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BUILDING- INSPECTOR BECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steeli Holdowns
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lalh
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif
<br />I I
<br />FINAL -7 1 1.,)\a-r*K1
<br />Certilicate of Occupancy -\\t1
<br />Notqs, Femarks, Eto
<br />1 l
<br />I I
<br />OTTNER BUILDER DII,CARATION
<br />I tEElry .ffrm udi.r FMxy oI Frlury rhd I im .rcq,l ton rlr Co'rd6 Li.ns br tItr ilr foltrrh! E $n 156 rlllld
<br />ltusitrcs rn Pror$.irn CoJ.l Any Ciry or (i,unry *hkh r.rtur.r ! F,nn r. mncEr. .lls. in{'rok. &mlnh oi itt i.Trny
<br />{rucrur.. t i, ro ih irsum.. rl$ Equn.\ rn !pFli.. tu 3Nt Fn h ntr.ieEd d{.mn h.' h.ot {E ir lian<n purru!,'l
<br />to rlE Frvni,nr or rlr Conn.td r l,i.nen br (Chq!r.. 9. CoffiEinr rnh SariI 7(In of Oilir.n I ol E BusiE.r ..d
<br />I'ior.$ionr Cod.r o, rh.t h.., rlE i. crc.mr rlF.fi.m.,n llE ttrrn ttrln d!8.d.rMVk'. A.tlhhnnolS.dnn70.11Jhytn,
<br />lnrlic.nl irtr a pcrnrir uhFclrrh. lpplicanr lo !civilpcnrlrynrnor ftt. ths livr hundrcd ltl,tl$rlSSOO).
<br />l.ro$mrorth.FoFny,(myciploF.r*nhB!s.{.rrhcn$hn,hFn{rt,n,s lLh'tErdt!dllt('ElFnn
<br />inlcnd.d or.ficmd for st (S< 7O+a. ltusimst ind P,or.(iohx Cdl. Th. Conra.roi r l-tue L,w docs nn! rrrry ro sn .wM ol
<br />rh. Fr{dy wlb hlildr ( irFr6 rlrNr &d *rr, &s uh kxt h,m€lf o. h.r-lt.r rrE u3t it .t ts otn.npk,y..r.
<br />F.idd tni sh un?ffit e br hr.d.n ( oilcr.l ftr sl lt ,Il{w. ilt hiiuiB d ,qrlJrmd n $ld *ilhh m Jr
<br />oroq,brh.. rtr o$Br Builr.r will nru llr lnd.n orFovirB rhd ,lor qn drdn tniu fl tqmt tlE PmFny fq rlE IUIE or
<br />l- !so$rcrorrlE F,If,dr. 'mcklosiv.lt drntxrn8 *nh li.dcd.odr!.rnr !i' mndMr ih. F,Fr (S( ?()1{. BaiEs
<br />Pir,tr(iM C.dc rhc conrodor's t-ic.tr\c l,* docs nor irply rn !tr own.r.lrmp.ny $h. buildr or imlmvrs rh.r.on.
<br />ell' mdslr lff {uh tn*.h *irh r cl,nreloa o lr6ed nui(ud lo rlE Conkalolr Lr.nr tr* |
<br />I n '.k nt rtr,l., Sc.rnn,, B &PC n,rhtrrcrn'. ^GFu,r,l,tt .r,:*v,\/ .luraf,.Ea.i_.lQuPldsa[a!A uErlJ.8anod '
<br />r i\,rhrms ikrh6"{.I h..cby.trnnun'ld ,rulry ol rErjury
<br />I csnit lhar ,n rh. ,Errorroftc of lhc enrt h, whichrhn Frdn tr '\rucd,I rh.ll frn .nT,l.y lny F6oi ir rny nrnmt
<br />s' st, tf,om lrhFr ro rhc *ol*s! co'iqE.qrr,n hw. orclliiorni!- ond s3Nc rhd irI (hould lE oE sul'j.tr kr rrt
<br />rortdi d,qFN! a. F$vti,nr of S.d h. lrtn ol rlE tjlrn Cod.. I dblL fdhlnh 6inly tr ilh rhot pmlnnnr
<br />WARNIN(| FliluE 11, Etr srt r' r,qxnor*r .\*6Bc s !nhu6rl..d shlll.ut'Fr d.q!kF rn aimiMl FBniF.rd
<br />d!il lln.\ trf n), k hun,l'.,1 rhounrl ,loll '\ I n ad,lirstr ro lh. nxr or rtt*n\ari,)n, danhSN a\ p!'vidtd ri, rh.
<br />S(rion :l(r'76 olrh.l,htr Oi., inr.F{
<br />.*.{r,r)
<br />ul.l.tkulr\
<br />I hvnh\ rlrntr,trnJ.r |iIxlr),'l BrJu'\ I l.m lt!.ql lnLi Etrri.r)n or(lsr'6g'i.r'mEEinS u(h Sdi'n ?mr) of Divhhn I
<br />.l ttu Bu\i'r$ rrl Pn,fcl\i{tr,\ Cod. rl 'nv licnsc n n hrlf.rc( rlclft.r
<br />!10li.$f,l]llllllu.l8DtllilcEd!:r
<br />I ffit l,lrn ui&i FMxy or Filry lh.l rlg n. mnrrndion I'ditrs r8cry r.r rrE Frf(rlrl!tr. olrlE "rxl ror whah rhi p.air
<br />trrucd rsR' 1(r7. (ir c)
<br />kdcrr Nlm
<br />-
<br />I
<br />A!I!1;II!L!EII.Af,AI!I!
<br />lh.r.hydfmrud.r Fmhy ol p.rjrry dm ofrh.lulk*rng delmri N
<br />l).mlir$n Pclrnils.A$esror Norificark,n Fcdcral RrSxbrirN lTirl. {), Pd6)
<br />-R.rtu&n
<br />Lrrd or Niiitudm
<br />I .d ily rhd rrE f.n r.l Esuhriont raudior .{,$ro\ rcnDMl m. ftr {,tlrnhL b rnn pmFl
<br />r.rc ,rlN (tplrrr 'tr' (rr.rl,nr rh. rlur i',|,trt k t(,t'lcr l rri(t r{, .onlnt s hnll(-f}_rt(l(irunrv
<br />ir.li$srtrri"s rot iHinS.oirrtulx4 d,lE chy luthtrn. rcr.{nrDrirc! ofrhi\ Cir, ad ( ounryl. cnrd oFn rlE
<br />t nnrFd!- rm mrF.ri)n nurres
<br />Uq *,r1
<br />1 HY riq,.-.*\y u i )
<br />Erection Pads
<br />Brown Coat
<br />l)K\d
<br />-l
<br />hlw rd e ill dinrrin . C.nifrclr. or C.nE.r lo S.ll lnsur. t( w,kdr $nFnsrion. !r lrevid.d r.r b, Selbn 1700 ol rh.
<br />libor Cod.. lr lrE Ff.)ffi .f tlE *ort tor *tkh rlE pdni i1 iBEn.
<br />-l haE.nd will ei.rrin sortd contrm.rir. i.rw.trr, ts EtuiEd t'y S(rbn 17fl, oI rrr Lhor Cod.. lor lL Fftn1rra o,
<br />rlr vtrl r{tr *hi.h lhn F.mir ir LsEn. My wo.ksa comFntalion inunflcc otrir un Fniy numlEr e:
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