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BUILDING- INSPECTOR RECORD
<br />DATE ID/SIG.oWNIIR BUII-DIR DIII' RATION
<br />t hqcby .i-rr trods l,6a!ly ol pclu| ltu' I m .ronp' fiom rn. (ir6r6cron l-i<m. La{ aor rhc follo*inU EMn (s6 70l l .t
<br />tlu.in6! !.d Pnlsion ( od.) Any Cily or Counly $hkn r?qot6 . Fnn to .odrucl. !h6. imrroE d.,mlnh .r rcp.lr m,
<br />irME Frtrro n! isuft.. rto r.qird rh. +ilicdn rdr lch Fnn h n!., r{n dlidBt tht lEor.lr! I'GE d FlrEi
<br />h
<br />'h. ForanN ot rrE Conu&roas l-r.n*d Lrw tclq'rr s. Comtr'.s *nfi Scrion ?000 ol Oivnior I orrfi. t\6irB Md
<br />Pfl'ftsiom (i)d.) or fiar lt r 3h. n .rmr, rh6.nom lxj rh. hais (n rh. alLE.d fioFi.i Anyvnrhrionofscdi).70115 t', lny
<br />arplicanl lorapsn slbjdtrh. tpplicr roacivilprtrrhroamrmo..lh fiv.hun.lr.ddollm(!50o)
<br />'T,k o*E olrlE p.stdy, or m' mFbt6 *nh(+66th.n hk.omFMit.. { &tlrtrdIdldrrErME6d
<br />ot o,IFd tc sL lS( 1r4d. BclK ud PmftsrhE (o{t : ,lr. Conrdoir lxc L.u rhd ml 4?l! l. u otrE of
<br />rh. I'.pdy qto Lril& o, i,nFovE rfigon. !d *llo d(6 $ch $nn hrr.lt.. hsrclfo. rtn'ulhii.r t6 o$n onplo).6.
<br />Ilnvid.drhltJoch impro\€nat dc Rn hldrldl orolrdld tu $i. ll h'$a6.lh. tlirli.8 or inll,.vffilis$ld sihm o.. )d
<br />of.onpkF.. rrr (\c tlu,Un *ill h.\c tlt tlrdor ol Fouts thd lE c lhc dt mt hild o. inpr.r. th. FoF!' aor llt Frroe.l
<br />L a o*n6 olrh. |notd!. ,n cr.lusr.lt onk&tn3 *nh I'coBj contadnBb con\rtucr rh. Iiol(r lS*. 701.1. lJ6m*r
<br />Md PNr6.irn ('( c: 'l hc ( i'nlroclo.s Liccnec I aw do6 nor .ppl! h .n o* nd ol't'n)td\ $ho huil s or imp, 016 rh6er.
<br />lnd \ho $nrids n, .u(h Fol.ds \ nh i ( o anroirl lr.s.dl,urltrr nr rh. ( nirrn1oas l.ic@ 1.5\ )
<br />I e.\6tr,! urJ6 sdh,n lr e Pc toLrhtr'J$n t
<br />,,.," ' /(lfsh"[r ."".'^r- ULt.l, \U W' -\lr8riEr6 qru[tf,ralllrx
<br />uECt aSarlr!
<br />I hd.br .mm un&r Fn.hy ol paiury oE ol $. follo\ i.s .k<l['t pB
<br />I lr\.old $illnbn(.i (.nifi..r.or(i,dsc n)S.1l lnrur.for\orlrs'coufsr nn,.!s FoId.,t rbyS(rtr)n1700ofrh.
<br />Iiltr (-Lilc. for rh. Flimfnc. oirh. M ntr \h'ch llt lmit i3 rsrEl
<br />IhAG.ndf,'llmlinllintro 6 conFNtior ilMe., d Equ,li b sdh ufirord.l,t (n.E tu rh.Ffffi.of
<br />rh. uorr tor th'ch $n p6n!r B isucd My $ork6 omrEEdion iNurmc Mi6 ed polkyf,unb.t r.
<br />Pol'.J Numl'o l.\pr6
<br />\p.-nr,n,.,n,*r*'ndnc.oarh.*o,tfor$hichrhirrsn,ririrsu.(Ishallnordr,loylnypdoninlnym6nor, a k' tE !'E lulrdt t, llE Nrl6 smFnrnion her of califomE 6nd eR 'hd
<br />il I {$url tErom soti.d tu ltr
<br />(o*d' snposrion For lnd of S.( b. l7(xl oflh. liho. Cod.. I iElL nnh{ nh snpl} $ th tbr FrrisioN
<br />ITARN|NC hilur. to su. rrt6 comFsi.. $6+. a urhllul- .n<l Jull sbFfl e dnptltE lo lmnll
<br />.trn fin6 ol) n, .ft hundrai rh.umd (n)lh (rl(x),uxl). r arjd,ron t,, rh. con ofr
<br />l-*-U^["JI,n-,, D(-
<br />l_t( t\stl ( otI &u t(rRDrqia rut
<br />I hr.t'y dfinn unds psahy ol pdjury rhat I &n licdsrl undcr rmvilion ofChopld 9l.ohnEcinS *ith Setion 7000)ofDivisi$ 1
<br />of llE BuitK sd It l6ioN Cod., rn oy lt.M t i. tull for.. an dler
<br />IOIiIaIJCITA!1};!DI!G-AAI!CI
<br />Incrcbyrmrm 6 pdalryolFjuryrhd
<br />'18.
<br />is r co.sh'crirn lcndi',sdldcy rn rh. pdromM(. orrh.$o!k li, shi.hrhdF 'rsisn'd {s( rU97-Civ ( )
<br />Aftll(llfDEcrJf,Alro!
<br />I hdr6,.ltmu ld Fuh ) ol Fju)' or .t rh. folhtr '.s &(lrllioB
<br />Ddnolinri PdmiG-Asb.rror Norincdnu f<darl Rc8lld ha! ( lnk ,r0, Prn6)
<br />R.qutcd lnrn of Norincdion
<br />I cqlilv lhd llE f.dsll ..ruhlrB E3,d|n3 BtEi.. rm\ rl d. mr r'plE,tL ro rn6 pmi.<
<br />UiLd,a) r hd I h.' c ,a,l rh,i .prlic'r ion md nnr. r har ,h. ,t$y. in tunEr$n i3 cotr<r I dsrc ro cofirly *irh lll cny .nd counry
<br />onlmn(B M.t Srlt t $! el,rint ro brrldins (olsdi.n. erl hd.tD rurlbrn...pr.sl i!6ofthnCnyedCounryioflduFnrh.
<br />ilr\r nr.nr('n-l l(.t{t\ (tr rlnrnn
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<br />l'qtrllN nsmr(Drioo: )<
<br />i9-
<br />t=+fu4 {'
<br />{IL\-ENJ
<br />- tr 1",,L'. 't rr P,I
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />ln su lation/E nergy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />De puty Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />FINAL /bc/tct n 12ld,
<br />//--l ' a-/Certificate of Occu pancy
<br />-a>
<br />SITE-WORK COMMENTS
<br />Notes, Remarks, Etc.
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