|
BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDER DEI,CARATIoN
<br />I h.(hy .!rrm undcr Fn.hy rn l.{ury ih, I d c!.nlt, lon rh. O)drtt,^' trcn* f.* ttr rlE tullo*tr8 ,.r!'n 15..70:rl 5
<br />Btrlmls xrl Pr.l6q)n Citk) Any C t or Coldt whrh ,rtuftr r Fmir b .r,n{ur. .lrq. mph!., &frnish or rcPrr My
<br />{krur. tn* ro [r r{4r. rln' E]un.( l& q'plarnl ntr uh lrrrur t' liL r \l3ftd rd.mnr rhli tE or $c ! l!(..tJ ,)@r}
<br />tt rh. no!tr(,ns nr rh. G'nrrrroi\ L(cnrcd l-.w (Chnprcr 9. C mftrcnrt r h Sdr$n 7m) ol Drv6o. I ot lh. Busr( r"d
<br />PNfc$Nnr Codcr.r rh.r lr r tk r.r.npr rlE.h,m rrn rh.6!r!1I,x ih. rlkld.r.rtrhr A.t ynLr$nolSdrrrhT0rl l ht..y
<br />rnrli.{r itr ! rrmlr lubjek rlr tmh.nr k! r riv
<br />'l trMlry ol ,r mn. rh.n nvc hu.J,ci dolht (l1l[]
<br />l,8owrcr i I hc pn,tEny. or my cmplorfct w h wr!6 r\ rh.r a,k $nqrn$i on. w l.h rrE *mt.,n rlr {turft ! n
<br />d. lrrldoi.Rdforsk(Sr7lnj,8u{rs..dPDr6\r'NCd.hlhcCinfi-nxtL16(Llw&t.,l.t?lyroxoPE.o(
<br />rlEF rny *btx t q niF)E!.lrE)( ul *ho Jms sqh k, hin(ll or h.rclf or ltnu8h hrs or h.r own .nploy.cr,
<br />Frvrndih:r {ch nqro(mdr R n,l ot.nr.d ornlf.n'l r {L.ll h,w.E. rlE ho Jtn8{r!ryrcENds$U*nhroFFt
<br />olrdnkrD.,rlEO*rrBu.rnllhrErlrtn].norFnvDarhdlE(,ltr!r!B{hudlorrFrEdEFFltfintllFrF)rof
<br />-L
<br />sro*n iofth. FUFny. rm.rLlunvclyc.drkl13 E[h l,r..ei colrr.r(h h lr,nrtul rh. Frtur lSd. 7Oa.{, Bo.ds
<br />I! l\l,r6w C.ij.: 'IlE Cod ttr.' LE.nr b, &E rn ri'ily k! r ormr dr pn)Fny *lx' bu ]lorih ovs rh.rctn,
<br />m! rb.!dr.!rrlb.tu.hIn)Fkunh.Conrr4lonr)lE.osJpunumtorh.oinr&1.r'rt.r.n€llw)
<br />-l
<br />n.xcrF udcr S<rEn-, a & P C i*'hr e!e'n
<br />[08f,[8S:gEtPiBSArqr
<br />DECI {NATI(,N
<br />I hcnhy !lltrr dnJcr pcruhyoltrrury ok rl rhc n,ll',wop Jcl!r!rx)n(
<br />_l hrk an *,ll N'nrro . (tnni.r. nl con- r b sclr-lnru( ntr rork.n d'nlllner tr)n. rs tdvrlcd n, hy Sc.r trr l7u) ol rh.
<br />lrhn C,rlc- tur rh( p.rloru. ol rhc wn ntr*nrhih.Fn sfu .
<br />I hrEtnl will mr rh po.t n' .on{Enr.r ih muhB.. .. rcquir.J lty S(r.n .17(X, ol th. I rht (ii., lirr rh. l.nnrll1&. ol
<br />lh. erl furwhrhlhtrFrm! R nru.! My *olk.^ Llqxnrdronin tur. @d !n lDlf,y.umt r r.:
<br />_1..n'ryrh:r mrlt Fnormk.l rlx uork Lr *lkhrhr|Frnnr F r\kd. I lllrllrtn cryk,yrnyf..on tn.ny mlnn(r
<br />b s lo tEq,m \rhiri l,' rhc work.( (n\xo\!rtr)n hws {l Cshrffnu. rnJ r8N rhrr if I .h'uld hc.om iut'rd t'rlI
<br />wofts comp.nqrtrr pnrvxi'r oJSeri'n 17(x,or rh. tllxf, Coi..l {ell,lodh*lh omr'ly *nh(hre l,Ulrr)nt
<br />$ARNIN(; FIhr !, (ur. rrr*cB ()mlEn..(xr orcn8c rs unuwltrl. :Jrl rh,ll \rhi{i .n klv.r t' smuul FDLr\ rnn
<br />drrutcr !r nnrlrlcJ l(x rhc(MI iikr uf n' Dk hundrcd lhouslul JolliG l!lur.lxx)). In a!,l k,n n' ih. ron or r
<br />S.cr$n 1076 olrh.IrhtrOr,c. urcr.n J ory\lr1
<br />+\l0rt*or\
<br />IECI4tAII)!IlErnydturudLrFulyo,FrrurylhdIrmlktn<rr!.rtntr(krolCh!..9((nmNuuwrhSeli.TunlolD,vrion1
<br />oi rlx Busixs r.n Pnri$onr Cixlc. url nyIr.nE ir u fuu nn [r].llccr
<br />r.""...".., ' Q,l0 0 0
<br />r3\l0tlJ0t9
<br />lalTIlIJ!;IIIINIElUNr;.d(i,8llI
<br />I h.Ehy all trm undcr ltmlry ol Jrrjury lh.l I hcrc ! a .on{ rulr !,n LBlDg .I.ky nr rh. (Etrlfrm. ol rhc *!trl lu *hr h rhtr Fmi !
<br />tr\u.J (Sc( .lU)?, C,r. ( ).
<br />AP?LICANr DECLATATION
<br />I Hry .rim unkr F..!y ol lxr,nry or ol rlE l.,lt'*D! deLd nn!
<br />D.m)lri,n P.m'lrArtrqor N,'r {.ri'n Felnl RcruLri'nrrTnE 4,. Pln6)
<br />_R.{u,Ed lnkof t{rfdrr
<br />-l
<br />rcd y rhn rh. l.Jfl rl'cluk[nr'rlIJ'rr rlh.{'r rcnn
<br />u1,,-rr,*, **.r,n" !n riuDr {d.,hi ih.rt.r
<br />n .ptlt.hlc k' rh! pn'Ft
<br />rro (.(,rut I.tEtuu'rply* hrUC yrdlcolnry
<br />..nu. .3. rSl.rc UBiNlin3 b h{rlJi"B ron(tudx'tr ul rotktrrcrcprccctrrih\rrollhrC[yr.JOrdnryk,cnr(uF,nrlr
<br />rh'v. nknri'n.d p$!.dy nn rsp..r!'n purF)ss.
<br />,\ppli.anl trr lr.nl SkMlun ,,. , cl lor I ^rot1
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq
<br />ln su lation/E nerqy
<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 />Engineer Final Report
<br />Flood Zone Certif
<br />u/7//q --Ha'
<br />Certilicate of Occupancy //T./
<br />Notes, Remarks, Etc
<br />/\r/ vntg- 0"1-
<br />FINAL
|