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EUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNSi IUILDXT DELCABATION
<br />I lEEby !fltm uD,lr FMlly ol F.JUry rh.l I I ctctrI, fNm trE Conlr-tn Lr.n< llv for ilr lolh*ry E.$n ls<7oll J
<br />Bllrsr !d Prn6q,n Cel.): Anv C'ry o, Ca,ry ,hrh Equr\ . Fnd ri, on<Br. .lrq. mpnrw. J.ihl6h li EFr ey
<br />{rudurc. Fffb ns sruB!, rko rcqunci th..tJ'liar f(tr ruh Fmr t! lik..(md nicmnr lhrr lEor sh. F lEfltJ lus.rl
<br />h rtr F,vNr'nr of rt* Co.k&t(*.t L..n(i Uw (CluFr.r 9. Conmtu,.! wnh Sdl$n 7(tr0 ol Drvu.n I .i rlE Bu!rc$ sd
<br />PnnctDN (ilj.) n rh.r EqrlE !.r.qn rlrEfmm.,n 'h h.rN r i& .lh!.n .r.tqr!,n AI, v$Lrrn ols(i.n 701I 5bydry
<br />rp, Mr ft, r Fm ubFts ih( rml@r h r u,'lp(ulrtorrn m,. rhu liE hutolFJ &'ll*s ($m).
<br />l. ar .wxr oltrE F)Fny. r m!.,r{ ,F.r wnh ut.r a rrrr (k.snlttn{r5n, wl(r) E ** !,n fE (ui@ n ,
<br />lr.nhr ,, orl.EJ nn sb (Sc 7{x,c. BurEr. .rJ PrrL.u)nr CirL: T,E cdrrtr r Lr.n( trs (lEr d rod, b .n .rrr or
<br />rh. pn{En} *h) h!ru( or urynE. rrrKn. arl *h. (}n uh *'lt h'mcllor h.rylror rhnu8h trn nr h.t ow..mnL,y.cr,
<br />tnrvdc'l lhrr (u.h ihl'nrEEdr c mt ir cnla-l oroltcErl fttr sL ll. h,*.Er. rhc I'oi!ir3 or iqnNm ir v,tl *nhf otud
<br />orph,h, !h. O*rr Builhr lil hrk rll tr l.noftt)r{0ErlEo.{rJnn l['ll 1, nlmw dr InrFd, ft{ llr Flrl!,r of
<br />l, as owmr .t rh. ln,,xny. rm .(luqv.ly . nkf,t inr w h l,c.nlrl onlr.(lo6 k, .nn(ul llE I'(+d lsc.. Ttrat- Burtrs
<br />rd Arr.<!r CuL: 'l h. Conrrxttr ! l-(.nr. lj* &xr an rmly r, d o*mr ol lroFnr rt$ bu lr.r imliok. rh.G,n.
<br />.nl *h !.dRt n, {Eh Frr.t. q{h. C.nrtukil!,1(.<rl prrd t' tlE Coiirar.i( LEiE l:r)
<br />l.n.\.nrpl unlcr Sc(rNn
<br />tvoaf,Ef,t.cquEElIAllo!
<br />DECLATUTTON
<br />I hc.Lty.l!rn!nd$ JrDhy ol JrrFry.E il rh.lolhutr! &1Lr!ri,.t:
<br />-l
<br />hlvc !d wr ll mhllu r Ccn i..r. ol Con{nr lo S.lllnsuE l(tr wortcfi . mpcnsd!'n. tr Ir[vd.d tur hy S..ron ]7{xr ol rh.
<br />ljhnC .. ntr th.lErloII*-^. ot lhc m* lttrwh.hrh. Fmir n (rual
<br />-- I h:k rd *nl mlmrro *orl.^ ..mn o1.ii,n m{tr.R r. .i r.quk! hv SLair,n lTlxt or rh. Irxn (ixi.. k, rh. Fnor!11e. ot
<br />rlk work lnr wh'.hrln! ncmir ts tr{kd My *orl.a'ronlP..qrr,, m{urrk..rtrr iJri F,lry nnmh.r a.
