|
BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE IDiSIG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Roof Sheathing
<br />Shear Wall
<br />Framinq
<br />lnsulationi 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 />t I (Lll 67
<br />Certif icate of Occupancy
<br />Notes Remarks, Etc.
<br />--lD
<br />OWNER DUILDER DELCATATION
<br />I h.rlby .ftrn und.r ,Erully or p.lury lh.t I in .r.mrr rn,m (h. Conlr(kth Lt.nr lrw ,i,r rlE fdl.wins rN'n (Sc..70.11.5
<br />Bum.$ nn Pnt$rr CtrL): Ary Cily or CiE y whEh Equrcs . It fll lo co[{ut. .116. in9mv.. d.mGh or rrrr y
<br />ndft. Ff, tr {t Bon , .r{i FqlFs ilE +rilrri ror luh Fmr k, liL r i'8e\t i.r.M! rl'{ i. or {r ! lirsn Frulr
<br />ro rlE rFvnrB ol rtr ConrrEla.r Lrcn€J L.w (Ch.rld e, cl,tlwErr *nh Sari'. ?rm or DrBir ] or rlE Bu,ns ri
<br />tur$*rff Cod.) or rh.l lx M rh. a .r.r9r rh.r.roh r,xl !h. b.iu nn rh. !Ucs.r.l .rcmflifl Any vn ,!io. or Sdioi ?01 I J try .ny
<br />rrrFlk'lrlr r,trr 0(m luhrq( rh. !fi!l(!nl ro r Lrvrln{nal'} I ror horc rh.n livc hundrc,j d ll&3 rl5o0 r.
<br />'(t. . ,** "r rr. g"p.ny. f my .rg}oFrr *!h *r8.s B rh, {h (urp.nddn, v Jo rlr *dt .,rj rlt {ere . nx
<br />,i(rlAl .f,alLRlnrrk(S( ?O{,a. Ausfts J Pllr.$irN clrkr TIE Odr&r* s ti.M lrw &Es ni {tly ro r 0*6.f
<br />rlr |RlFny *hr trru, or nqhEt rlEs( ril w&i J(B s-h ql* htmsclf or h.rclt or rhruth ti! or h.r o*. .q)loy!.!.
<br />ptuvrlc.l rhr such "nfroEft.k & an hrcll.J o.onirEJ rn, !!.ll hiBE. rlr hillhg o. EInEBnr ! r'l] DnhroF ]rrol.1'ril'Hirr 'lE()*Er Buiricr v!! IEE tlE h,!.n oiFovr'8 0d lE nEdid r, t{ l d inFrE tlE Frsry I'xltr FIFE.a
<br />l. b owft. or rlr lrn,Ii(iy. an .k lurvcly ronr,.rm3 * h l'(cnrJ ronrekns h conntu.r r h. I'l'Fr ( S.r 7044. Bunrc(
<br />itrl lhnasir C(nlc Ih.Contrr(rtr'sl-r.nr.I-r*docs rmlyn, snowh.r olrupcny wh,, hu,ldsor imFrvsrhcr.otr,
<br />rnJ *lx,.onLr.rri(,surhpn,F.k*irh!(i'nrhcn,nr)ltcnsdpuFunrh'rh(bnli.(rtrtlrcnclr*)
<br />_l rD . r.n,i u[!r Sarx
<br />""*,>< ,'7-Z- -
<br />I lrRh, dlm unLi Fulr, ol n<irury om of rh.
<br />wonxffi..rEf.l:,rna!
