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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS otfNltR BUrLDl:ta Dtil-clta TtoN
<br />I lE!!, .nm ,rt r !6.r, ot Frrry dr I m .&trpl t!6 itr Ciddr' tiff t * rr ft lollor4 6s (se.1oll.,
<br />ItBitus rid ft.fBiri C.d.): ant Ciry or ceny yl,ih Equer r Fd ro 6dM, dra, ir?mw. .kmlid ,.Fir ey
<br />stuM, !n, ro iis ise., !L. EquGr rh. rppli.dr fo. s!.h [.mi[o 6L A d sl{.Ed rhd lE or r& i lirtrql plEar,
<br />to rtE Fvniotr .r tl! Conrdre r ljdned tr* (Ctp...9- Cohfttuiia *irh Serbn 7clu of Divnhi ! ofrh. Buirs..d
<br />Prcf.snn: Co&r q rrq tr d dr i!.r.nir rrEdrDo rd rr.lis for rL rl} !d .rcl4.in Ary vtiLti{ o, Sdbn ?Oll.t by.r,
<br />.ppli..d ror r Fmr {6Frt rh. .p?lkrd h . ovil ,681, ol d llm rh& fiv. hdidEd dolL.r (l5q)).
<br />-L
<br />6 orn.r of rlE FlEny, dr hy c'rthEcr sirh w{cr c rh.n arL orlEndiri, will d1 r}t wI lld rh. {M@ k d
<br />idsrlal r DlT.r.d fd rL ( S( 7oa,a, Buli*! rnJ PrDfBior C{rL Th. Co rdor'! Lj( n.lrwdErdiftlytoeowrof
<br />rll FrFry wrD hljlh r n T.D6 rlElr !d vb &B rdr \i{it hier or lE f,lr q drDurh hir r tEr o*n.trpbr6,
<br />prold.d rh'r r*t ogrmtu c d id.ddn[dd Id sL lf.t NE, rlE hrlt d lrtrqrd ! b! rihi! c Fr
<br />or.mpLria ilE OwEr Boil]a willh.E 0r lnln olFsvina rhd lE or CE lii Bn h(itl or rp.!E t E FDFr,lor EF FEof
<br />-1.
<br />6.w of lh. F}pqty. e.!U{Ell stury *ah lactrql .ddm t. onaui rlE FoF lS€ ?O44. Buih
<br />ul PEtq{Cod. TIE Coddq'r LE.E trs d.B d rt l,buorEotFopdy*l!buildro.,nproE rh.te^
<br />lnd *ho morrdr {d ch FoFb eirh. c.dftro(r) lt4€d f{Bud ro rh. c.did.1' Lj..M bf,).
<br />-l
<br />d.rny{ unLr Sd$r-, B. & P C fq tha Ersnr
<br />uaf,rErut(l)llt};Nlfl&!
<br />DECLA&iIIUi
<br />I h.r.bv 'rhrmun&r !.n.ny.I Fjurvee o, rh.ld[DnE d.cljdr)n)
<br />I h.E.rl plllBurrin r Cdfir. olcoM ro s.lf-lNuE ,{tr *rrli6' NiFdirn, I F.viLd tor hy Sdbn ]lm of ill
<br />uhn Cod., lor ih. pdktrmr. .f rh. wod tu qhth rh. iEmn i !$.d.
<br />_l hrE.d will .luu m.t E .ontr6rrb. uora!, u Ertu-sl by Sdrs l7m of rlE t l,or co&. fd rlE rEflm ot
<br />rll uit r{ vhrh .h! IErd ! isrd My eoltd! otrpcdr'. lN.le @ rn I.lIy NnlE ftl
<br />-l
<br />cditythd 6rlEFnor'ffiof ih. volt lq rh*h thi4cm n$wn,I .llrcr.qb,u,Fhnn,yMM
<br />s r. ro lxor obirr l. rh. s*.r'6n?.n{i6n L*l of Ciifohi.. rnd 4e rh{ if I *huld b..otu .ubj6r r. tlI
<br />E 6 @ilEurrn porilix ofselp! 3?m of E Lld cBi..I3lrrl. tdhwlh $nDly wirhrlE pDam
<br />WA&YING f.i!E ro @ Eta'orFdE. @s{. ir u.Lylul !.d rl,.I tu6F -.rEbF h sirr !a.r6 !n
<br />c'vil liBr oF ro oE hrdr.d rlI,ud doll6 (llm.fi)). h rd.rinn ro rl! cor or.o(EErio.. d.!q., a povir.d ror rlE
<br />Sdrion 10'16 ol rlE bhn Cqlq ir.d !i droEy r fes
<br />''r]ffi
<br />DEEIdBAIIIX
<br />I hcrtty rmrm undd p.^.hy of p.rjury rhtr I rm lie^ed und.. fnvui.i ofCh.rrd, (comrtuing wnh Sdrtr 7(ID) nll)ivi.ion l
<br />or rhc AUiEB .,i PDL ou cod.. nl my li.ns n in tuU for !r! .tf.c'
<br />cQlirrBlclloNrldDMlquu.q
<br />I h.Eby !flim unn.r lEnrlryorFjuryrhar rh.E t !. .iru.1inr larlurg ag.r..y lo. rh.IEomr. ofrtu *dl td whi.h rtut F Dr n
<br />uru.d rs.c ltRT Ci! C)
<br />ATE.ICATIDECIA8^IIO!
<br />I ha*'y tfm udd Foly ot Firy om of E folbwor &.L.rtioB:
<br />D.rolirion P..mik-tuh.no! t{diri.rrDn F.tL.d R.!uLri,ns Onl.10, Pd6l
<br />Raui&l lrnd or No.ift.rbn
<br />-t
<br />.dlr} rhd rk a.doi EluhliiN Egrrtug rrlBix Emtrl E d qrrli.lhk ro rhir pn,Fd
<br />_l cd'frrha! I hxwE rhn .pplt.rion uri {.r.r .boy. rrormrion
<br />^
<br />.ordr I ltc ro onplt wirh lll Cir y lid Cou ,.rliur6 rrrl Sri. titr Err€ddiw! of rhi Cly rd Couny ro d d ,4or ilEt,t
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Ereclion Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framino
<br />lnsulationi Enerqy
<br />Drywall
<br />Ext.i lnt. Lath
<br />Brown Coal
<br />ltrlaso n ry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enoineer Final Report
<br />Flood Zone Certif.
<br />-l/-r,
<br />FINAL .4lt[ztza Ufw/rdl q4 s)
<br />Certiricate of Occupancy
<br />Notes, Remarks, Etc.
<br />Rev.08'07-2015
<br />Drr.:
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