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BUILDING. INSPECTOB RECORD
<br />SITE-WORK DATE COMMENTS OlVNER ATII LDI.JR DITT,CARATII)N
<br />l h.rchy iilirD undcr pcmhr orlcriuy rhrr l N.xc \n innn lhc Contr.bN Li.ctrk l-r$ klr th. rirllo{i'r8 rrt*nr isc'7{rll5
<br />Irunnc$ rtrd ?nfcsi{,d C.dc): Any Ciry or Counry s[i.h rcqutcl r Frtrril l0 cotrirud. ilrcr. imProrc dcnn'lish rtr rc|'t rtrv
<br />irucfirc. !r&lo ns niurtrc..ho rcqutr\ rhc rplli(i Inr such Fnnn io lilc I \iEn.d {arcrmnl rhlr h'or shc is li'rn\rd Nfurtri
<br />lo rhc Pr(,v^ioN olllt Contx.ttr's Llccn{d llw (Ch,pr.r g Connncrti'r! wilh Sccrion 7fi}0 ol Divnion :l olth' Ilusntss aid
<br />Pdcssi(nr\ Codc) ot rhd hc or shc k cr.mlr rh$cftommd lhc h'sis i,t rhc rll.gc{lcxcnr nnr. Anyvolrnon'fs(rbn703l5bvltrv
<br />rlplicrd tur iplmir \ubj\--h rhc apflicanl ni r civil Fmlrt oi n.r motu rhrtr llrc hundnd 'lollrr
<br />(S5(x)r
<br />l- !r .wncr .r rhc rmPcn y. or ny cidoy.cs sirh *ascs as ihcn sh comprnsri i(,1. will d' rh. soik uYl rhc \lB-rxrc n mr
<br />inrcnddd.rolltrcdim;h(sLi'T04"l.llusincss Pillc$nnN Colc 'l'h. c.flrmroi\ l-iccn{ Lrw do.s noi ,f!lv ki o*ncrof
<br />rh. pR,,rn! qh) huikls or i'nprot$ rlaM!. rld who d(E\ $!h *.tk hi'nsclfor hcr{lfor rhdrlh hF or hcr owi cndovcc"
<br />p",,a.a rr,u 'u"rr in[ovcm u n.r irr.rkl<l or oficred lnr s[ ll horcrcr. rhc hu i[ling or ihnn^otnr i\ skl t irhio onc )tr
<br />;f&nDlclion. rlt osNr suidq *ill hrlt tlt hud.nolpmvi',g rhd tE or rhc dil rn toild oi inlrnra rlrc lmlsrv fin rlr !u{F* ol
<br />l. !\orn.rol ih. polrny. imc\clu\trclt.onlrrr ng rirh li.c *d..Mr.rtr\t)cotr{n'.lrltlnoj.(l(Sc.7ol1.8trrn'sr
<br />rtd l\ra$i,t((irlc lh. Contrnt'( Liccr\c l,r{ tkts iornlPlyro ri.qdcr.lProI. r_ th. h ldr'r irnlrrc\ thctrrn'
<br />id \!h. in ' cr\lnr{rhfr,[cr\sirha(]n tuckn(sr li.cn\.d ttrrluir l{] rh. (inn'&roic l-ic'nsc Lrw)
<br />Dsle Oanerr
<br />rvoR(I.Ri (i(,NIPNS TX)
<br />Dricr.lxtrItQN
<br />t hcrcbyrliilnrM$ lcMlryol Pcrjury.n .flhctulk,wins{l.cln'rti.trs
<br />LCcnilf, r.olC.trscfloSeltl'rurcfitrworkcrr.o r|Ens.rio.. !s prulidedlorhvsNrion]70(rolrhc
<br />ne olrhc so for whEh rhc Pcrmir ir issuLi
<br />rk.rJcompcn\xrn,ninruhtr.c.rsl.qtrnldbySccri,in.l?(x)ofrhctrhorGd..rirrth.P'nnrtu'col
<br />A $u.(l Nlj- \qnk.rr (o irt+ rtr',tr.untrrr(Jtr'.rr FlL' nrn'ft' trc
<br />,/tu.//?/-:3!ryf1:3Y:!A o,//2- n
<br />IccniiylhrlinrhcNduirnanc.{)irhcqorkLr*hiuhrhi\tcfllri\i\sucd.InrrlliorcnI'lovtr'rylcrsninrnvmltrtr$
<br />n) ast,hcconrc\ubt clroltusorkcrs conrNnsdbnlrtr\olCahlatnir.lnd Erccrh rl, shorld htcom subjccr t'rlt
<br />dn Nn\iltrl,'o\ni(n\ol S.cli,r,.l7(x)olrh LLhr (ixlc. l \hrll. 1(trrh\irh.o nlPl! \ [ rhot ni{]rnnnr\
<br />WAtaNlN(;: Irrlltrc k' \ccurc $ork..r ..Dlxnsdion.ovcflgc i\ uDhLvful. rnd shnllnr rn c {n,,y.r ri di' $rl B ilriA x !
<br />(ivil inc\ up ir onc huftltcd lhotrsrid dollrn (S n$rnnr, dntr gc\ x\ Ftrnlcd ln. rhc
<br />Sccrt r 11176 olrh. LnlnrColc. i' o'c{rM[lornc
<br />?- f 2o77^
<br />.f( hiflrr 9 (.onnrf,n.inE rvrrh Srciiotr 7(xx, of D^ndr:tI hc'rhrrllr rrfdcrtrnrhyof t.rluryrhil Iun,!i
<br />!i rh. lnrnrcs rtr(lP'.lr$i,rl Codr (lnD li..tr\'i\ i'r hLlLl,(.. )nlcll..r
<br />K)34
<br />?.5.2!6
<br />I hcrhyallnDu dd NDalryolPcrFry rhd rhcrc i\ a cotr\lErri,)f lcMtrrg r8.ncy f.r rltr NriornrrNr (l lhc \York tur shi'h
<br />A\urtltsc. .llr97 ( iv (' )
<br />Irn(lc.\ Nnnrc:
<br />l.nd.is ddi.sr
<br />-
<br />APTI ICAN]' DIiCI,AR{I]oI
<br />I lutl,ydnnnr!0(lcrJtnrlrtol tN]rtry, ( of rtu r,)11,,\ir! d.cIrrri(nr\:
<br />l)cNn iotr Pnn{s A\hcdo\ Nor'li..ririn l:.dcrrl R.Suldi( \l Iirlc 'lo I'n'161
<br />Rrqrncd trrrcr or No(ifi.xr(r
<br />I ccnilyrl, rtufcilcnlrceuhrion\to! lnrgn\b({.\'dnm! l uNtrnfli.rhlc!)rlris|'rllld
<br />I (cnilylh lhrv! rc rlri
<br />oi(limd.cs rnd Slrrc Iiws rcbr
<br />rhovc mcnri{'ncd pn,pcny tur i'
<br />d rc rh[ rlrc h)vc i'rftn rrf,trr is.otrccr Irgcco.onP]vt Irll(ilvrtrdCou r]
<br />/b;"::;.;l ^"
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Sublloor/Vent/l nsulation
<br />Roof Sheathinq nlnlt?&anam / 61--.
<br />Shear Wall
<br />Framino
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coal
<br />lvlasonry
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Report
<br />,
<br />FINAL 4/zlt trrb/h ce
<br />Certiticate ol Occupancy
<br />Notes, Remarks, Etc
<br />ID/SIG.
<br />Pool Fence
<br />Flood Zone Certif.
<br />,7
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