|
BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.OWNER AUILDFI UEI,('ATATION
<br />I lr.rchy rllrn unt r !.n.lr],n IFrIiry th{ I m.rcqn G,m rh. (l'nr&k{t I'tn*bq ln rlr robw.s Eih (9( .!
<br />Btrnk( .Dj Pn'fcrri'n C,iL) Any C y or (,rdy whf,h RluKr r Im, h cdn.lMr. .lr(. mFtE. d.mllrh or RP'! av
<br />{ru.r$.. rxtr k) s rQ!R., also tqxr.r rh..rDl(.rl li)rsuh ltrn t{' tiLr riSNd n.r.mnr rhd h. or rlt ( lf,cnEl pur{td
<br />!' rh. pn,vsDns ol rhc (i'ik,cttr's Ltcns.J l.Ne (Chrfl.i 9. ComtrErcrn! w h S.ct[n ?fin.i l)rvr(k)n J ofrh' au'n'( rnJ
<br />Pn,lcrqonr CoJ.) nr ih.r h. or {E A cr.frF1 rh.rckom .n,l rh. h,$ turrh. rllqc.lc\cmlron Anv vdrrirnol Serk'n 70:lI5 htry
<br />rmhratrr lnr . F.mx tuhFlrs rhr rf't'lEad n' r r,!,1 FMlry of Nn frk r n l,v. hundrcldollur(t5(IlI
<br />-l.rtowrolrlEFrFny.(r6y.nptrJt!*h*.asr\iltrrrl..rntEnqrFn*dldrrh.HttrJrlr{rtE!ridolal ,r orit ,r fd sk (Sa ?0,14. BlsBi .d Pr,r.sbN c{r!: Tlt codftro r Lit.M rrB dB nrr .t{,ly id M ow 'n
<br />rlr I'r,trny rlr, hrll.o. lnlln)B rL4.rn wt' dBurr q, ttn!.ltd lErclf or rl6,u8h h( u lFr off.nploy..t,
<br />Iln,vd.rl rh.r iEh uqmEmnB t Brr nrctldl orofi.rEl ftr elc. ll, h'EE rL t
<br />'Uo3
<br />n qFN,Bd L\ sU wihh rE Fr
<br />;l unn!)ldb". rlE Owr Bn &r wdl hrrc rlE td .n oI nn,iry rh, rE .r {x 'li on hull or iqmE 0x lh,Fnv rM tlE FtFle or
<br />L r! .wE of rh. I'rndrt- rn .\.hqEly .onrd u! , h lK.ned ..ttrNnF io (,.{frr llE lrrAl (Sc 7044. Burdn
<br />lri lbhrqn CuL: 'I h. CtrrBk{'\ Lrcnc l:s &f,! ftn .rrly k' d o*ffi.l,'n'Fny *h! hu dr or mnov.r rh.frr'
<br />rn! *hn .-dBk nx tuh F Fl. *rh r G, dtrl , l..rcn Frm{n b rL codElrii lrtM bs}.
<br />I rmctcnrpr u l.r S{ron
<br />Itl]8f,EeE:eAMI[XSArqBo[ctdtarla!
<br />LrRhv.lltrmuei.' Fn:lryoi Frlury or o, rtr n,lltllmS d(hIlri'trt
<br />I (.d'lvrhrr rrh. i'.rlornuR.nl rh. *ork ntr *hf,hrh^l).flnn 6 rstrcJ. t rhlll N cmnhv rnv Ixr\rn 'n.trvD 'f,r$ x\ n, h.!om rubl.rr r, rh. * ltcn .omtl.nu hn ltrw\ ol CainrmD, fil rtr.. rhr 'l I \hruld tr cor* {'hrrr b rk
<br />wo' k.^ (.mp.tr.rr r)n pr)vr{"r\ o, S..hn 17x) ol rh. l trlltr (ir]l, l dull, n ihwi h .onllv wnh rlDt l'n'vtrnN
<br />WARNTN(; i:!'lurc h {.trr. u.rlcn r.mf.n\rrrn' <r.tulc r! unLslul. rrtl \hill rul,irr rn.nd.yc. b uimmrl lrruh.r
<br />cr li*3 uI' k, oE huhiFd lhrqd !hlL^ l$l0o.0ul
<br />Sar$n.l)76oarlt Lh, (iiL. br*n lrlrn!fty,r lc.
<br />r, h rdJ k)n n, rlt ( < ol t(n,n, .m36 3\ ln'vr,.ti nr ri.
<br />r t('t Nst:D cotrra,r( r(,R
<br />l.lE(:l&,Ul!lN
<br />Ih.niyrllnnutul$Irrrlry.lp.rIryrlurIinlldrarl!n,l.rp()!N(rol(hr.rr)l.omntn(ritwfhScdirn7XX, I Lv'uon I
<br />ol ih. Buiu,r* diJ Pn'lc\rlr(*!. ail Ny ltcn\. r1 tuI|ktr.ul.lrcLr
<br />l-k.n-CLsr:-
<br />t
<br />I ltnr'y {lltm unl.r Fnlhrol Friury rhrr rh.E tr e ('inru(rr{ tklur! r8c^_y nt rh. IEnomd'f,. .1 rh. qork itr whf,h rhr Fmd 6
<br />trirJrSR llr97. Ctr ( )
<br />APPI,ICANT DECL IATI(JN
<br />I lrR'hy.ltim uftier F-orlry ol F.jury oE.f rhc lnlktwhS Jclm{lnn!
<br />I}m,lnk,n PcrnnlsArh{dor Norff,.rFn Fcrlcrrl R.Sohrnns (Tdlc:10. l'lnh)
<br />R.qu!.d f.lrd ol flrlizrr{
<br />-l
<br />l.n y ih, rh. t .Lrl E!ILhN E8r,rl'.s .rlt(or cm,vi a. * rJ'Cr..i,L tu th15 l'mFl
<br />l(cnrryrhar lhrv.r.&lrhF lltlElnonar nn.rl rh. r'v. l
<br />dnl0rtrc.\ Md Srrrc l-rw\ n Lir'nr h nuiLlinr.$n(tu.r(,1 rd hcrchv
<br />IrlrLrn'(trnt,ly { hrll(ryrnJ (,trtr ,
<br />itrvc\ otlhs (
<br />'ry m'lc.unryn'cnd lfrnrrlt
<br />rll'v. n.trrB,n.J |)nrFdy ntr nI\.r
<br />Appli(.nt or Ardl SirMloF
<br />P.mlk Bm(prlr0:
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />Roof Sheathing
<br />Framinq
<br />lnsulation/Enerqy
<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 />FINAL fi/7/ lq l).,,-,"a t3 trd
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc.
<br />COMMENTS
<br />Shear Wall
<br />Flood Zone Certif .
<br />I h.E Dl *'ll tuDrro r cd'fr.rc oi Ci'lffir t! s.r-INUE fu s'rt6' LulFr..rlr .! Frvdal htr hv SNrd l7m !l ir
<br />khr (:lri., fs rlE Floltim. o, llE rul tq whth r,r Fmn 6 B.u€J
<br />-l
<br />hov. .n l wilt rorfuln wortcE' .oot .,.b n hrur{nc., !s eqx@J hy Sel Dn 17(D or rhc uhor Cod., fot 'h. IErf'lmx' or
<br />rhc worl li]r whrh thr JErm,l r nnkn. My wrkd $nFn!.ri,n u!un. uei.r lrr lDlry numh.r N:
<br />?aotl
|