|
BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE tD/srG.coMuEIrs
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsu latio n/E ne rgy
<br />D rylva ll
<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 Report
<br />Flood Zone Certif
<br />FINAL t(L1 'll oAmst $rl
<br />Certificate of Occu pancy
<br />Notes, Remarks, Etc.
<br />(r\r\tRlllllt,lIDtt.( \I r I t()\
<br />I h6.by .mm undd p6!h, of psjlr, rhar I m .r.mpr 6!m th. CoilrrcroB Li..n* lrw lo.lh€ follo*ins r.&. (sd 70ll.t
<br />Bs'nd Dj Profson Codc): Any Cn, or Coudy uhth Equo6 r rEfiir ro 6dM. dr6. inFove &rmlisn or q.ir my
<br />nMu. Fi)r !o irs iM.. .t r.SriG it +t id for s.h Fnn b fik . r'srd ,ioml llld lt or lrE ir lr.6.d F,nd
<br />ro rh. p.lririoE ot tlr Confurd r L@nd tts ((1'4(d 9. ( omftin! * irh Sdi6n ,0m ol Diririon t of th. BdiB ud
<br />Proadxrri Co<!.) or $.1 lE or rhc i! .rmpl fia.ioE od ih. b66 fo. th. .ll.8.d .rmption Any vilLlion ol S.diii 7(rl l 5 by any
<br />.pplicdt aor rF6i ubjdalh. +!lic. ro . civil pdhy ol Nr mor. the fivc hund,.d dollat ($500)
<br />-1.
<br />a o*E of lh. Fop-ry. or ny mpbrG *irh wrs6 a lh.n $t 6np.dD.. wi[ & lh. sat !d llt rnrrE ! ml
<br />idodql or ofia.d ao. $l (se.7o{,1. B6ilB ud PtofdioE (-dl. Tn Conr,..rt'! Latu liq'&6 mr .p,ry ro d o$G of
<br />thcFopcty who h!il& or imp@E l!6ol! ,nd *to d(s och st,t hitu.lf dr h.&lao. rhmu8h hL d nn osn mployd,
<br />,.ovid.d rhd ruh imlrrrffir! e mr inldi.d or olH 6r et lf. lr*rq. lll taildins or i,?.ovtu ir 5ld *ihi. o.. ,d
<br />olonpkm E orrE &riLls $i! h.w th hr&r ofFsIB !L lE d tE dU mt hlld o' morc\r fi. FoF!, 6r rlr F,Fr of
<br />l. s oRnE ofih. p(Dary. d .rcluiv.ly codrlcr inB {nh lrcdMd .o rido6 ro.otrdtu.r rh. Fqd lse ?l}14. Buin6
<br />Ert P$t*ion Cod.r 'rh. ( onl(croi! l-i..N b$ do6 mt.pply r. r osns ofr.op6ly who builds.r nnphr6 rhden.
<br />.nd who mdn ir for.Efi Fojalr *nh r Cod.i.ro(s) lts!61NE4d ro rh. codr.cld r l-kru L.sl
<br />_lscrmpt uodd S<l'on_
<br />Dfl. Oin.r uoltxr'{\'( ontrE sa-I toN
<br />DECl.AI TION
<br />I hfth, .mnh unrkr FMny of p-rury or of rh. fohwins &(ls!rbB
<br />_l hN. ,rl $ill Mini.in ! cdifr . of Consr to S.lf-lNr. aor srk6. onD.n.ri,n, a Fovidcd Li by S€rio.l70o ofth.
<br />Ltbor cdk frr 0E Ffolrle. oloE *.rt td $,ith rhc Fnn ir su.d.
<br />_l hr!. rnd tr ill drinr.itr *$rI.A comFMion iNulmq s r.qun.d h Sdlirn 1?00 of th. Iihor Con , tu lk Ff.lru.. of
<br />rh. wo.l for which rhn pqnir ii isoj M, wortdi .omFsdion iBurmcc cMid ard Dolicy numbd el
<br />I cditlhd h lh. r6forfuc. ollh. sut fo,sh(hlhi!Fn'l t Bc4{.1rh.ll nor dplo, ey p.Mr in Ey mlllE
<br />$ 6 i6 tm'ft ebi.rt to tlE rur6 onFMb. h$s olcdifomi{ xd *r rl if I !h!ld lE .ft rq<r
<br />'o
<br />rlE
<br />*or*d omFerion prn\ irioE or sdion l?m of rh. L.bor (fonh\ nn .!trdJ u nr rb* prnriDc
<br />llARNlN(: l'a'lurr t) <rc *orloL $nl'.nsrkr, ()3h.ll srbler & dploF lo mtul F{hi6 dd
<br />d of cotrrp.Nlion, d.mas6 a pro\id.d rar rh..T.l ltrh\ .'t, r. i rc l.i. ',Jrh,,,\i,i,tlJ..llrqrlii,'.'ni'Sdt.n 1076 orrh.lnrtr(ftk. inrdd Md.trorB', fG
<br />o.,., 2-l ll .-.-..::
<br />llCIJSArlqt
<br />I hsd,y .rm lndq p6lhy of Fjury rha I m hcdsol ud6 Forbion of chqrd s (6lffiir! q nh Sdioo 7000) or Dn irFn 3
<br />of ilE liBu6 rd PDfsbE Co<h rn by licdE i! in tull foE !n c,I<r
<br />Liccc. ( las
<br />-
<br />D.r.2'L',t..
<br />c0!$al(Illr!J,!!D.uc-Acl:!g
<br />I H,y !,Im uo<Lr Fulry oapdu.y lhi lhn ir. @dtudb. lddi,s.rftt, lor th. FfolruCc of lh. troa li,rrhkhrhnFmii i!
<br />isu.d (sd !oe7.cir ( ).
<br />argJcaxfDEu,ASalral
<br />I horiy alIm undd F..hy ofFluiy oEofrh. folloring d..l{ nros
<br />l)cnoh a Prmn$AslBros Norili(dn'n F.ddrl R+uldi.tu (I nk {0, Pd6)
<br />R.{utr.J tm6 of M{ifknio.
<br />-l
<br />c61ilr rha[h€ L!6alrc-lulsrtrff r.lddina (h.srot rohilft nor arpli.nhl. k] tnE lroldr
<br />-l
<br />csr,ry rhal I h!r. rod rhi. rpglklri'n lld io. a corq]r I !$alo ompb *nh !I Cn, and (.our}
<br />ord'ne6 dd id. btrr EliiB to tli
<br />.&r!. mri,n d proEnl ,or iNpdi.n
<br />.drn6 otfin Cny &d (\{rl-r ro drd uFn rrE
<br />,\ rli(rnl nr ,\penl Situlur?h b-o+du OG
<br />,,,," 2,/ 11
<br />I
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />l,cBld r Ad&s:
|