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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNET BIJILD'R DELcARATION
<br />I lE.b, !,Im ulxlE ps'.11, of Frry rh. I d danF 606 0r Cofi..ro6 Li.Mt *for x follo$itrg l6i (Se.mll.t
<br />BarB rrd PrcfBiod Cod.): any Ciry or Coody wnrh r.qun6 a pqnir lo sn{ruct !lra. inFove &rclirl' or r.Fn uy
<br />ridue Fi, ro iri iwc, .ho r.$16 ih. +lid for *h Fnn ro 6l.. !ai.d nrdcn rhn lt or dE . licd!.d $ed
<br />k' th. FDlitrN ol tlE ConE.dor'r Ltcnsd llw (ChrFd 9, Comllwng wnh Setion 7000 of Diyirion I otth. Bai:B ad
<br />P6l6i.N co&) d lhr h. G nE ir a.,q{ ltdlnon !d rlE hsi ror rlE .llq.d d6qnn Any rioldb. ofscti}.7011.t by o,
<br />tppllc.nr for i pcmir 3ut e:ls rtu +?licaf,l Io . civil pdhy ot nol mrc rh& fiv. huidrcd d.llE! (1100)
<br />_ L a osd of rlE FotEty. ,n fty @pLy6 -$ waB6 6 rh.t x'L comFrql ion. will &, lh. elt !d rll dEiE a tul
<br />inrad.d o. or6.d fq d. (S( 70.1.1, BuilE Dd Prordiod cat TIE (.<r.!d 'r I rqE l! &,6 tul qdy to d otrc ot
<br />rh. F$Fr! *ho hril& or nrFnr6lh@n. !d vho dc *h mr hin*lf or tddao. lhrcuBh his o. ha oq.mployd.
<br />ptuvid.<l thll ,uch inFnra1tfu c mr i!6d.d d otuld 6r rt lf. h.sw, dr blrtua or in$.or€i!. i. lld $it m d
<br />of@l9ldiE $. ()*E A{ d. $iI h!\r rl'. h!da! ofP.$irg rhi tEmCt tld ml hrld or ifiFllr $. FDpd} tu $c F!.p.c of
<br />-t, N osla olrlE Fordy, m dcluliv.ly .onrrdms *nh [.6!.n conrdm ro codru.l llE For.n (Sa 704,{. aB,6
<br />!i nnki. Co&: TtG Conrdor. l.k.M L.* do6 nol .pgly lo e o*nd ol propa, *ho btildr ot inprDt6 lb46tr
<br />lnd who cofld.ls for ruch p6j.d3 unh i Contrlcro,lr) lic6!.d p@@l lo lh. ConlrIloi! Licru L.$)
<br />I xn.rcnpr undn S$hon It & l'( fdihis rusn
<br />D.r. ortrd:
<br />woRriFns aoMPiJrs riofi-
<br />DECI,6IAIIO!
<br />I hch, all'rnn undd polht or pqjury dft ofti. rou,Dwms d.(L,.rbB:
<br />-l
<br />h!!c &td *,llroiluin . C6rifi..r. oaco.$l ro S.lf-lose for Mr\6 mnpqsiioE B pro*,.d to, by Sdtbn 17@ of lh.
<br />hbo. Code 16 rL Ffotu. of 0'. Erl ld sltEh rh. ldnn ii i$!cl-
<br />I h!r..nd $ill M'.r.'n hAa .omtEBdr. rffi.. s EtsiEd by S6lior 1700 of lh. ljtor Cod., fo. $. p6fo'l1e. of
<br />rhc wrl for *i(h rii! tEtrit ! as!.d My workd' .omposlion iBu4.. Gi6 rd polty nodb6 e:
<br />. 1{/\rxladrb fid u rlE Ff.llM.olrlE wort fq rhrh rha p6nn ! sucd, l3h!ll @r @plo, s, F$n in sy men6
<br />i s to bqon. rubrd ro rh. sdd onposhn Ls olcdifotu !d.sr thd rll ,buld bt{ft sbFl ro rlE
<br />*ort@.bopodiorFlvir@ofs<ront?OOoltlEL.!dC.d.-tdlrdlhunh@6p1,wilOorFDvsioE
<br />U/aRfllNC: t_lilur ro su. w!tm' codFldion .ova.g. i. uLwtul. .d lhil $bl6l o drploF lo aimin i Fdb &d
<br />cnil frd up ro oft hu!&.d rh.u$d (btLB (tlo0,o00). in.ddibn to rh. cor of of,pa on, d!,836 B p.ovilod for llE L
<br />Sd1rcn 11076 olrhc Lbor Cod..6r6cn Dd arx,nrr'\ lc
<br />t /,,,
<br />u(Llsf Dl.!l-:!llt \!l(,B
<br />Dl,C!!&rMr
<br />I hch, rrm un& FEly of Fjury th, I @ lic€!.d u.b Fovirbi of clrpr( I (@Mi,r€ wnh Sdnn 7(m) ol Dn'Liof, l
<br />of rlE Bsi,B r,!d F oft.lioc Co&. d my li.w b in niI forc ard cfi6t.
<br />.t*cr,,,--,-.Gll
<br />o.rc, tt /t t /t I
<br />t{s sr (
<br />c"",,.,,.,. < (-/ t)t" q L1.v1
<br />CO]\STRUCTION I TNNI\C A(:FN(J..
<br />I hdr6, llTm un& Frty ol Fp,y lhd llE a 3 Ninru.tio. ladi.s .8acy fo. rt. FfomMcG of lhc eit for whth lhir Fn! b
<br />iiiu.d (sd. 10q7. Cir C ).t n&'t Nd.
<br />AIIII(AtrUTESJ8AIIA!
<br />I h6lby allm ud6 pcn.lty of rEiury oE ol rlr folb*nu &.16r i.c
<br />D.iblnDn PmileAsbdor liorlicriion l.ds.l R.8ulrrionr{T lc40. Pan6)
<br />R.qut dldtsoltldfidnn
<br />I cdiry thi llE Ld6.l csuhrirB Esirn4 6!do! lq6vrl ac 6' +?lt.bl. lo lhi lxljrll
<br />g!i\o,ii rt'. I t ,..oa,u rp?lEaion rd r.rc rhr rh..I!E intlmib. i! clrrtt I rE ro conply sft.ll cny &d counry
<br />ordinm6 md Sdc Lr$ Ehins to hriidins coGrruclk !! ald nd.by .!$oriz. r.!.sriiE of thit Cil] &d Courly lo s s Won tlE
<br />rhoE rEtrbnod FoFry tq &0crioo puFg
<br />{ppli(rnr or Agor siln.rurc4. /'1 ,t,<7
<br />o.,, rzly'r r
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Ssbf loorNenUlnsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<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 />Engineer Final Report
<br />Flood Zone Certif
<br />^/-lFINAL7-2l"Za Jr.U7[/
<br />Certificate of Occu anc
<br />Notes, Remarks, Etc
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