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BUILDING- INSPECTOB RECOBD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNEX IUII,DER DEI.CARATION
<br />I h.Et'y rlrrm unl.r FEly ot Fr,lry lnr I n cknlPl fnm rlx 6dB.'tB' Lro- l:* f.tr rlE l.llrw6! E u lS(.7011.5
<br />Blrimrs nn Pn,les!,n Cnr.): Any Crry or Counry *hirh rcqu($ ! Fmr b .$nnru.l. dlq. 6pov.. &d,llrh or r.l)d u,
<br />ntutuft, Frtr to d( slu.s.. .Ls, E!!rc. rrE .I'd.&t tu .kh Fmt n' tu r lrsFl nd.ftnr rhd h. or 3h. ! lkcns! pua.tr
<br />n, ft rolni,nt oi rlE Conrst*.s l-..h{.J bw ichrfl.r 9, Conmtuha wilh Sdri,n Tllt} or Divi.ion ! or ltr Bunm$ .,rl
<br />Pmtcsk,nr (hL) or rh.r lr or rlE u.!.q'l rlEr.fnrm.,n llE lEr! lo. rh. .rks.d .r.ntix'. Any vshrk'n ol Ser,n ?01I J btr.,
<br />rFrh$r nn r rmr ulrrth rh. {?u:nr ri, r 0v FMhy ot mr mF rh.r |rv. huBltd dnl[! (S1O0l
<br />l. .r o*Er ol rh. F)Fny. q m, .q olr.i hrh ,.!6 rr rlEr :)k (!d?..qID. w !h rh. qIt rd ir nerF 6 nr
<br />'nrc L! or oflftd t(tr uk (se.7(144, aurft* rJ PruL$$nr c*k: Th. co.rr.cttr s l.!.nr lrw &Er nor {,rly b .. owmr ol
<br />rlx FtEny wh' hlllr q EIreEr rrrtq ![l sh) &- h Hxt h,h<ll or lrrcll or rl[uuth h.. or h.t dwn .itolov..!.
<br />nnrvd.'l rhrr .urh mnnrv.mnk e fr{ fl.nlol .r oltaEJ i(tr d.. ta h,rq, rtF trrlliry or ntmtrnr ! erU wnho oN ,td
<br />ol Lvivlirn rti O9rr au[kr *dl h.e rlE hhLi or FIIB rh{ lE d ilr J rn l! i q lqmE rh. F)IEry ftr ttt purFE or
<br />-1.
<br />r\o*mr ol rhe [!n)p.dr. m.(lu(vcly.onbdo! *(h lr.n{d c nlrrk,F ro conntuL'l lh. poJ.cr lS.. 7044. Btr\hc(
<br />.nl th**rn Cirk: I h. codr*rtr r l-f,.nr L* dr( mr .mly b , *8. oa pi'Fny wh) bu'U\ or m!ro(( ih.ron.
<br />lnJ *ho (dn krirrurhp'!*rrrw hrConhctu(r)ln.n{J N ur n' rh. (hnl .ntr r l-rccnE Liw)
<br />lo tq
<br />DECIASAIIA!
<br />I lEr.b, rftrh unLr F ty ol FJury om ol llE r{nhtrd &d.dnB:
<br />-I
<br />h.w rn! *rU Bdd. C.nr.d. of GrEd to S.lrltrtuE lir rdt6 .rvqhd.n, rt Fovr$.jr,f, hy Sel$n.,7m oa rh.
<br />L.bor Cdk. for ttr p..rm orlh. wrl for qh.h lh. Fmn it nral
<br />_l hr(.rl *iU mi,{rin hrt n'$mFn rrion inrurtu.... Equmd hySclhn.1700 ol rlE L.rbr CdL, r,,lh. Frfollrw or
<br />r,r kri fti *tuh rhB FmI 6 srEl My s,tsr oqEtrdm r{rc. ffir ]n polly tur6., E:
<br />I (nrly th.r rn rh. JErfitrMk-.c of rh. *ork ntr *hrh rhr I'<m F irrtJ. I !firll frr .n{'kry rny P.R'n h .., muE
<br />q' a{ k' tiror tulr.{r ro th. k 16'$r{Ehdxn hw! orcrhromd. rhl.8N
<br />'h!!
<br />fl rl$uLj tErod hFr n,rh
<br />wo nr rompm$rion F)!n$h of s(rrln .l7m ol !h. lih{ Gr., I rhrll, fonhwnh Llrrq y e t rh,E ln,v(ini
<br />WAXNING: FlluE n' s@ krt.^ lamrEnqti,n ..vs.rc 6 unl,*,ul Iri rrull suhj(t o dr?loF, to rul lr[li.5 rtl
<br />cod I'n.r ul t, oft h{kEd rh'u$rr ddllr ltllro,lxn)rh. Lon or .!frp.n53irrn. J,
<br />lc lq
<br />DEITJ.B.\I!!,4
<br />Ihc yrrl(mu crFnrlryof!.rJuryrh l rm h(th$d und.r tln,vr$n ol Chlplcr 9 (cohmR FI * hS.(bn?rl(Xr).1Drvni{,nl
<br />.l rh. Bulrs .d tt .si,nr Cuk. ,n my lr.nc n h llll fd( nl.ff(r
<br />l-i..nrc Cl.r\
<br />CONSTRUL.rION LF{DING AGENC}'
<br />I hcEhy irrrnundcr Fnahyolp.rjoryrhd rh.rc r a on{fl.ri'n kn,m8.!ctr(y i,, rh. Pcrlotunc. or rh. ktrk r,tr wh.h rh( Fm( !
<br />r\kJ r S.r :r()0r, Crv. C )
<br />ATTLIIANUTE{IIEdIIIIB
<br />I H'y dl'm nJ.r pcn.h y.l FrIrry oR ol th. ftnkrwrnt &.trn !'ns:
<br />D.mniFn P.mr!A'lE<o! l*irrlrrh F.d.al R.8ul{.hr llllc t{t. P.n6)
<br />_R.qnrn Ldr.r ol l*rJirir
<br />I ccnIyrhd
<br />'h.
<br />rcJ.r.lEluldrni E!r,!os.drrtx Em)r.]r. n rrd..bk ()
<br />'hN
<br />FrF!
<br />-l
<br />(d , rhi I hlh Erl rh! {tpt..lrr r^l {er. rh.t tl* .lr'rc on)rdi,n F rnd I .!r o .!q,ly *rh .ll Crt r,rl Gdy
<br />onnnrn.(\ atr(lStdc Lrwr Nbrrry r, hu'!trn3 (on(n'.rkr ul lf,'chyrurktr k.l'.{.nrartrcl ol rhtr ( [ylklcounryh cnr.r trlFn ih.
<br />lhr. nrnr$mJ Pn,Fnt id mr
<br />t+Ar d nwn hv<ene-
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/Vent/l nsulation
<br />Roof 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 />FINAL ti -7."r1 x j\l)ft,l0'vCertif icate ol Occupancy
<br />Notes, Remarks, Etc I
<br />lrnl.rr Arn lrr
<br />. 14011
<br />Flood Zone Certif .
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