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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS
<br />Sel Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />/.
<br />!ool Sheathing 7-r-t"?
<br />Shear Wall
<br />Framing
<br />lnsulation/Eneroy
<br />Drywall
<br />Ext.i lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />rcapHand Req.
<br />Deputy Final Beport
<br />Engineer Final Report
<br />Flood Zone Certif
<br />FINAL 7-5*lrt',rza )
<br />Certif icate ot Occupancy u t \--/1
<br />Notes, Remarks, Etc
<br />O14NER BUILDER DELCARAI'ION
<br />I ttrrL$y uflnnr u cr pcnulry ()l Jrrjury rhur I um crcDpr lmm rhe Conrrlcbn l-i:rn{ l,rw for rhL n,lhsin! (r$n (s(10:11.1
<br />Bu\ir.\\ lnl Pruls\\i{in Crnic): Any (:iry or Counry *hth rcquiG ! rErnir k, .r,nntur!- rlrrr, ,f,lnrvc, dcnini\h or ttBr My
<br />{tuddr.- Itri,t, ir\ i\\u4c. rl\o tqriftr rhcrppli.snr fln \uch Frmir k' lil., rigncd nnkmnr rhar Itor \hc h lRn\cd trtrr$mr
<br />n' rtf, noviri',nl ol rlE Cotrtroclor's l.i.cnsd lj* (Ch,ptcr 9. C.mmrcin3 wilh Sccrinn ?(xlr of Dilirion I ol rh. Buiin.s rnd
<br />Pnnt$ioh\ Codc) or rhar h. or rh. t dr.mpr rhcrcfn, rnd rhe hasi\ turrhc rlkBcd dr.nfrn,n Anyvn,hrdnofScdi.nTl).115hyu y
<br />rfpli.lnrhrrtErmrsuhFcr.rhclpllic.nrrorcirilp.Mlryornoin$rcrh live hundrcd doll.6(J50(r)
<br />l. sr owtur of rhc pmli.ry, or ny cqilorr.\ $irh *ascs as rhcn eb on{cnd i,n. $ill do rtr wk dl rrr {rL-iE i! rn
<br />dcnu or on Ed f(tr sh (Sd 7O+4. Aurirc$ rd Pmr.sftn1 CdL Thc Co rdrt Lien* &w de\ rer opl y ro u o*mr oa
<br />rh. FoFny *h. trid.or i'nFo\s rlE si !i elx, &6 h Mrt hill$lr or tlrlr or rhtuqh his or h.r oun cnployc.s.
<br />pn'vid.n rhrr tuch inrmEmrri E ,l irt rd.d or.nArn lor eL. lt lFftq.llE trildi.s or iqmEmnr ir v,tl f,irhin.r ]t-
<br />of.rni.! nn. rtE OwMr BUl,. wll hn\t rh. t{nl.n or tmrvine !h{ Ir or str dil mr b{ill or iqmrr llE ,n4Eny for rL IrF,e ot
<br />_1..s owrrolrh. rmFny. !n.r.hlivclyonreri.8 wnh lk.tr€d cotrrrdm romn(ur rL Ir.Fr tS( 7(}14. BEtrKr
<br />!.d Plr,esb. Cod. th. C6nrkr.l s Li...* trs dd: mr +pl, b d oqkr ol pmF y elE builds or in mEs lhsor.
<br />rnd *lx' o.rftrs for sch rrlFls *irt ! ConrEdono lt..rn punuur torlEConr,&ioir Lirne Li*)
<br />-l
<br />amcr.mpl ud.. Scdhn-- a. & P.C. lor rhir rca$n
<br />lLl. _ . Orff__
<br />worxn
<br />[[CIJ.EArq!
<br />I lErcby rfftrm !nd.r pcolly 6t Fjury on or rh. tullowi.g ddh.dirGr
<br />-l
<br />l'.vc.,n $ll Binrlb ! C.nirrrrc of Cdn$r ro S.lf IFE td lUl6 d,nFndbn. a Fr*Ld ror bt Sdtion l )(f,) or rlE
<br />I ihr Cq,.. lr lh FforttEN of llE eqt tu *hth l& rEmn ir ksxn.
