|
BUILDING- INSPECTOR RECORD
<br />tD/stc.a DI coMMENrsSITE-WOBK DATE
<br />Set Backs ,
<br />Formsi Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Roof Sheathinq
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lvlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif .
<br />IzIM.i,)FINAL /o /z//4
<br />Certiticate ot Occu an
<br />Notes, Remarks, Etc.
<br />OWNER AUII,t'ER DEI,CARATION
<br />I hcrchy lllrm utulrr p.trrlry (|! pcrrury rh{ t m.rcnfl fn'!n rh. O'nkr.ns- l-rfit lrs nr rlt t{,U,rq e rcarn (S.. .ll5
<br />Irlnncr1 .d lnn (,n Coi.): Any C y or c@d, *hrh ..qu6 . Fnnr n' (rn{el. 16. mr !!. dcm'lsh or rIEtr ev
<br />nturR, Fxh, ils i$ur...lq' rcquiN rhc qllll.dr lor{urh Jrtn n, rik a \3*d {.r.mnr rh.i h.or \hc a l(..i.tl Purulnr
<br />r) rh. pnrv,\n'n\ of rtF Conrr&ttr\ l,r.n*J t:v (C-tlftcr 9. Comft*-'r! qnh Sernn'IIfl.i D,vrrn I ol rlr BlnBr.ntl
<br />Pn,lc(knr CirLl q rhzt lE or \tE tr.rcq'l llFlfnu rnl rh. hI$s n* rh..ltrc,i.rcmtinh Any v,oltl ion .t Sdr,n 1):ll5 hv.nv
<br />.mlh.nr tlr 2 rmn rut jR. l, lhc rmli.ur b r civ,l t.nilry dr nor nu. rha hvc hu*lrcJ d.llr! ( SsID).
<br />-1.
<br />r\ owmr ot I h. I'oFrr. (, my cmJlhF.r wirh wrS.s ,\ th.n q,k Nmn nsd rm- wrll do rtr qnk lnl rlr rinsm r n{
<br />ldsLtl o, oltuEd f(tr sk (Sa 1114, EutEs .rxt Ptrf.srnnr Cdc ]lE Codr-(r'r l.r.n{ t,* &s d .fl)lv b u.rri ol
<br />rhc F'tqry whihl ls ( u(n'6 *rG\ .,n wh) dB uh *rr hm\.lt.r h.Rlf o, rhNlsh htr or h.r oun cn{'lov..!
<br />tln*iJcJrhsr{rh rmpnrEmnReB, crlcl orofErc! ft, sL.ll hiEE, rEl!flrSd nFrEld ir q'll *.h{ tn !t-
<br />of Li,tTkrrn rtI Ow Bu[&r *rll h.E rlE h'{n d FEE rhd lE d. rrE J! nn kiX d -Ftt rh. F$IEly n, r,t lrtry'. of
<br />!. r( ourcr ol rlk F0n n y. d c\(lurrcly .ontrd tr! w h lKrn$J !ni!{(ntr\ n, .onnn( itr JnIFr (Sct 701'1. Bunrs
<br />rol tk,l6tr ('Glc Ih.Ci'nrr ntr r Lk.nK lif, &8 nn .mly r, r o*kr ol P!,F y * h) hu,lNl\ or mrln){\ th.K'n.
<br />rnri whr (.ntn.r!iitr\ rh lln AG wnh . Cr)nx..r,( n l{.nsJ Nrurd r, rh. (irntNttr's I-'* s.l-.w)
<br />Irn.rd uhLr sdrr,n .B &PC fitrrhno$n
<br />lVOR|(EE(', (-(rnIPIrNSAT|ol\
<br />I'IJCL ILTI]ON
<br />I h.r.hyrrlm,unJcrl.Mlry rtcrluryorcolrh.nnL'wtr,8 J..l$rrt)n\l
<br />-l
<br />h.v. r,n will mid rin r ctn i.tc ol Concnr ro S.lUn.urc rn work.n comlEnvron s F,vri.! tu hv SdrKr ]nrl 'r lh<
<br />bhtr Cl{.. nr tlE Frfol]ffi ol rlr *rt (tr PnEh rh. tE h !n kl
<br />-
<br />I h!v. rnJ w'll h.rn!!m aortcu cooF.dxn n$ntu., $ rquud h, S(r kn t?tn ol rhc |ihor (iir.. Lr rh. Fft,!!l!.[._-.-. ol
<br />llf wt ld *hrh rhn Imr L\ irhi My ur*6 .$n{E.rri,n in\utn..aE .rn Fnry non Fr d.
<br />Cftr:-
<br />Iccnrlyrhrrrrh.F.rr,rmm.,'trh.sorkn,*hrhrhtrFrnnrrslFlt\h1llrt.nfldy.nyFro.rlnvtunrr
<br />!' r\ h trom rut'rtl t, ih. wortq\' $trqFn{!"n Lrr .f ( l!n)mE- rxi !!r. rhar rl l sh'ul,l t'c.otu ruhrcr k' rh.
<br />$rt6 .rh|rnl, bn I'nrvsrrnr ol Sdro. .]70o or tlE tjhtr CrrL, I {Ell. ltnhu h!
<br />WARNINC F. uE k, Ee krt n'dqEnqti,n Nvcr3. ,r onhwtul r.J d.ll
<br />r'tr{ y errh rh,r p(,vr$n\
<br />I trI t) N hu rr(l rhor\rn!, dol!. \ llllx).lxx)). 'n
<br />rnn !r i' I
<br />)76 ol rlx L:lr* crL. xrd! .rl ri.my-r ls
<br />t[(l-,\tt\l l()\
<br />I lrx.hv illtrn, u'rl.r F.nxlryor IrrNry rh l Jm 1I..n\lutrJc. |sr'\rr'ol('hrnrr9ktrnnrrn('nt qrhSe(rLin TlXx)) orl)r!(r'n I
<br />ol rh. ll$trr\\ rn'l l\olc$rn\ (inlc.,uil nir lidri r n hn1 ntrL. fi l.llir
<br />CONSTRfIL'TION I ONI)INC AGIINL.l
<br />I h(rc6y.lli(m onJ.r rxnrtryolF4urylh.rihq. n '$hntutr,n L rt :!.Et ntr ih. Fn,nuLt ol rh. u*t ti'r rnth rhr Imrl B
<br />APII ICANT I)F('I ANATION
<br />I lrehy .ltm un lcr t^-nslry ol tt rJuty oE .l rhc i)lh'*r3 JdLftr trrrl
<br />t).ni,l[r'n l'.rm !Arh.n5 Noi'lr.rir l-.tLr.l Rqulr$ns Il ik {O. P:n6r
<br />R.qtrril l!r.ror fdi f,arrnr
<br />-l(.d'ryrhlrrh.l..(lcr{lrcgul.i(nnt8rrJr!!\trnulrcn|*rlr!nnilr[,lr kn)thnnn,Fr
<br />I c.rrllyrl,rr I luvr '.d rl,r rtitll'c nn{rl{r(frhrr rtu,,h,r. tr'ionnd
<br />nltrErs.nl Srrr. brt ELrot h borlrrn! .onnNr i,E r id Coo!! h.nrd uFnrrr
<br />lhN m.ntr,tual pn'I'.nt If untf,(ronNqi
<br />\Ipli(rnl or 1!.nr Si!trrlurr P<
<br />P.ditr Em rprlrrrl
<br />Subf looriVenVlnsulation
<br />,,,,,'lta€tl?
|