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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OW]TE{ BUit-l'Et DEI,CAIATION
<br />I h6.ty lffm uidd p6dry of Fjury rhd I m dcnF fhfr $c Conrr'do6 t,toe r,* lor rk bllowinS ra$i (sc.7oll.t
<br />luinB 8d F otdion C6d.)r any Cny or Coudy whi.h r.qut6 . Fnir ro oNrucl. tta. imprcvc danoli.h or re.n uy
<br />dcrue Fior to itt iM., .lo t.qui6 rlE ipdiql aor {ch Fmn lo nk. riercd nrtur rlli lE or sh. i li.d.d FrBlr
<br />b th. For'irioB ol rlr C.ntud! Lh.N.d t * ((.1rf,6 9. CoiMng wnh Sdio, ,000 or Divirbn 3 of lh. 6uilB !d
<br />iNldioE Cod.) n rlur lE d CE ir ddF rlE f,om.d rlE hEir tor rlE ,lle.d ddFbn Any voldao. ofscrir 701t t b, &y
<br />irf lic&r lor r Fbn $bd! 0E .pplrdt lo r ovit Foiy of rct @c $r ar. h!.&d &'116 (1500).
<br />L s oq6 of thc propdy. or ny mployB with w.sB s thct rlc comr.Glrion. vill do $. wk od rh. nn.l@ ! el
<br />iinord.d or olYsql for sl. (se 7044. BBinB ud PolNbB ( od.: Th. Codaloi. LkN bw do6 ml ip?ly lo e om6 of
<br />rhr rFFry vho hiikb or rqo6 rlEor.d I,rD dd rrl *!'t h,lMlto' ha*lf o. rhr ulh hn or lE os 6pk'ys
<br />Foliii.d rlllr s.h hF!fficd lrdrLddo&rd 6.5l..l( lDrw. dE hrildlB or rproeEEr B $ld *alin oR
<br />'aolcoqldi,! tli OsG Burr, *i! h.E $. hnlar ofFovag Utr lE o, dE dn d hiild d ir!.oE 0E FlFry 6. d! Frr* of
<br />l.6oueof rh. Fopsln @dclBiElrco,urcri.g wirh lrc.tred conlradoB to lltrnocl rh. Prqal (Sc. ?044,lldhd
<br />.,i hrftsh Cod.: 1 t. ConlE or! Li.d. L.w do6 mt ryply lo s ona ofPmp.ny who build! o. mpor6 lhqon.
<br />sd ll, o,]r&1, for ct For(ri $1li r Cortaro(r) lf,aB.d pnBu,r 16 rlr (o raroit Li.w L$)
<br />I d.r@F u-b s<r6n_
<br />WONKTRS'COMPrNSATION
<br />D}:CIA8AIIO!
<br />I hdl$y lllm ond.. IErlrr of Fjury or or rh. follo*in8 .lalsrlbc:
<br />I h.E ed will mi .h . Cqifxa. of Colgr b S.ll-lNur. fd mrt@ onpdrio.. a Flvii.d for by Scrion 1700 of rlE
<br />l$., Coda fo, rhc tEf(rrM.c of rhc Nrt for *itL rh. p6ni b i$u.d
<br />I h.1 . lnd sill nrin .rh tr ortcrs (otrrp.Balion iNurcn(c, a r. utoi h! s(r ion 1700 or rh. Ltrlr Ord.. ro, rh. F|.orruc. or
<br />rh. $ ork for rhrh lhE p6rn is is!.d lilr q 0116 cnnFEd io" inu c..ur6 trd Flk! nuntE &.
<br />(.M8. - r..)crrrr* B?er.sJI=
<br />f,n,c! Ntrmrf,, -/ c-tc-lq+A . tlt. Izo'z-l
<br />I cdiry rhll ( rh. rdh,r!@c of thc uorl to, *hi.h rh! Frir ! isuql. I !tullrcr d9l6y lny F$n in mymuM
<br />n B ro bdm 3ubid
<br />'o
<br />tlE wrla .ompodi'n L$! of ( llilomi{ ud .31 lhr if Lhould baoB rubjel lo lltqorld 6,pddhn FrBi,N of Sdion lr0o of rlE lrtv ('o& I JdL fonh*nh oEply { nh th- Fltir6
<br />\TARNINC: Frtur ro sm *ql6'onFEri,. sv6rs. E uL*tu1 &n 3h.ll &bi{ 6 opt F 16 cinid Flli. r.d
<br />.r fin6 up ro 6& hundr.d rhousnd &lL6 (ll00.00{), i, .ddnio. ro rh. .or 6a.o"rFMior dam.g6 6 Forilal for tlE
<br />sdr(n 1076.frh.lltrtr Corl.. inrd.n i(l C-rl-
<br />DlcIJAAIq!
<br />I lE!b, rrm un& Friy of FJUry rhr I E li<a!!.d ud.r Flvibtr of clrF6 9 (mffilis *nh Sdb. 1000) of Dw!r. l
<br />of rhc BaiIB rd Prof*ioa Co&, ad my lrcog i i. tull lore di.ltrt
<br />,.,.*.^,1\-'i--
<br />D.. aG4r"{4-A '77tdzv
<br />cq!$alcrqB..LENlrBclcEBq
<br />I hd*y rrm u&r Fdty of psjury $r rh@ L r onrNdih lqldi4 !s*y tor th. Ffoffi. of llE wl tlr *lici lhb p66i i.
<br />isqcd (Sd. 1097. Civ. C ).
<br />AIIUIAITDES.AAAIIO!
<br />I hrd,y.Jrm unds F .llr of Fiur.t oR .a rh. folloq,n8 dELr.l ion3
<br />l}mkior P.mne^rbdd NotiaEdio, Fatd.l R.3lLlioB {Tnl. rO. Pd6)
<br />R.q!ircn lnr6 of Notff, d6n
<br />/Pfi;6,h' r h5.,Br,h6 &el-od,ffi6 di S'd. lrcr Eh"a ro
<br />rd. th! $. .tiv. mfotuion i conrl I .sE lo snrily *'llh lll Cny ind County
<br />GoruMrc tn halbr dhoo. EFe !n6 o I $i. Cny &l Co6r) ro drq uF. dE
<br />itr\r m6trn d lrorciy lor
<br />,\Dtli.N l or .\8enr shn.turc.
<br /><reac.6S
<br />4,y'*
<br />Set Backs
<br />Erection Pads
<br />SLAB Floor
<br />Subfloor/VenVlnsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<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 Certrf
<br />FINAL rclnln Dt+{(tg a-*e7
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />"*", r?!,n[".,"
<br />I cdrrylhur rhc fcdsolr*ulatoN rqrdina 6tEnr. roDovrlrc nor,!d'(ihl. ra ihis proldr
<br />Forms/Steel/Holdowns
<br />UFER Ground
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