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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNER BUIT-I)ER DELCARATION
<br />I h.rhy iflom od.r FMliy of tEr,tr_a th, I s.kq{ h,o rlr Conrain' tr.ns t* lor rn lolkrp 3 Etrr (Saro!t.5
<br />6unnc$ .Bl Pn,rc$h'n (,r1.): Any c y or Counry rhEh rcquc! r tEm n, !on(ocr. .lrq. rmllrl,rc. d.dnnh or Etf,! uy
<br />{uror.Fr,b r n<lJ.E*., .lg, rcqur rl* rrr'lrlnr lor rNh Fmr n' arL r s'!61 namnr rhd lEor rtf n lrq{lt Fmd
<br />h rhc l^,vFDn! oi tlE Conrft.ntr s l-r.nE! L3* (Chrr cr e. Co.nmtuin! *irh Sall)n rtm ol Divrsn 1 of rlt Bordsi &l
<br />Pnn .r'.i C(xL ) d rh{ h. d rlE r .knt, rh.rdn'm .it rtr hrnr lu rlr rlk8.d .kfrOir. A.yvohrinolSerk TotI5byrny
<br />aptlt. lnrrl.rm {hl.d! rtE rn l(rnt i,.crvnFuhydl mr frjrc rha lrv. hlnlrql 'lolllr llll(x))
<br />l, $ .wmr ot rlE F)Fn!, n mt .n0hF.r wfh w.!.] ar rlEr $l $n{f,ndi,.. *dl d. rrr srt .rl, ih. reiE ! n
<br />dcnidl d ofi.Rl lu qk (Se.7fi4, Burtus 'rtl PrDLlsoN Coilc: Tlr c().trck* r L.cn€ ljw d*r Bn 4nly Io 5 o*rE. oI
<br />rlr F,Fny !b hiLl! '{ othE! rh.ft{ ,n qh, .lrt \-h urt h,malr or h.rkll tr rlNulh hn ir h.r oe .n{,trFl.
<br />!r,vrr.'lrhN'!u.nmlroEm.sr,lroltloro,lirlr(nsl.Ir,lnEE,rlrhu[ruuoritrltftEtu,"!5Uwnhinorrtd
<br />ot I rphn( rlr Owr. BuilLr *dl hak dr tanLr dl FrlE thr lE .x {E ltrl * lr'! d 6FrE rh. Frpdly ir rk FrFr of
<br />l,.rowmrolrn F,Fny, 0m.rclunvcly co rado3 *ih hc..r.d codrdoF lodnrut E FUF_I1S... ?041. Buim(
<br />.d hDhrsnCd. Th. Co Bloi ! L..nE tr* &a Nr tEiy trr u orF or ln,tEdy rh. h rU! o nFn,*r rh.rd,n,
<br />.nJ wto .onhlrsrdsuchFn,euk wihrC.nurLr)(n lr.nedpuKunr lorh.O'nrRrois l,rcn€ L.r,
<br />I am.r.trrpr ur.tcr Sc(tr
<br />oEtL &u.l!lt
<br />I h.chy.llrmuntid FMlysl Ftlur'.rF
<br />I h.vc i,n uill ddro. (inir..l..l clr€ h S.r- IBUr. rr, *r*.'. cor!E.!d $n, !r F'vrlcJ lnr by Selil)n .u$ or lh.
<br />trh, Orl., tu rh. tErfoM-*. of rh. wdl t( whrh rlr tEnn ! irrual
<br />_Ihnlc rnl *'llmr n *orkcr' .onp.nin x,n mrurrl.. 2r rqumJ nv Se-rln 17(x) (l rh. I-hn (ixll. ktr rh. |trl,'truNr ol
<br />rh. sut l,x rhxhrhtr F,n 'i trsrn My worl.^'.omFn{,r()n 'nsoru.. rn*rl F,lr, nunrb.r ftl
<br />PolryNu,rh.,i____Erpr.\
<br />_l rcn y rhd m rh! pcnonuEc ol rh. work ntr whrh rhr l.rnnr tr s{'Bl. I null fr .nlt'li,y rny pcrv'n ,! lny nsfrr
<br />q' .( nr h.Lnr ruhFr rr rtE $r*6L rnrfxnern. hB oi crl'romE. rnJ ryft rh, I rh,o[ tEom ruhF! rrhc
<br />unt.r (dnrll.n(iu{n pn'v6r,nr ol seuntr l7(l(,ol rh.ljhr crrl..l rhrll. lodhwlh .omply wrlhrtuE rn,vFDnr
<br />\\\l{\l\(i r,LLtr, ri !..iri (!rr.r. i rjl\f.i, .r3. n unbwtul. .d rh.ll ruhr.r u d.r,krf, t, 6n d FEk .nl
<br />rN' rnr\ uI r, otr. l,tr r.J rhotretrJ ,1,'l['\k,, ni dr to( ol .on{tn d2r^rtm8.! x Fovrr.d ror ',rs(r$n 1076ollll uhx ciik. dcn{lrlibl-D-lolq
<br />u.lL\arut
<br />I h.Eby rfltm!hd.r F.r)lyofFrjury rh, l.m lienrd uflLr lnrvrM ofCh.Fq 9 r.ommrinS vrh S.LrIn 7(n)) ol DivnDr.!
<br />of rlE Burm.{ .il Pft'(.$.nl Gii., ,rl m, l(.n* r D rxl n'd lil .tlet.
<br />L*chk Ch\r:-LEnr N!h[..:
<br />(-od.*lr-
<br />AIILICANLDECIIf,AIIA!
<br />I lEnJ'y rllim unhr lEn.[yorF+ryor !lrh n,uow'n8 tLcLdr,n.:
<br />lxnn[i,n fermrtsA\tx(os Noxlirlr,on lldcnl R.8uUrtr,n1('1 L 40. Part6)
<br />_R.tl!rcd lrtr.r ol Nir'fHrnn
<br />-
<br />l.cn'lyrh. rh.lrJ.r,lrc!,'hrk,n nfrJm! r\l\.qos drk,rrl rr. n,i rpt]lrrhl. r, rhtrF'llr
<br />I (cnrlyrhlt lhivc rcrJrhtr lpplf,ar!)n {rl (rrc rharrlf, rh,vc 'inrmri,n F corcd t aEeh(,r{'ly wirhtllC yrnCounly
<br />o.rt&n r.d sr.re blr Rlrnv h ,c e f.{hr!r'!.\ or rhtrCnyr (nu.ty l. .nG lFr rtr
<br />i0v. tr{nrnnul !r,p. v tar tr,
<br />Oc t4 ^,.o1-iz-\0 t?
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Tloof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsu lation/E ne rg y
<br />Drvwall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Qeputy Final Report
<br />En gineer Final Report
<br />Flood Zone Certif .
<br />I
<br />FINAL +llllot ?Yllolx,.tf7.,/
<br />Certilicate ol Occu pancy 11 t] ', r
<br />Notes, Remarks , Erc
<br />coNsTtuf-fl oN LE{DtNc ac9N(1
<br />I h.rhy.llth unJ.r ltnrlryol Frjury rhd rhdc ! a d'ndn,.r$ l.fth84.my l,r rlf, Ff'!!fuh. ol rlt s n{rh.hrhsFrh!6
<br />tr{r.J (N( :l(t)7. C'! C }
<br />l.nJ.r'\ N.mc
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