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BUILDING- INSPECTOR RECOBD
<br />SITE.WORK DATE rD/srG.COMMENTS Ol4NER BT'tI,DER DELCAIATION
<br />I h.r.b, annm u.d.r Ftuxy or pdjory rhA I m.r.nlpl lmm trE Conlr&-roE Li.rnr lj* f(n rh. lollosins Ers. 1s..70.11.1
<br />BunE$ lrl Pmfsbn Ccl.) A,y C y or CNny *hih EquiB . Frni to 6n{d. rhd. inpreE. d.mlih or EF xy
<br />(nriw, Fr" ro ilr i$ure- .ko ErluiE! rli.ppla r ,or r6n l.di! h nh r nlrrl {rm rhtl lE or dE i! lEnEd l!r{d
<br />kr th. pnrvi\i)nr drrrr Conlm.lM\ l-ic.nkd lrs icho/.r 9. ('otrmNrs wilh Sccrn,n 7q)0 of Divtrn I .l lh Ausim$ .nd
<br />Pof.shn! cd.) or rhrl lE or slE i< cr.qrl lh.r.fr.m lnd ltE bGn ror lh. rlLlcd.rcnfrn,n Anyvktlirb.ofselirn 70-115 hydy
<br />.mltanr torr Fmir iuhFrrrhe .ff,licdr ro rciviltl.rxyof mi mRrh$ fivc hudrd dolbB (!5{[,
<br />l. sr owmrrfth. FDFny. or my.n{,by..s qirh }iscs ai thcn v,k.nmn n$rn1n, willtn) rh. u*r lrl rrr culE i{ ml
<br />itrrcdcn or nllcrcd for slc (SE 7044. Bu\ift$ snd P|Dfcsri,nr Qrl. Ih. Cudnctor'. l,a.trc L.w dE\ rd .rply t' rn owftr ol
<br />rh. rmFry *lr hut& ir inFN rt.cn rn *rr &6 sh *'t him€ll or tstlto. rtNuSn hir r lE o*n c'q'l,y!6.
<br />pftv!&l, ih.r rkh iqro\.lrds e d -r.oiLd n ofi.Ed frr et li IIME. rrE ltrildura G id?rlffi t $ld *all[ m ).r
<br />otcoi+tlid. rtr Owrr Buirln will hlr! rh hnd.n or Fori.B rr. tE or stE dil ml tlild o, i,ttuE n ptlEry i, OE Fqrtol
<br />l. .s wE ol rrE tn{Mr. o.x.turnlly o r(in8 wirh lEtren mdrrrm ro oniM rlE FrF (Sd ,(x4. BciBr
<br />r h Bri.r Co& Th. Corrrelor ! l.ic.ne ll* d.: @r rtttly ro m of,n.r of FoFdy who b{'ldt or impow! ih.r6(
<br />dd *h) co.rEch ror ruch Imj.rk snh ! Conrmb(sl li..nrd lliiunr rorhc Cofldcrois Liene li*).
<br />I ckmd und.rs(lnn .S &P('nnlhNrc$,n
<br />lr.l.: OiEr:
<br />W(IRKFlL\; T(llt|PI.NSI'TI(IN
<br />IEIIJSAIIIN
<br />I lErhy rmm undd FB,ry ol F.,lry or olllE nnl'riry dc.l,[rr,6
<br />-l
<br />h.vc and w,ll minrlir . (td inr&t. of Conscnr x, Sclf'lnsurc tu workcn co +..srirn, ds pftlvidcd ln by S.(ri,,n ]700 oi rhc
<br />bh, Cdl., for rtE Ff.rmB. of rlE e t fn lhi(h th. Fmil r n{ud
<br />-l h,E.nl $iU Dintrin *ort.r\' coqxneii,n Durmc. $ r.qu'Fd bysftrhnlrurulrlE L.trtr ('ul. for rri Frmd. oi
<br />rh. wort tor which rhn Frmir i3 hs{l M y eorrq' $nVr.sri,. insur.n.. clEir !n Plicy numhq e.
<br />4 t?lc
<br />oq{^JAoDD Uo.l
<br />I c.nily rh.r in rh Fntrmm. ol tlE *orl lm $hth lhn Frmir is t\En- I rhlll n .rrthy .ny IEmn in .ny mnrc.
<br />q' .r ro tEsN obrcr x, rlt *qt6i Nntmeran l,*r trcllroma. 8n {e rhd rl t t'rld lEor bFrr,'rt
<br />*o*6s or{rNrbn Inrvnii,ns ot S.cridn:17(I, or rh. tlb.r c(d.. I <l!ll. fdhuirh mn! y wilh rlnr pm*io.\
<br />WARNING }riluE b dur. wo.k.m'Nmp.nruri,n covcBgc fl unlawtul. lnd shdl subFr .mrk'y.r lo dimiul IEMh-! tnd
<br />.N,l lifts up ro.m hrBlr.d llEu$nd ddhs (Sl(n.ut,). in oddnion ro l,t .o{ 6r ronlEnsrt n, J.m3.! .r rolil.d ntr rh.
<br />HII*trI--'"ln l:A,sd^n"-
<br />l]l;!rtB.u&)
<br />I h.c{,y.tfrn urhi FoIy of Firy rtd I d lh.r.d u,i.r Flvirir ofolPr( 9 (onrl!6i ! *irh sdbn ?fiDr oa Diyni'n I
<br />of rlE Busims In P f.shni Cod., !d my la.trs ir h tuU 16B !d clter
<br />0r0 lqotno-1 3-b vtr& {M,4tc!:t
<br />c0lualcE)!.ltiliDNiacAi0
<br />Ihcrrhysrli',nx'xlcr Fnrhyofl.rrrrtrlsr tho. n!(on{Mli L,rdrn3ilcmtli'rrh(prlonNmcofrhcf,u'kntr*hichrhtrF(n(N
<br />is$cd (Sa.3(,7. Ci! C )
<br />lrftl€li Nlr,
<br />-
<br />AI&TS.ANLIT&SAf,AIT9!
<br />I hcdy lJ[m oaLr FnrhyorFriuryoEollh r0lL* in8 d.. hrrrrs:
<br />Drn)lirh. fc,dilr Ashiror Norifk i,n tid.hl Rc8uhr ionr lIirk .l1l. P!n6 r
<br />R.lutcd lrtrfi .f N.niardb,
<br />-l
<br />cdify rhd tlE f.d.fll rqlbrirr! Ea.rdlna.ct$xx rcm)val rr mr Tplrrblc tr rhn PmFr
<br />l.difrrtu! I h*. r.d thn rprlrdr.n!n a,n i.or(r I qd rod,mplt *irh.llCi
<br />d. nl'knd ns ot rhn Cn y lrd C.unr
<br />alr)!. mnr$md lfl'Fny r(tr
<br />At'|lliennl or A$nl liilnnru
<br />MtAw.,+la E*
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />SublloorVenVlnsulation
<br />Rool Sheathinq
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />N/ason ry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif
<br />IFINAL "TT-W PU ft tu 1
<br />Certilicate ol Occupan'cy
<br />Notes , Remarks, Etc.
<br />Set Backs
<br />iE
<br />T
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