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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNEN BUILDET DELCARATION
<br />I trRhy .lrtrm ult r lEMlry t)r F+ry rhd I s .!.q{ fmm trE G)nrrar6 L]..n{ llr lbr rE n,llo*r8 Esn (Se 70Jl 5
<br />8!rlB\ .d PNr6r'n Cdk)r Ary C y.r (i{dy whrh Equc i Ftur nr (!n(BJ. r!d, ,rthE. &ml!h or EFr sy
<br />dNrurc. nntrkur\ Num., rho rcqoftr rh. +pl(. ttr suh Fmr ro lik. r+kl rrcmnr lh.l rEor rlE s lienEd trlNs(
<br />r,, rh. F)vnDns or rtr Conrr-ktr r Liurd trw (Ch.pr.r 9, aohmft'.s *'rh Serm 7(I)O of odi!.n 1 or tlr B!!rcs ,i
<br />Pnrc$ion!Cur.rurh.rlrqni!.r.q rltrfrDn ]rl ltr h.r.li, rh. .lL8.d .r.qfuln Anyv$Lle.orSdDn70.ll5byt,
<br />r!! Kmr n,. Fmn rubFc rh. rlTlr.ni t,rov n El'torftn mErhd I!y. hudEn llolu (lJm).
<br />l. a\ o*xr of rlE ,mFny. or ny .mpl"..i ,'ih *.r$ rlEr $h .$6ltnqr$n, sdl &' th. s* .,n 0r dBrE t n,
<br />d.nlcl rr on.dl rtr qh tsd 7lxil. BrrmI .^l Prr6r$N Cdt r TrE 6dr-rtr r LraE L.e dx\ d {,r'r, b i orrr or
<br />rh. pNlxny *lr,br lt or h{'D(\ rlE6n, r wlh drE '**h u,* hmrlf or h.rlf .r rtm'ulh hr o' h.r oM cndor.r.
<br />I,ovidcd rh.r tsh mnoErdremi hrc .doror!.Glt,rqL ll. bw.ki rlE t{iluu o. uqxMm n aii *iihinon. }rd
<br />or(EpLrn., rh. ()wmr Bu l.r *'ll h.€ rh. t[nL. orth'vurs rhd rr q rlE nn or hrlll or d+ror rlr Flpdy tu rrE F[F)E of
<br />l.aso'ncrolrhcnn'nny-!tr,c!.lusircly.onL,criry*[hlr.n{J.drrkFn'conilru{rlrF'Fer(Scu7(14,1.Bu\im*
<br />rd Ptir.ltrh CuL: 'th. Conhrtn (l-r.n( lr*&8 { rJ'flyh -.*ncr { I'rolxn y who t u,Li nr sphv.. rh.r6r.
<br />..d *h, (rrBl\ !,r 3Ni I,{Frr enh r (i,nhron \) L.nGl I!o^M b rlE Codtut{ s t}.n€ lr*r
<br />,l d.\.mpr uodcr S(!!,n-. B & PC turrhLs rclqrn
<br />uaxxESs:(ouPiNtalllrN
<br />IECIJEAIIO!
<br />Lrchy.llum uftLr lxMltyolFrruryor olrh.,ollos t &rlriti,nr
<br />-l
<br />h.v. rrl wrll mdau e C.d rli'd. oa O,n{.r ro S.l,-lnqur. n, ktrk r- tr,r{rcns,l trr.. rs F)vrictl lin by Ss-ton .u00 or rh.
<br />I jhtr Cilc, lnr I h. rErtttrMr of ilE *orl fitr whih .lr lrrru n !ieJ.
