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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS ()NNtR Bl ll.tlt R t)lt.r'ARAI t()N
<br />I lErchy .lfrn !d.r FDlrr or F JUry rhc I m ...mt h,n rh Contsl6' Lx..r Lre ror rlr ldr'wo8 rc.gD rr^-,7oll t
<br />Bnn6r dn Pror.$on c,rr.l: Any C'ry or Ci,u, , ,hf,h ctukr . Fn'r ro !!nner. txd, 't{n,E. &nlLrh or EF! xy
<br />(rudurc. nndlo fi i$utn.t, d$ r.qun6 !h. ll)ph0nr rat such tr nil b nlc r rerd { {crnl lh.l lEor {t ii lc.nEl I'usanl
<br />ro rh. F vtilnr ol ttE c{'.k(l ! Lx.nsal lr* (Cr', s 9, Ci'nmBin[ wirh S<rrin 7ffi) or DNn,. 1 ol rh. Ru(E( r.J
<br />Pnfc$r'.r Oi.) n rh.i h. ry rh n rr.n$ rlEdNh .rn lh h.3n fir rh. rlk3.rl .r.ryr A.y vrLrx. of S&rtr 70 l l .5 bv mv
<br />[pil'.!nr ldalltm sublek th. lpplMnr b rcrvilFEhyofnor mr.rh.n livc honlF,i,lotl(! (i5m).
<br />l. .! owr or r& IlrFny, o. oy.ng}oF.r *uh r.!6 s rhcr $L $nBmdon. wll.h rlE **,n r rurE! d,
<br />6t.n!.1 or od.rd td ek ( Se '7044. Busm( ..d Pn,r.tr,,r C,rL Trr C rtntrrlx.n{Lrw(l($ft'l.mlyt,oowtn(
<br />rh. fmFny lhr hildror uir.)E rh.d,tr lfll whi dxr ru'h krt h,hscllor h.rtu o. rhtuu8h hN or lEr own.nPl.r..r'
<br />rtr!.J rlll| rkh dln'rmdr G n{ rr.d.l q ofi.rJ nr sk ll, h,EE, tlE hllllu[ * lqn,krd ! r'll srto ln F{
<br />.llrrpLrE llt o*ftr Bulld sI hrE th. hor.Ln of Fnvn! lh, lI.rdt drlnrt! d rPrst 0r pn?dtv rq 6. F!ID< ol
<br />-1,.\osEror
<br />rlr In rdt. .m.! luqrrly rodrarrt wrh lrcnQl Ndr.t'F b.onrtud rlt F,F!r rSe 7{EJ. B!!m(
<br />anj tn'krstr C(xl.: Th. (b.ktkt r LE.n( l,rq &xr nor,plly r,, ouEr.fPn)pcd, wr$ bu'tJ5 or mfruvcr rh.r('n.
<br />and who. aG ,u (uh FI..r! wtrh r Contidn( 9 |(.nqt Nrua,* t, rhc Conrkroi s L$ne li*)
<br />_Irm.rchlr unLr Serr
<br />IAEEEBS:(OIdTEBIAIIAN
<br />IIECIJXAITO!
<br />I h.r.hy rllio utr'jcr r(nrlryofFrJUryom ol th.lollo*o! !c.Lrrnon\:
<br />-lhrhrillrllddo.Cs.
<br />ilrcorci$* ro S.li- ImuE ftf, qit6' .orrl,.n{bn. I F)vrrn! fttr h, Sa!.n 1700 ol llE
<br />ttrh, Cir.. i,llE,Erin']r1e. o{ rh. h& t whi(h th. Frni ! Ntu.!.
<br />I htE.rn wrll m'lrM k,rt6- coqEN.rrr m.unE.. .. r{uttJ h, Sdtron llr(D of rlr llrrtr CdL. ld
<br />'lE F.l(xlB{ oi
<br />tlE k{k rn *hlh thi! Fmn E 6tE1 My $trk4 .rh{En!r!n nort!.!mr.rn F)lE, tuhl* a
<br />, " . Ar,ieAcar, eatuliy Q,^Pxt/
<br />6orrt s Lor q
<br />-l.cn'lirh.t
<br />rn rlE lr.torllsc or rh. $ork n, whrh rhr rErm! tr r(kl. I .lull ft{ or{h, rry FBnn r.y m.mi
<br />$ .r r' tBaft rubFr t, rh. h.t.^ .oqEnqrNn Lvr ol (:lrl,,ma. ,nl rBE thrr rl I rhnu! tilom sul'tt o llr
<br />woltc^.onp.n\dionrn,vronso,sc.rlrn1?(x,.1lh.lihtrOrl..l\hall,bnhwnhNnliyerrhrh,{ln'vrNns
<br />WALltlltc: l'i'luft tJ qurc sort.6 (omFn.!ri,n ("\.rrg.
<br />rr'l r'ftr W n) or hulrcd rh,uq Jollx\ rsllxr,lrrr. ,.
<br />j(r .n ftrl0F, t' lrllml FEls .ttl
<br />lr (mecf,siD ,!tu!.t ar pnrvn.ll lor 'tx
<br />id:'';i;h.I rhi liit. n .'(n m{l rnnkv \ l\r\
<br />It 't
<br />DECLARATION
<br />I h.rcby .rtrm unj.r IEE!y .l p.lrtr, rhd I m lrrnsn unkt F,vNnn ol C1ufld 9 (d':mNlU YIh Sart, TUX|) ol Dirt$n t
<br />or rh. Buffn .il Pnr.runr C.it. d hy lr.tr< E m tull ftnt rnl.ltd
<br />tr''-'.u- 6 Cttzts-
<br />o^,*"^ EL!&.4*Sa EEIiY SYA&. S
<br />( oNsrRU(-rtoN l,FrlDlflc aGEN('r'
<br />I h.Nhyrlltn, nJ.r F-.nrlryol p.rlury lhd rl{rc r ! con{n'.rrn, Lnlm! rsci(Y tut rhc Fdnrunr. ofrh. rork ltr whrh rhtr Frnnr (
<br />i\$.trrs.c v,9? (-'Y ( )
<br />trnl... Arljrfl(
<br />-
<br />APPLI('ANT DECLATANON
<br />I Hry riim !.d.. !.n.!y ol p.rjury oE ol rrE li,Uowo8 &<l,rr krnt:
<br />D.mlrnn Pdnr G^ilr.(o. l{olfx.r nn FrLrllR.luliirr (I.k ll(l. P.n6,
<br />_R.quft d lrtr.r of Ndfulhn
<br />-l.tn'fy
<br />thd rlE laLrirllhtitr s8.,nrn! ilrE(oi rcm'v.l,c mr.ltlxlbk b
<br />'h8 F)Fr
<br />I (nrly rhrr I htrv. rcrt rhr rJ'0lr!ri'n ,n('frrr{ R&rur Irsdn,.ory y rnh .ll Cirr.Ll Co! y
<br />.r Dr.t,Il Sr c LrreEro3 tofu'4 lr.iiy .urhoro. rcFlEdnr6 0l rhtr C.y ul Courrt ro ..td uFrh tlE
<br />rt[r. nilirncJ pn)p(dy l!tr tr]!.(rr)
<br />Appllol or At6l Sitdlui /s/,1
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Su bf loo r/Ve nVln s u lat ion
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq
<br />lns u lation/ E n 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 />Enqineer Final Report
<br />Flood Zone Certif
<br />FINAL qllolu 10,fl,J€*d il
<br />Certiticate of Occupancy UI
<br />Notes, Remarks, Etc
<br />Set Backs
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