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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.or\ \uR Bl I Dl lr lrll.{ \Rul0\
<br />I h.rhy .llirm !fl cr pcnahy ,n F.jury lhd I .n ci.md hrm tn Conk ,'n Li.lnr ll* idr rh. It)lk),ir8 E&,n ls.c 70:ll 5
<br />Burm!! ol Pr"f.sx,. CdL,: /sy Cny or Cou.ry *hrh r.{ur* . F nr ro (r{tur, .lrq. inv'n,v.. &mh.h or EIE! ev
<br />riturr., Fnr ro r Fss.. rl$ Eliufti rrE .tl'lr5r 1,, lEh Fmr ro 6L . srtE{ {r.Eni rni tI or .lE 6 lkrtr<J l{lu'
<br />lo lh. In)rlrons ol rL Conu..exi l.snEJ Lw tch+r.t 9 (i,nBBtr! * i Sdri,n ?m0 ol Drlrirn -l or rtE Br\tr\r DJ
<br />Pn)r.((,iiCo{t )orrhdlhcor\h.sc{.tgrrh.rcrnm. lrh.hrnsnnrh.ilkScdcrcnflin.Anyunro.notselrrToll5bvrnv
<br />.t'nli(lnr ru r n m ruhFk r& ttTlc.nt h..rvilPcMllyor mr tur. rhu hvc hundGl JoU,! (!5(D
<br />-1,
<br />ri o*w ol tlF F JEny. or 6y .ntldFr wfh *4c. .r rh.! $k $r{rnqDn. *tll l!] tlt frn rrn lh. rurG ( n{
<br />dcBLlt ,roll.E,lir rk (Sr.?04t, Butix( F,i Pro,.*nN Clrlcr Th. (irnk-rois L(.* L.* dE! B +Pl,tueo*E ol
<br />rh. notEny wh) turlJ! or nr{rcEr rtrB)n. ul who t]ffs tuch ullk hmr.lfdt h.Ml, orilB,u3h hn.r h.r o*n.mrhv.er.
<br />pn,vrt d rhn ruh m|rl kr.tr R d idnl.d,tonatsl Ln rE If. bl.w, ih. l!lli!l3 r, aprD(Ed !s sU *.hn oE )t&
<br />ol(rqrkrrn irr ()*er aultlr v l h.t rrr h|nLn orFlEl! lh, lE q {r Jn n hxll or qFE [r F{Ery lu rh. F,po- or
<br />l..1oeftroi rlE pn'n dy. rn ckluriwlyc nlri 13 w h l,(nicd conk!.k'N tlu,ndtu( rl* Frd ls.c. ?044.Itu1oc$
<br />si lh,kl\s CsL: I h. a:odr-fttr ! LK.nr l:* &t! e qfly lo u o*Nr.r P$Fny wh) bu'ld!.r mptuwr rh..sm.
<br />ril wlr, codLr( litr sEh F)Fr w h. C.dBlo(n l..N.J Fmd nr tlr O, rrtr'r tr.nc lrw)
<br />_l rnckmfl und.r Scur 8 & l'( ntr rhtr '(x!{r
<br />llorl(ERs coit PF-rtsATloN
<br />llEct AEAUII!
<br />I h<khy rtltr utrtlcr fnlliyol l.rltry Dnc ol thc l,'lk'wu3 dcchrrron\:
<br />-l
<br />h:v. rn *rll ddurC.dfrrr.of Con(.|b Stlf.l.ruE [i{ qrtdr d,tr{E.d$n.8 FoBlai lttr h} S$ri'n .17(10 ot rk
<br />Lrtr{ (-ut , fd ilr F.lo'mc ol rr: urt ftE wnlh tlE Frmr 6 NsEJ
<br />I hdvc rol willmlnra'n wdrk.rr ..mpc.s!rtr,n 'nrurrnc., r! Rqtrtrd hy S$r!,n .17{Xr Dr rh. L.trtr (tJ. lor th. FrlormRc ol
<br />ihc *orl lnr*hf,hrhtr l.m r\ rn8r My wo*.rs' $n{xntrri,n tniurrNc tMtr !n f'lf,ynumtxr rc
<br />-EIlrt(I
<br />I (.nryihir tr rh. If,no'fur. ol tlE *..k ttr witi rhn Frmr tr niu.J,I rhzll ci{l,v .nt Fn'n 'n
<br />:nv lmF.
<br />qr rt t) t'!\r,m rubFd ro rlx urtsr oryxhvri!. hwr ofc.hf.mE. tnl ryft rhd n I d)ull I^Lom tuhFr t) rlE
<br />*orl.^ r,nFnori,n llfiru(x,nrof scrton 17([.frh.Irhtr cdc,I dull.lonh*irh !o6l'ry w'rhIhr{ pntvson{
<br />WA!aNING: Fllurc t, EUr rdkcis {n{xnsaroo covcrr3. 'r unldwlul, .n'l shrll trhrq d mPl,)rr n, dhorllrdtrcs Mrl
<br />ri, oE hu,rirn rbu!.,r] 'loll{r (Slm.mo, m ald rn N rrE .o{ or omFnsatnn. dr[8.s .r Fovn.d i,r rlt
<br />Serrr !076 ol lh. l,trt Cdi.. rr.E{.,n dtftr'rfe\
<br />a
<br />I h.rb! rllidoll.r FBIydl JErrury rrd I rm or (1u|{c.9 r('mmhm3 *!h Sdrrr ?U[J ol D r.n I
<br />.i lh. Burms .nJ Ptrfesirnr C{,t. ui ny lr.nr Ls m
<br />L(cn.. ('hsr
<br />-
<br />I lrEhy.lfm uftL. Ftulryol IE lurrrh, rt5. n r on{
<br />6.uctlrse 1(l)1.(rv.c)
<br />E, rd rtE Fri(x1lle! ol rlr qf,k tn *t$ rhn lrfu B
<br />t nLit A&lr6i:
<br />-
<br />APPI ICANT DI'CLAI TI(,N
<br />I hdr{'y riid udcr ltnrlry oI lrrrury orc olih. lolkrwrS Jc.lr.!rkDll
<br />D.nrlir,. P.rmnl^rh.{or Mrn(r$. Fid.r.l R.3u laronr I l 'rk 40. Pa6)
<br />_R.quftd tIrr.rol Mrftrirs
<br />lL.n,ltrhr rlr l.d.r!l r.3uLhonr ft3rJhr r\h.{.icnrrvrlJrc rti rml($lc t' rhn Pn'Fr
<br />I (.nny rhd I h^. rrd rhtr lft'lx.rrln ul (rn rhir rh rhnc
<br />ilmJhc\rB1Srrt Ir*t rcUro3 r,, hu l'ns ronnn(ri)n, arl lf,r
<br />I.3ie r!, confly *ifi .ll Ciy.tl Counry
<br />hrurr.Inc(nr$rv.\ollntrC !lntlC.unryh.nr.ruFnrlt
<br />rtirvc nrnlrr.d l]t'|xny I'r rn
<br />.\ppli..nl tr.,\Fnl sil'uru(
<br />Set Backs
<br />Formsi Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />Rool Sheathinq
<br />Shear Wall
<br />Framino
<br />lnsu lation/Eneroy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif .
<br />FINAL
<br />Certilicate oI Occu
<br />Notes Remarks Etc
<br />COMMENTS
<br />Curr
<br />'t ;.1>441 )
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