<br />#]$*#lu
<br />Ih,v.urlw,llnunnnaCtn'riurcoicon{,llk)ScUttr{kntr* cri! nrrnslrtr)n i\ F)vi!.JlnrhyS.rr!)nl){Xrolrhctihtr cid.. ntrrh.F-rroturkc ol rh. uort ktr !hr[ rh. Frmn a A$.d
<br />I hr\t ,El *rll nu'mln vorkd! ()mFm.r x'n 'nru'rRc. r! '.qurcJ by S(r rm .l?UJ or rh. tihtr C,r].. n, rM FrrrNmc o,
<br />ih. work ior *h.h rhrf.mf 'r N\1rn My workc^' $hirtrsri,n ,n1r.1Nc (dE rdF lry numt r{.:
<br />IrrRs:
<br />f("n,ry'r'", ,n,* p,r,*-Rcxr rh.vdk h, Ehkh .nd rE,nn 6 6(.r, r sndrsn cn1,by ,.y 1160! ,h rhr tu.&r
<br />$ s ro tE!!m ruhj..l to lhe qo*cr( .omlEf,rln,n hws ol C.lin,mi,, .nd rBE lh.l il I sh,u! b.aom suhFr to ilE
<br />*od6 rlr{iulrr Ih vn$n! ol Ssrirn l7m ol rlE L.!n Arj., ! {ull. lGrhwrrh o,r{ y,nh rho. F[hqN
<br />WAiNING FrJurc b rm witqi oqmdnn o@s. E unLwtul rn nru $5Ft .n dtl|LrF b t:rlMl FdlB .
<br />civrl rkr ul ro oM hnnlr.J rh,lsrl Jrl|{! (tll,o.Ull). F r!.riro b Ur o( of.ohFtr{ror dttusc! 6 ,tro,n.! n, rlE
<br />Sc.rBr, l0l6ol rhc litxtrC(,Jc. 'ni.r.{ rnJ rrttr,.y \ Icc\
<br />-7'2.--1/-z-t t-
<br />r.rt r:rsr rr rJXr *(frrrxllt!]Ja!M\
<br />I h.Rhy rliim uojr Fnity ol tEUury th.t l .m l(.nsJ !Br.r F,vibn or Clpt{6 9 (conmh*,n! vfh Sdr)n U)orDrv((r]
<br />dr rh. B!sin.$ Md Inntsoos Clrlc. u ny l(cnc is in tull lnNc !,rl cllt(r
<br />CONSTIIUCIION I T{DING AGr{CY
<br />I lE .i, .fim !d.. Frlty of Frru.y lh.' $ft u r .!dBu,n Lft]I4 .!.8, for ilr Fltl|lfuE of tlE qrt for vhrh
<br />'hB tEDl it
<br />ilrkd (S.c J09r, Crv. C.).
<br />lrd.r'. AJdr.$r _
<br />APIUANNLDECIAEAIIO!
<br />I hdlt'y ,fm u.dq !.n.hy or F Jur} o* oI rh. lLnbwn! lEL Lurrx'n\:
<br />D.frn'l$n P.m e^.lEsios N.rr,k.tsn Fc&r.lR.suhrDn! (Tnk.l0. P.n6)
<br />R.quucd tltrcr ul N{,firhrr
<br />-l
<br />ccrlitrhd ln r.1j.rilrrlLri,B E8r{'n8 rrrrnos rcfr'vrle nn.r'FlrrhL tu dqh!.<
<br />LI \drry rhr I h.v( rcd rhB.[r grM.rn n.r. rh.t rtE.h'E hlomtb. ! (mr I .rE ro onpl, wlh.ll Cuy.d Counr,
<br />orJinm.r .nl Sl.r. L.wr EhtuB ro t ilh8 conrddotr .,rl h.Eby .urhoM EFErnratv.. or rh( C , r,r.l Counry ro mrd utbn irr
<br />,h,vc nuxo.cJ Ootrny tu irsp.rrk'n t)U4rosr
<br />Appli.sl or AA.nl Si!tu1 *x-4-.Z
<br />/B/",
<br />II
<br />I
<br />7Z|li8!'JL7
<br />Subf loor/VenVl nsulation
<br />Flood Zone Certif .
<br />FINAL
<br />=
<br />I
|