<br />I h& .d sill minr.i. 10r*6 cofp.Eri{h inrl)ft., .! GquiEd b, sdbn:t7u).lrh. l2}or CdL. for rh Ffqllre ol
<br />rlE wt fd whih llli\ F6ir k a$!d My sod6 onFndbn illffi ffid ,rn pok, nunb.r cl
<br />,.",,.,'kuenut^ Zuvvlwcql -eb--1\4 r1
<br />-l
<br />drry rh{ m rh. Ffdfrre of rlE *orl ftr *h.h rhn Fnir is irsE4 I sh.ll mt cn9by.ny FMn in.ny Mftrr r ro lEsrr iubFr r. rlE $rrt6'FtrFn{.rbn bwr of Crl,fomil rd 'rrft rhar ir I slbuld t sft subFr ro rrE
<br />eod6' mqnerbn pmtirioN of S6ri,n l?mor rlE L.lfl Codc. I Crll. rdh$iih 6n9!y siih rtbt pmviri.'n
<br />WARillNc: Fntu. ro ru srt6 6rp.nsto. ov.d!. ir unLsni!..rd shrll sbFr e.trphF ro nimin l Fsli. md
<br />civ nFr up h oE hutdEd rhdrqnd dolL^ {JlG).flI)). in .ddirion ro rlE .o( ol conlEnqlion. drfla$ ptuen.{ for rlE'HE*id.r.{ rnd arlmy s aei \ib$t Corsl @h;a r
<br />L]lrlrllrlurrBi!1a.8.
<br />DI(LJ3.ITAi
<br />I h.r.6t .nm u,l&, FMn, or JErrrry rhd I m lau$d u,r&r Fltirn of ClEprd 9 (o'mxing rnh S6lion 'lClD) of Divirb. .l
<br />of rlE 8!riEs! ri Pr.tdi'6 Cod.. rrn my lt.tr ir h tull lor rd.rdt
<br />,/l ?ltqw7l4a(*os*G+&rte
<br />qtlsI&,1l:II(NtEdDINGrtiENt}
<br />I h.Ehy.ifrmu icr Jr hyof ,Elltlr) rhs rhcr6rmnldi,n hndin8.Esrcy foi rn F 6l1rm orrh. *ort t, rhahihn Frnn i
<br />nsu.d r s$. 1{197, civ. c )
<br />AIII.ISAItI.DETLAAIO!
<br />, hdrhtlllmu kr Irmhy of p.+ry otu dtrh. finb*ing dNl,"ri,n!:
<br />D.m,lirbtr P.flnih AslE(o! Notificrli,n F.dcrsl Rcsulari,ns (TirLrO. Pan6)
<br />-tuqutcd
<br />tdrd of r*{irsliE
<br />lccnilyrhrrrhcl.dcr.lrcglhrii)n\ EgarJint r\h.nos roFvol urc norrpplt lc n, rhnIn,Fi
<br />-,l..nnirh! I h*c rcrdrhr rtflr rh)vc i'rfornsrtun s .o,N I aE E tu Nmply wirh all Cir y od Couniy
<br />o!'lnr($ond Sr.tctiesrhrin8loburli nralNei olrhn Cny snd Counryb cnrs qx,n ltr
<br />rlt)r. nrnrxnRl Ix,Fny l{tr apc.ri{tr!
<br />o"*, ' 4Appli(lnl or Aa.rl slpEluF
<br />f.-,fr* nu.. t p.lnt l, I
<br />7
<br />drl hcrcby rur h.riz. rcpr.{
<br />la
<br />IaEfrE
<br />UFER Ground
<br />Subf loor/VenVl nsulation
<br />Y,VS0t
<br />4r-t
<br />---T------i-
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