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B NG. INSPECTOR RECORD
<br />MMENTSSITE-WORK DATE ID/SIG.
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Roof Sheathinq
<br />Shear Wall
<br />Framing
<br />lnsulationi Eneroy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coal
<br />Ivlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Fleq
<br />Deputy Final Report
<br />Enqineer Final Reporl
<br />Flood Zone Certif .
<br />Zc 2.1lr/6 -? t^- z.)
<br />FINAL 7-z-a /2ct.,/oCR-dg'c'27
<br />Cerlilicate ot Occupancy
<br />Notes, Remarks, Etc.
<br />owNttR BUTLDI:R Dlil,CAt(A',fl ON
<br />I llcby iftrm o .r Fnalry of p.riry tha I d.x.rtr ,mn rh. (i) n oB lj.rM lrw fd rlE tolluwinX sen lsa.?oll.J
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<br />h rlE l'ovBioe of rtF Comarri l.t.nr.d li* rch!fl.r 9. Collftrmt virh Serrn 7fr or rrivirbi I oflh.86Nar..d
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<br />I anreknl, trd{ S.crn
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<br />DECLAIAIION
<br />I h.r.hy rlrnmund.r FMhyofp.Ouryurc otrk nn[r*uE c.l[r!.N
<br />_l h.E .rn rrll mida, r Cdf..r. of CoM ro S.lfidr tu u*tda 6atEM!r\ .r FoviLi for by S€rirn l?0o ol !
<br />t lri C.'&. lq rlE prlo|le oI ',r *qi &r *nin 'E Fnn i is(d
<br />I h.E l will Ej rin ftrt d ..{rD.B.rirn i!ohr., a Eqoird ry Ser.. 17@ dt rll l-!o. Cd.. hr th. F.fl)md ot
<br />rh. turl fur *hrh rhi' Frmr n irnkn. My sdld! .r,qEtunnn tuurar crfi,rn |blty nun$.r ft:
<br />&ls Numbd
<br />-Frpfr
<br />f ,*'h,- ,n,* *t,* ot rlE wort fu *hxh rhr Frdl .nrrhy.nyp..$nr..ylMri
<br />$ .i ro b.oru ruhj.cr ro th. s.t.r'.onD.NIb. lrwr ., Crliromq .nd .8Ec rh! rlt rh.ukr h..or lubj.cl ro rh.
<br />*u .6 .o 9.nrr.!r povi5ioB of SRIDn 37m ol rlE ljbor Ood..I tull, ronhwirh$n'l,ly virh fior pDvitDu.
<br />WARNINC F{loE t, lG snta enrtuii .rrwnr. 6 url.*tuL &d rh.ll .uhr( - .rpbFl k, onrrl FrtE !n(!n 66 o0 ro oE hurl&d rh.u{Id .tolls (ll{x).urr. r .ddabn ro !h. .d oa.orqEMr d.rt.r ! FovxLd ltr rh.
<br />DECIISAIIITd
<br />I trl'y .rrm ull,.r p.uly ol Fju.y Ind I m lEd.d u.&. FDri.h. 6r Ct+is 9
<br />ol rh. 86Br rnl Pbh.sia CdL. rd rnr li..h ir r tu[ fod !n.ihtr 'nB
<br />w hSdrh Trrrr.r lrrtri,n 1
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<br />CQIi CTIONI,T,IU!C.AI;};X(I
<br />IrrEby rflirnnRl.r F'uhyofFriuryrhrr rh.E r r.otr{^,.tutr L n,r !lr.'ry li'r r h. Frlon,E r. of rlr eorl tu whirh rlN Fmn n
<br />AIIUSA!tr.DESd!6NON
<br />I hcrt, rtrmlnt Frxy olDdilr, oE ordr roltorD! &.Bnriont
<br />D.mln6n P.dl^rbqos Ndif.dbn Hdl turuld.E (Trl.,lo, Pd6)
<br />R.{unlJ Lctr( or Ndrftrn
<br />lat .-,ry rt u r* r.a...l .8,t ri.tu c8lr,lnx !ih.io! Emvrr G
<br />'tur
<br />rpprubr. ,o rh! po,*,
<br />,_! rd'f, tnr I h.r E l 6r {rpld.n rn i.E rhr dr ,DE inrtuior L .ffi. I .tE ro otrpl, *$ .I C., .!d Ce y
<br />{xtlN'rr ril Strt. tl*r Eriry b l'{'Bor (@rDr rn llE6,ft ErrMn'E! of rh. Cry t r, cl)ud, ro dd qrn ri.
<br />J}rrL nrnrpMlt,(,t{ y l,r Gr.(Dn
<br />/\p0li..nt or /ltcnl Silnotu h,, oto oi ) i7 L
<br />Rev. 08'0/-2015
<br />Subf loor/VenVlnsulation
<br />lrrr.
<br />",",cU,'6'2020
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