<br />I hrE rnd *rll mmhr rort.F .rmrnrrl &n r!uaE-..- r r1u!.i ty Sar irn l7ll) ol rh Lhtr C.xL, f trr Ffi'm. of
<br />lhc unk,r whahlhr Fm( r! s!u.d. My *ori.r' q'nlt'.ns0li.n rnrurm. rm.t.r Frlty.umh.r E:
<br />.--' Nm,{rur'*n fi.Uilpr$rG 6r,.{/ErrY
<br />d
<br />I cd,lr rh.t n rlE tr.iolfrtur dl rtE *.rt ld whf,h rh,. Fm[ r rlFl. t lhrll mr crq,L,, y Fm. h r lME
<br />o !r kr tEom {hFr b rh. urt6'@mI.nri nn Lwr o, CrhlomL ,rl +6 rhd if I rhrll lE od subFl n, th.
<br />*ortc^.on,p.nsari,npn,visbnrolSccrn'n.lTlnotih.lrlbrGrtc,Ish:llbnhw,thLonrdywlnlh,El{.vriioir
<br />i4ARNlN(;: f.nur n' c(@ *ut.r lr,rsf,nerrn li'Eare n unL*tu1 r inil ru$F"r r .npt'Fr ro rtrlMl FDiB ul(!rl nrc\ !n r, om hunlEJ lh.uqnl dlnkr (!|oo.(xl}r. 'n d,ro rti oi of unp.nqrk'n. Jm8.r .r Fnvrrdl (n rlE
<br />S.!ri,n \ r6 olrha lrlvr
<br />"",,,
<br />. tlult Gnc, hrcrcn andri,my's r..\
<br />1TT1 t,I( l \st:D (()t t &t(l{)L
<br />l]l!!"1-8!l]!l!
<br />I h.Eby .l lrh und.r Jx lry or p.rjury lhd l .m lErr.l uDjcr lnrvnn,n of Ch.fl.r 9 (coMtBinS enh S.t iln 7(D0) or D'vnpn .l
<br />ol rlE BurG( ril P^,r.!r.nr (]liL, lrl m, l..M . r tuU fohr .rn .fid.
<br />"l
<br />gurllallflqu.oBDl&crcIlcr
<br />I lErcb' tllnn unLr Ful, ol Frlury rhr rrrr. Lr r on{Nru LnldS .8.r, ntr 'lI FrtlmBc r, rlE k l d f,irh rhr Fd n
<br />trrucd (se !tIr7,crv. c ).
<br />APPLICANT DECI.AT.ATION
<br />I hd+ry.nir uDlcr Fnilry ol F.Jllry oN ol rhc fou'*mt &{[sii,nr:
<br />l).Bnnrr lrcrnnsArhc(o! N.r (3r!,n ljcdcrll Rc3uhr!,ns (I[lc 40, Pan6)
<br />Rclrurd lrrl.rdl fir irDn
<br />_l.oi yihr rh. lcd.nl rc8uhrons rc8edin! rsb.(orromv.lu. rra lf,rbklorhnFDF.i.
<br />2-tl c&'ry 'hr I h.E rcd
<br />'hs
<br />q, uru rn.bk thi ili ftr I .8r to qxqrry wrh.ll cr, r,rl ciiud,
<br />onlh!turr M! Srirc ll*s Ela'iry r, h,Lir3 rhh ( ny.rd Counryro cir.r oFh 'rr
<br />-*'" loo /t,
<br />!h'v. nrnrrftrl nn,rrdy n{ rslErtDtr
<br />,\pplinnl or Aq.nl SisMlu(l)l'"''''*
<br />**..*"'
<br />--T-r-
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor 07 ,{ ^/rt c 6) xho* r,,'lsh--
<br />SU &aA e'tt a 0
<br />Roof Sheathing
<br />Shear Wall
<br />Framinq
<br />lns u lation/ En erg y
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certil
<br />FINAL 1 l"l \q ,(ME(O
<br />Certilicate ol Occupancy
<br />Notes, Remarks, Etc.
<br />Set Backs
<br />Sublloor/VenVlnsulation
<br />./ A/-'v rr Il nr'l .l?,tttn'ri F-pprFxr
<br />I
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