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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE COMMENTS OWNET BUTLI'ER DELC RATIOII
<br />I h.Gh, rlltn !il( p.EIy i,r F.iury rh.l I M .rcq fn,m rhc cro rat,N' Llc.€ Lw ntr rh. lolklso8 ft$n (S.a.ro:ll J
<br />Buin.( .rn Pnncsion Ctt ): Any Cny or Colnry *hrh r.qurcs . Ffl( lo L-n(Mr, .xd. mrroE, &mlnt o! FF, d,
<br />{ocru.. F.tr tr !r! !rue., .r$ BtxRi lh. amlEonr ru u.h Fmr ro fJ. . r{EJ .l.rcEnl rh.r lE o. rlr 6 l(qcl Frsn
<br />ro rtF rmvtrirnt ot rlr Conr.rr r L.!n*J l.q ((trFd 9. ConwRue wnh Sd:r.n 7(xD ot Diviibr I ol rlE Butft( id
<br />Phf.(i'h. Cu].)d rhd h nE Lr..cq,r rh.Einh.rn dt h.rn turrlr rlkfal.xcnv'lDn AnytiolrlonorSdl$.?01I Jbylny
<br />.m'l..nrr.FmnobjctrrlE+pli.rnrrorriv'lp.Mlryolmrmrcth.nfrvchudl'e,l,lollsr(15m,.
<br />-1.8owxrurrh.pn{Eny,,trmy.mpbF.twhw.!.rrsrtrtrsk.oqEnqhn,wld)ilEhrl.nlrllnturri!flrd.nldl d oficEd for ul ( S-.71X,1. Surm$ rr}l Pnrclq8 CcL: ]1E (i'didort l-si€ tis dGr Br .fi,Iy t, e oqftr of
<br />rh.F,tdy *lb h.iLl\or uqn,E!llrN[ !n *ho JG\ lhh k hrm{U Dr h.rslf or ihouSh h( or h.. om.nPlrrc!,
<br />provli.d rh.t !u.h mlruEmn( E , idcnldl,rofi-ul (d qL.ll lDwq, rlr lxilllB fi !$6Emd r$!*irhho F!
<br />olLln{'lt4rlrOwErEulLr*lhl*ilrhlrl.ioIFovrErhrlE!,irdnd,h rdlqnE,rFqdyt rh.,{.F:ol
<br />l, !r oqmr ol rh. IrllFnr, rn.rctunwly o rdmB qlh lf,.ns.l.od.d6 n, $rrBr llr In j.\i (S& 7044 Bu!trs
<br />turl hrlht\sCdL:'rh. Codtul rLxcny L:*tIBnn {'?lyro rn}ncr o, Fo['.ny*lx' l,urldr.r,mtmE! rhc.con,
<br />..J wnr lrdert &r rkhlr,lrr{wnh.cronh ,(s) lnuEl punlm! n,rttCdnkd,. L&nr t,*,
<br />I rn.r.hd unLr Sarbn .S &PC tor rhli E.rr.
<br />IUrf,f,E8S:.CllllfEdlaIIO!
<br />D8Cl,ARAT!(}N
<br />I lErct'y.llirm unlcr I'.Mlry.l frlury o,rc ol rh. nrk)wo3 d.Lhnin'n!
<br />I hrv. ad enl E'nr:m r C.d 'fr!r. ol cirrd rr 5.ll. Inrur. l,tr *,trk.6' $n{rnsr'n. 8 F,vllc'i nr hy S..hon:l7l)Ool rh.
<br />l,{llElEnoIId-.ol rh. *ort lorwhf,Iilf, ll.rnnr rl,suol
<br />e'llhahrl'hw rtcr-.dnlxni ..qrutalh,s{arrnl?Ulolrh.IrkxCuk,n,th.JErtum@t.l
<br />6 nqhl My yxl.r' .oqrnqr,,n in\lrfr. (frt .,rl FnEy numb.r e
<br />I
<br />l..nrryihar rnrh. Frlorms.olrh. *oll ntr shih rhtr Frnrn n R\Ed.l \hrll r.trpk,yrnl lE idn tn.ny nbncr
<br />q, :r n, h.!$r ruhA_r t! rlr u,r*d\ ..qrnqu,n L!( trl C.l omu. r',1 rrm rhrl rl I \htuld ntoft ul,Fr t, i lE
<br />*orrc^ ron{rnqr$n phvhrn\ tScerk'nl7(x,olrh.ljhtrCiil..l\hnlln,nhwhdm0l}*nhrhrEln,vtrx,n\
<br />WARNINC: f.rlurc t, ruurc workc^ roqf,nsrx'n (rcr.F. ,1unh*rrl. .l d:ll rutFr u dlllloy.r n, ffDl Flulr\ d
<br />.rvrl fik( up t' oF huBlEJ rh)renJ &116 (!l{l).Gr}|. m
<br />/li',i
<br />lo irx od of u','e.6.'ion. d.M3.! 8 pn vddU rtu
<br />rh. lihtr orL.'nr.r.i Jvl r(ony'\,.c
<br />0pcL6EAIlN
<br />I h.Fhy lnirm un&r n un, ot rErjnry ttd I m lFnBl udLr FDYKTn of Ctqr( 9 (.onftBn8 vrh Sdu ?m0) or l)ivrsn I
<br />of rh. Burft!! dl PmLs. clil., rn hy lr.n- tr m lull ftlM .d ctler.
<br />I ncEby affm un lcr p.mhy 6t Friu.y thr rh.E Lr . ur<ut nn lcftlh! .!fry ror rrE Fdollrls. of r,r krl rd whah th'r Fnl s
<br />rnkJ 15& 1u)7. (iv C,
<br />AfILISAIIDECI.ASAIION
<br />I H', .fm u[l.r Fu! y or Frlury om or llr tull'w3 d..&.1i'r!]
<br />o.mlrsn Pcrh'l!^stEsto! Nrilrar[n Fa].r R.luLrk,ns (I'"lc /t0. P!n6)
<br />_Rcqu@n L.rr.ror Mifrru
<br />-l
<br />rdlfy rh4 rh. fcd.r.l EluLlnn! E3sJm3 !th.{o\ 8fr,.1d n{ .l|P!r.]'L lo rhs I'DFI.
<br />-lcnrl,ih.tItEEr!rhrr.pth.r.n.,n(rt.lh.trlErhrv.intoturi,nncMerI.sNro.a,mFlyQdhrllCry.
<br />Counlv
<br />{tiiEB.\ url Sr.rc U*r Elrin8 b bui(uu onrtruclo.. itrl h.rct y rnfu! rcFlcnht rY.. ol lhn Cn y .rr Coudy ro . s qDnllE
<br />atl,lc rnnik,ncd ln,ncny l'tr nlIE("ilw-
<br />Appli.rnl or AA6l Sigmlurc v
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<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 Beport
<br />Flood Zone Certif
<br />FINAL
<br />Certiticate of Occu nc
<br />Notes, Remarks, Etc
<br />ID/SIG.
<br />//iltfis T,
<br />futuc4 I
<br />-"*.3/t/a--
<br />l/,--
<br />IJ'klrir Addrc\\:
<br />^,",flrtrf )4
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