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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDER DELC RTiTION
<br />I h.Ehy !flm u.J.r Jxnrlly,n Fcrjury rh.t I m.\cr{ num rl! Conhkka' Ir.n( hw rltr rtr n'lb*h! Er$n is*.?0]15
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<br />.J't E.nt l.r . Fmn .ul'Fk (lr qt'l..nr h ..rvrl p.Elr y ol r n)r rfi$ liv. hudFJ &ildr (t!g))
<br />_1, $ o*ftr orth. lh'Fnr. rtr my crpl,yr.i *(h *.3...3 rlEr $L on{rnuix'f,. w'll d' rh. ufi an lh. rlulw r En
<br />urcrll ,xoll.rc.j n, eL (Sa 71,,1,1, Butm*rnJ Prfdti,n! CdLr TIE C. r&nr'rllorlr*drrE{!rpl,roao}trol
<br />rh. I'qEny wh, horll! or !qn'E rEN'n. rrl *h' iliF nrn slt hmEll or lrrcl, rlm,tlh hn,, h.r o*n.q'byc.s.
<br />ptuvrLd rh.r rurh ur{h,v.ftdt ftn{ dakJ or.ii.r.! fd el lllrlrt€,rlIlt uBorr4r,Fmdsxlu*ihroEF.r
<br />ollnrl)hnG r,E O*Er Bu }lelh.\.!hhni.nolln,!o!ttdlEMslrJrl ,r t!d! or rF,t 0E pltrFry ft*tlr Pqscor
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<br />Md Pnn lvn(iilc Ih.(irrrr ttr\l.(cn\.!.r*,1,'c\nrrpnlyt,Jno*n.'olProt t *ho hu'l,nor rnrEnvc\ rhrr.on.
<br />rnJ *h..onr'r.r\1,tr\'.htnJcr\whr(nftrdtrisrl'(.r\.dNrruu(r)rlt(i'flrr(rr'\l.krn\.1.,'w)
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<br />_l hrk rd *nl tu!{!'n krt.^' conFnl.tiln ilrunD.. .. Rqur.'l I'y Serrln !7lr) or rlr t lff (irL. tu
<br />'lE Filrur ol
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<br />Polf,y Nnmh{r
<br />.A!_unrryrlDr rrln |rrl'trnHRrol rh. *rr[ lrn *hf,h rh'\ p.rn ( tr{k\l.l {hJll.!i (nlt!)y rtryIr(^on
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<br />M'kc^'(nnf.h\xrirrt'x,v^tr'i\!'rS.crtrrl7lX)olrl*1,!hn(iil..ldu'll.l;nh*hronI'lyrnhrh){t'.!'rr!!N.
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<br />crrl llncs up n' dk htrn(lr.il rh,trNtr(l(lolIr\ ($l(Nr.(XX)). in arUn(n k, rlt c.{ !'l r!'nIrnlrrrnL (hau3
<br />S..ttrr 10,-6 I rhc Lihr (
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<br />u.t_!_!!r r!
<br />Lir.E Clr!:-
<br />CONSTRU(-TION LENDTN(; ACEN('I
<br />I h..chv alltrr u.n.r Irtrrlry{r t rtsry rhd rl(n N ! (,n{nkrx{ Lndn8 !3cky l(tr rh. Fn,mum. Dr rh. urk itr *hf,h rhtr F'md 6
<br />nru.d(se 1007. civ. c )
<br />AFPI ICANT I'FCLARATTON
<br />I istr'y rnim unlcr Ftrrliy ol Frrlry oi. ol th. lt,llowrg d.cLr{oni:
<br />Dcfrn[$n P.rm ] r&(or N(r'tf,dx,i [;.tt.h, R.guLrrnt (T{k40. P.n6,
<br />_R.q!r.J knd .f l*{frfin
<br />-Dt'or,ry 'hr rt" r"l".l .!uLrln! ftF,Jh3 rdtftx kmrd e ft, .I'l r.t'L k, rhu Ft,Fr
<br />q/[n,rr rh'r I h.,. ,...r r h,l .r.,rrr.tln $r (.r. rh.r rrF.hrc,nh,tur,n
<br />d ru*..\:i]$rr.Lr\FLrdt't{'!hr('n{tu'r,c.,nh.{rrr.urk'd.
<br />.!R fti rull'ly *rt.ll CryrnCoury
<br />Er ol lhtr Cdy .,n Cou,i, lo .,rd qbn dE
<br />rt;)r ftd$rJ |'n Fny nr
<br />Appli.sn( or Ap.nl Sitmlrr
<br />><>
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />SublloorivenVl nsulation
<br />Rool Sheathing
<br />Shear Wall
<br />Framinq
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coal
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certil
<br />A.
<br />FINAL 1-2q-11 Y'VI.X
<br />Certificate ot Occu anc
<br />Notes, Remarks, Etc
<br />Lm.rrmni ufrlrr Sc!ri,n*,.,-ilzel'T
<br />I h.Ehy,trtrm lnLr JEMlry.l Jrr,trry rhtr I.m lRnEn u k Eovirrn ot C'h.Fd 9 {(!mmEn! vrh S(itr 7{m) orDorDn J
<br />ol rh. Burm{r rni Pn,t r..nr (-ck, . t my 1..n. F r full loE! lil .frl
<br />-,,, zlzeltq
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