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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNB ITJILDEA DEL(AnrIIOI!
<br />I lIFb, rnrm un& FMry ol Fpry rld I h..rtir fim rlr Cdd6 Liw br for llr folb*n8 lEF. {Sa703l.J
<br />Busirc.s &n Pmfcsioi Gnc) Any Ciry o, Coony whkh ,.qu'Es . rmil lo mffiul. .ls. itrlJ'hv., &mliih ot EFt i,
<br />.turE Fir 'o
<br />ir3 irM., nv, ,quir. rlE.pplkur for 5uch Fmi ro nb. riSn d stlr.cnl tlll lE tr rlE i! liansn F $.il
<br />16 rh. FotuioN of 0r c()lllfud! LiH!.d t-r (c|ryrs 9. colftf in! Blh s<'-Jn 7m of Diviti,n I ol ln. BuriEss rn
<br />Prer.$i,ns Cod.) or thr lE or nE ir .r.npl llE!ftom .rd rhc h.!i for lhc rili8.d .r.n{rion. An, vioLliofl ofsrlbn 701 , t by ut
<br />.pplk.ir lor r Fmr $bFrs rtE +pltsr ro..ivil FMhyof nor nft rh$ fiw hudr.d dollss ($m)
<br />-L
<br />$ owEr of lh. FoFny, s n, crq,hte! wirh *!!6 f,r rlEt sh 6nFnsbn, *iI &r llE sqi.rn ErdrarE ii tl
<br />iio&rl or olf.Ed for sL (Sd.7044. BusiB$ md Pmli$io6 Cd.: Thc C6.r,tld r l-i.de Lw dEt ml .pply lo .n ovrcr of
<br />irFoFny rh' hiiB. o. .F$B dE6( rd *lb &6 rn Bit niEf ( IEBI d ltrc!8n his d lEr.en.r+bFc,
<br />prcvrh rh.l3Nn rqn\dEnB E Di iraid.d doft,.d ld sb l( lwE.0E hr'lriig q iq'mn t 5! vrhii m Fr
<br />of compLrior rlr o**r Build.r eiU hrE ilr hsj.. of FrvinS llu h. or nE dn d ttild q ntet tt! lnbtdy 16. tlE IurFs or
<br />_1. r\ owr oa rh. F)Icnr, d ctctusiEl, .onhdinS wirh lt.nrn conrrelon ro s,tr<oL1 rlr FrF (se. 70a4, BusE$
<br />d E!&1si.(in.: Ti. Co.trrroar Lisnr Liv dc! mr.fnlylo !n oeEr ofrmFnywln buildr ur impmht lh..Nn,
<br />rnd wlb onurlrlor sh FnF! * h. co' r-ronn lalnrcd Frtlld ro Ec.dr-idt lir* L.e)
<br />'14 ,.*,&/t',4 /,fuiot'I ,1.1ol(K+ Rs (joMPElsaTl(lM
<br />14tALtA
<br />!I]!I.!BIIIO!
<br />I lErchy rmm un&r Fulry of Fttry dr ol rlE follorlB &rLr! anr
<br />-
<br />I hitr srd e irl ,Mlnrrin r C.n ifrol. of Concnt t. Sclf-ltrsurc rc sftk.ra coqtnr,lio.. dr Frvi.lcd lbt hy Sctbn 37m of lh.
<br />trbo. ('od.. ffr rlE Frf(rlllre or r $Drt (d snth rll tEor ir irqi.d.
<br />_l hN rnd will uinrain wDrkc* domp.nslron insurcE., &r rcquiEd hy S.crion 17(n o, rhc Lrbor c(d., for rh. JrltrrM ot
<br />ilE ,ork for *hih rhi. Fmir ir Brat My wl6 coilEnrlkr itrsler trtl .d p.lty nlntb.r &
<br />-l
<br />c.niay rhll h rh. F,rormNc ollh. wlt ror rhkt lhis Frnit is i!ruc{,I shrllnor.dpk'y..y Frhn ir sy Mncr
<br />s .r ro lE !r -t'itl lo lh. qrt6'orFnt t hn LB or C.ffomir rn {c $1 ir I nlub tEtor ru+( ro rlE
<br />6id @nFN*jn lt.nlilB ot sda. l7m ol OE l,h.r Cat, I filL fontvnn onti, wid th6- Fotubni
<br />WAXNINC: Fiilurc ro s@ srk.B on{En$tion cotnsc is unlrwtul. t.n ihrU subF m cnll,Fr ro aimi,.l IE rli* tnd
<br />cMl fift. up ro.rc hutnr.n lhusd &,lLE (tloo.lltr), h rd.lni,n b rh. c6rl ofcotrp.n.lior drm3...r Fovikn tu r
<br />s€rnn.m7b orF l-d('/Cd.. mr.d !n dnfty'r 16
<br />;:,- r4/Z[i '-
<br />^**,,,)ao,it hbub,t f ,,cffi (tlfiloln
<br />I rrEby !,Im uni., FuhyofFrjuryihal I d liMeJ undcr pnrvisionolChrprs 9 (omDncin8 ]irhSditn 7cxl0) orDivisio.l
<br />ol rl! BusiBr.,n ProLa(bn! C0L. rn my ltcM n b tul tom !d cfiri
<br />ljQISIBUqDg .IBDI!Ii.AGEdII
<br />I tEEhy lrtr u'rlcr Fn.h, ol rErrury rhd lh.E Lr!@nioclnn bndif,g rgrEy for rh. lcrfmlrer olllt *orl ror ehkh rtli3 F.mh i!
<br />k*d (se. l{})7. civ. c )
<br />AIIUI]INI.DECI.^SAIION
<br />I hodry itu unr.r F$hy of Farory or of rh. folb*in8 d..hrli,ns:
<br />Dc hrDn Psmr! Ait {d Ndirrdkt. tu6rl R.Brldon! tT{l40. Pd6)
<br />_R.quiEd krrcr of N(iir.{bn
<br />I .dify lhd rlE tucnl rcsuLti'nr Ea.rlins lsli(oi cmvJ ( mr q'tli..bk ro rht poFl.
<br />aH*n*;c.d rhd rpgla..rton lrl d.r. rhd tlE .ton ufortdD. Lr wc.r I +E
<br />'o
<br />6rt l, wlh nl Ciy rd C.ury
<br />rsEhuB ro hrldint dr{nrl
<br />rhrr trrDrirtrc(l f'ot)cdy nn nripdr
<br />,\p?licml or AE6l SiAEloF
<br />t4
<br />Set Backs
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Sublloor/VenVlnsulation
<br />Rool Shealhino
<br />Shear Wall
<br />Framinq
<br />lnsulation/Eneroy
<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 Beport
<br />Flood Zone Certil.
<br />!-'!
<br />FINAL .Y/tE /zo70 4,&+u/
<br />Certiticate ol Occu n
<br />Notes, Remarks, Etc.
<br />Rev 08'07'2015
<br />Forms/Steeli Holdowns
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