' nn rh. pdf.nmc. ofthc qorl n r *h'ch rht lEni 6
<br />i$ucJ {sd 10e7, (-iv (.)
<br />lr'dd r a.Li6
<br />-
<br />afturA[Lrr(latAIla!
<br />I H,} !,Im und6 pq.Xy or Fjuy oE of $c fou,owiry &r l&.rmnt:
<br />ttnolirion Pmis-Alt6ro! Nolific ion F.dd.l R.ruht nnr ( l'nE 40, Pan6)
<br />-Raluir.n
<br />ln16 of Nor'6cariu
<br />I csr ify lhd rh. tdl'.I (sulnn'B Es,nliry abckB im! rr e mr rppli..bk lo lhi I'oi.!l.
<br />I.d'ftrhdIh6.Mdrhir.pplt.rir.rnesrcrhdrlE.hn.inlomdnnLct16lI4rdro@tpl)*nh.[(n!lrnCoud,
<br />ordimft6adsrrl.ll$sr.l,dBrotlildinS.oifuio(,nh6.bsdlErizrqr&riivdotrhaCny&d(oo,rodauFnllr
<br />h,r. trknlknBt lnop€nr ld 'tr\rrr(r l{rtr{1.
<br />\pp,ux,.,A*d sisnrinrr \\.8 .- V-..-c
<br />per$it* nrm. {prin(): f^-"a< l -c-'O
<br />\z-\ \3\r{3
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathing
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />A\
<br />FINAL >-tI-tt v.\Lba)
<br />Certificate of Occupancy \7
<br />Notes, Remarks, Etc.
<br />Shear Wall
<br />Ext./lnt. Lath
<br />OYNER BIJILDER DEl'AR TION
<br />I lEdry .lIm u.d6 pd.n) of Fju) lhi I e ddlF fiom l,t co r..ldr' l-i(.M t,$ for lh. tollotrll8 rNr (S6.?0ll.J
<br />BGin* &d Prof<ion cod.): an, Cnt o. cody trni(h (quir6 a Fni ro odtucl. .16. inFore &ttulilh or tp.r uy
<br />(oduq Ftu ro ir3 is!ft.. .bo r.quiE rlE rpplicDl tor s.h Fmn lo fik t tisn d ,rffil lhn lr or .h. ! li.aE d plI:@
<br />k, th. provtrioB ol$. Conl..crd t Li..nkd Ltw (Cirpr6 9. Comtring wnh sdion ?000 of Divirion ! otlh. BGr dd
<br />Proa.sfu.s ( od.) or th,i tE d rh. i! .rmpr ln@6om od rh. b.!t for th. lllcs.d Gxdrplior. Any rDhlion of s.dio. 70] I 5 by my
<br />lrrlic&r lo.. pqnir bjalr tlE qrli.ul ro a civil p<n.hy of ml rcr rho fir. hrndr.d doll6 (lJoo)
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