<br />c-",,
<br />^-tn.2."\
<br />6rnaV1
<br />PorcyNunh.r: tJCiatr6o[>''.P""'
<br />qftftl
<br />_lr.d , rhrr rr,r |trrornIn. olrtr *ort rir wh.hrhrFrm n F\uri.I rh.ll r.,9t'yryF&nr rny IuE,
<br />*, fi (' h.1 m subF*r b rh. hrd6r conyEnqrr,n h*r ol c.lift,mu, .il r8r rh:r ,f I .bu5 tE .B uhj.lr r" rll
<br />wo*cB' cofrJr nsrt ion lln,vronr of ScLl,on :l?(tl of rh. lrhtr C(rtc. I rhdl ron hqirh cootly wirh rly|$ pn,vnon!.
<br />WARNINC l-&luE ri' EE k .n (r,qrn\.lrr .oEn8c ! unhwhil. rnl \h.ll shFr u dlllk,rr, tu (moEl JrMl.r.xl
<br />.ttl liF up lo or hualr.d rn)uqnl JoU. lllm-q ). 6 rrlrDn nr rrr (o{ of ot{f,minrh, J@3.r rt fmvn.d ld llx$rr[n Vr76 ofrh.lihtr riic
<br />.,.n, LlrJLaI t' '
<br />I tkEhy llirr und.r f(nrlry.l Frltrry rhd I rB I nAnfl ol(l'.'t .r,)i(.rurrrrn3$rhS.(rrtr,rrXXr)!'rI)i!*ntri l
<br />ol rh. nu1ft.\ iJrl ttolcsln! C,iL,.rn.,y lr.nr F n tulltuk. nl.llRr
<br />,.,*^*ro* CofltL
<br />l' r
<br />I lEEh! nlnn unL. Frtt or Frrory ih, rlE( tr r onr
<br />rsu.d(S\_ .l)97,Civ C )
<br />r$n kds! rg.Nt l!tr rlE Fri()l1ilac.l rh. Hr* n, *hrhihr Fmr !
<br />lx'rl.is N.m:
<br />L.nld s Allrcsr:
<br />APPLI(' NT DTd AX TI(,,N
<br />I ho , rrfm ull.r rEnr!, of Frtrr, o oirL folb*h! &rL,.r,'nr
<br />D.n'hion P.rm(sAttrno\ Norrric.ron Fidcfl l R.xukr!'nr (Tnlc 14. Pan6J
<br />R.quRtl l.l'cr or M{f!.r,n
<br />I!.n'1rrh.nrlIr.,l('r]rr!tr,rotr\r.grkltr'sr\lr(o\'.nr)!rLr.mrrftl!JhLr,rhtrI[r,.(r
<br />l.cd(y rhi I h,E E.J rhr al't'l..r0n {n ir. rh.r rlr.h'q 6n'mron !r.(ftr IrlEroo tr{ t wnh.ll ( nr.hl C.u.ry
<br />odri^-'cs rnl Srdc u*r rcldm3 n, ho lh3(on{turFr., lh.rchy 'v.\nl rhr ( 'iy. lCounryr).nrn uF'nrh.
<br />rrxtr. 'Nnrxtrtral Dn'p(nv I'n m{'.( rkn' rurFn.\
<br />Appll€nror,\Edr SirMluF 4nl rnrl
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsu lation/Eneroy
<br />D all
<br />Ext./lnt. Lath
<br />Brown Coal
<br />Ivlasonry
<br />Pool Fence
<br />T-Bar
<br />Handi cap Req
<br />D eputy Final Report
<br />Engineer Final Report
<br />Flood Zone Ce4if .
<br />1rtld,<- A+'lz,i-CE a
<br />t4>?,r,v)n n l.tEl )
<br />FINAL t7,t.Lq lOt-12 .v-/
<br />Certilicate ot Occu pancy
<br />Notes, Remarks Etc.
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