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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE IDiSIG.COMMENTS oWNER BUTLDER DELCARATION
<br />I hcnh, lnnn u .r p.nllry ol Frury rh.r I "r .r.n, lm'n rtE Conr.a.loE t,i.is lr* hr rlF nnhu ! rcrv,n rS( 7r.ll 5
<br />Bo\inc\\ xdi Protur\ion Cudc) Ant city or Cou.ry whah quns a rErnri k, $n\rM. rlrd. inpmt., &m'lnhhr rIIi rny
<br />nd.M., Fr* b irr nru,rc. rlq' rcqlt.l rlE .FI trnr ror iuch rErnir !o lih r n8ftd n,r.trd rlEl lE or {t i\ lirn<l, |lur lnl
<br />n, rhc rovni,n. ot rh. (in r(nr\ l-i...!.d ll* (Ch.prcr L Co|lmmin8 wilh Seri,n ?(Xl, ol Divli'n I of rhc Borims rnd
<br />Ptut rii,nr CdLr ur rtur hc d rh. N cxcB{r rh.rcfion od llE h.si\ (n th. tlk8.d.r.nPran Atryri'LrhnolSdi,.701I I hy rny
<br />.rDlr! for. rErmn ubrcrrrlr rprlk.d nr . cilil FDht or n @nrhdnv.hun.Jdl'll,r(t5lrr)
<br />-1.
<br />rs owftr or rL thFny, or ny .,pbF. wnh w{6 ri llEir $k oqadiotr fill do dr *r* .,n lh. (nrrm n n,
<br />,.r.,n d orofiftd (tr rk (Sa 7o,{, AuiiEr..rxl PrordibN C.rL: TIE Cddtu rLEEt,*&6d'l.pd,roiorEol
<br />llE F,Fny *b tlitlt r ir!.trB ttfta !n Eb &E *t! qryt hiffilf or lFlt or rtuou8h hir d lE, or. ciploys.
<br />Fovd.d rhdr rEh idrrowd! e r rr.nd.d r otu ar -l lf. tbffi. ttE llildir! c ir+rck'd n r,tl *ihn m Fs
<br />.,f Mphin dE Oeffi alitlr pill IEE dr hrn n of FDyil* fir lE or aE dil Dr htri n iqmE dE FDIET, [, tlE FrF-ol
<br />-1.
<br />$ oErr of rlr F.rEry. m ci.tulkly.odtulr! wirh lthed 6ffi6 ro onra.l rlt IsFd (sd 'r0+a, B6G(
<br />!,n Pht1ri, Cod.: Tt Co.r.d.l.l-rcnk L.w &8. ml tflrly lo M orK or 0rnFnt *t h{ild! or inPrcEr rhrd,..
<br />rbd rh, odd! nn ruh Frrct. wnh. Colltrbntr lEred pond ro
<br />'lE
<br />(o rkroll lir,< l.r)
<br />I .rcx.nrfl ud.r S6r0n
<br />l)rl. ()*n.r
<br />lvoRxFRl L(lilPFNS^',rl('N
<br />DEILI.BAIIAN
<br />I hurhyrlltrn'trtrdrrlf,trrhyol txljltryoNolrltrn)lk,8irrRi.cl( ioni
<br />-lhr\cunl*illnuirr0h!(cdili.(cofCon\cnrt,sclflisorcntrsrkcr'cflrpc.uri,n,"rF,vidcdf,rhys.cri,,n.lTlrrnlrl{rlitr (irl., ktr rlE F d truL.'. {,1 rhc *olt lu whirh rh. pqmir ir n\ucd
<br />-l
<br />h:v. lnd erll mintlin rorl.^' conDcn{lrn'n in{urlmc. N rcqrtcd by Sci ion l7(D of I h. l rtrn (i'dc. rd (h. Pcrformrcc ol
<br />rhc $otk n, vhththit rErmir r. ku<n Myworkcn conqEndi,n i.irlmc.rtr en ll,li.y numtEre
<br />-l
<br />adifr rh.t in rlE F fnf,N ltrli *ort fd whih rhar Fmi I i$Ed. I sldl mr .rl,t t.ny Fn. in.nt .uE
<br />1 $ ro t or st'r{r ro rlE krtB onFndirn L*s of C.lifmi .d .rr rhi it I lrr ld lE$r sl'rd rotlr
<br />e (i on{tnqri,n pnivnioh of Srt i'n l7(tr of rh. tie C.i.- I tull. tdhrdh Ntt y *ith rho- FDri3i'dt{AlNllG F.iluE b r* qrt r' on+.ndi,n oEn!. ir unl!*tu| !n {n.I sbFr o dt*'Fr ro mirl Fili: rnd
<br />cnil [Et ulr ro or huidr.n rhDln n dolLn ltlm,mr. in ddnbn b rlE nh of 6rr.Nrion, drf,3.t r F{,vid.n ft, rh.
<br />Sdrin !076 .r ItE 1,6.r Cod.. id.d nn ntmrt 16.
<br />Ir.l.: Appllol:
<br />r (tr sFo (trNriaclot
<br />DECIJXAIIIJ!
<br />I h.Ehr rmrfl utn,s p(Mlryollxrrury rhrr I rm l'..na{ undd lfrJrtrri ofChJprcr I G)mnrftrn8 srh S.(rrn Tlxr)rol l)irthn.1
<br />ol rrr Btrnn.\\! l Ptul.\\i'n\ (-Gj.. el my licn\c n in fullr erdrrTtcr
<br />!10!Erlu(:Il0N.LENDINc-ea!!.ljr
<br />I hcrubysllirmu cr rEnully or Frjury rh,r rh6. i{ r s.srucrion lcndiry aacmy fff rhc rrruntuN. ol lh. woik for ehah rhi! l.nnn n
<br />f\!cd rse .{p?. ( iv c.l.
<br />ATTI.ISANTDECI.AEAIITd
<br />I hod,y dlm !n&{ Fdx, or Friury oE or rrr follopin3 &{Lnl ionr:
<br />I>mlirhn P.mnh ArtEdor f&{ifNi6. kEr R.8uh'i,ns fr k lo. Pan6,
<br />-RtnuiErl
<br />l.rrs of Mr,fdM
<br />I &nifr rhr! rh. fcd.rd Eglldn ESsrdinE lrlFror Emral rE mlrrbL b rh! noFd
<br />-l
<br />csrily rh.r I h.r Erl rht .pilidb. lrt i.r. rh, rlE rloE inlorrElin n cn<< I .!E h otply snh .I Cn, .,td ('o!nry
<br />udi fB rid slnc L,*r Erri,t io t ibin! $nrru.1i,c ii hft6y urlnri& El,.cdrtB ol thir Cil, .,n Colnry ro drd
<br />'{x,n
<br />rtE
<br />rlnE rnriorn rmFn, for i.!rdi,o pEFtr
<br />,\Dpli(!nl or /\!rnl Si!uluR
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />S ubtloor/Ve nVln s u Iat ion
<br />Roof Sheathing n lz7ln //"u{a L* frr,*,
<br />Shear Wall
<br />Framino
<br />lnsu lation/Enerqy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif
<br />FINAL //h//4 Darn>z - /1)-
<br />Certiticate oI Occupancy
<br />Notes, Remarks, Etc
<br />Pool Fence
<br />T-Bar
<br />Liccn!. Nun$cr:
<br />L!nd.r'r Add,6s
<br />fT
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