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BUILDING. INSPECTOR RECOBD
<br />SITE.WORK DATE ID/SIG.COMMENTS OI{NB EUIIDET DELCA.NATON
<br />I lEEty rnm und., FElly ot Fiury 0u I h.rcql nm dE C.drEod Ltre L.r for di f.lb*.8 Esn (Sd 70ll 5
<br />a6rtr$ 8l Phr*i,n C.d.) Ary Cily or C.ury rtth Equn6 . Fd t' cdai, nr. irtttE. &mlitt d EFr ny
<br />nM@ Fi ro hr ii3llftc, 5 EtuiB rlt tppli,r lor trh Fmir ro 6b . risn d .rd.mr rhd lE or JE n l.tnrd F,rd
<br />ro rhc Frvi{6ns of dE ContmrM ! LianEd L.w (Chqrl.r 9. CoMEfting snh Sdtion TOuJ of Divkion J oflh. BusiEs ud
<br />Prefcshnr Co&) n rhr lEor{. n.eqi E ftld]n E bGi fd rlE dh8.J .rmFio.. AI, vioLthn of SEri.. ,01I J by uy
<br />.ppl..d ror. Fmr $bFr tlt +tlirr ro rcivilFmhyof rFr Iftrlra. nvc hir!.d dolls l!5m)
<br />_l, 0r o*'rr oI rnc Irt,rr(y. or fry .n9by.cr wirh *r8.r rs th.ir eh smFns0li,n, wil .h lh. *(k en rlt rtrrf|@ n t{
<br />iddr.,.i or.ficEn tq eL (56 701,1. Burirs rn<t ftordrinr Co& Th. Cotudor'! L6c h* doct B,r lpt l, ro i o*t, of
<br />th.Illtdy *'lD hrillr or inFoB 0Enr rn *ho drB th * t hirelf r h.rlfo. tl@uah hE q h.r o*n.,pk'rt6.
<br />l'rcvikn $rr s.t ni{m\Emd\c Dr irsndo,ofsd ro.qE Ir. hM, irEtlixtrts n rFo@ EsUstlir,ftFr
<br />olcomplcrx,n.tlEoeErBuin6willtEw[rtild.nofImritrsrl&rh.orr.rrdit,hrirrorlqmwlllInrElyforltEItriFsof
<br />L ro*EortlE F$tdt. .m.rcrrsiElr.offiin! wili lirnsd cotum b onfu rlt FtF (sc 1o+{. aBlK
<br />rid Pibftsrin Cod.: Tn Contdor's Lic.ns. ljw der ml apltly lo !o olE of l,loFny Plr huild! or inPto\e lh..mn,
<br />rnd $lx' co.hn ror kh Frl..ts wnh . C!nldo(9 lt nsn lunuln to rlE Co'relor'. Li.M Lrw)
<br />_l rnckmp unLr S(t.n
<br />wolxrqs' coirm{saTl()N
<br />DICTISAIII}d
<br />I h.rcb, r,lim udcr Fulry or rsjury om ol rlE follo$ in3 (rq-l,di,n\:
<br />I h.h dn will m,nrrh r C.nir.r. of Conrnl to Sclf.lnr@ l* *nI6 oqtBrbn. s FtvlH fd by SErirn l7m of rlE
<br />lrn Cod.. tu rlt Frl()mE or E rbri tor *tti$ rh. Fmn a irsd
<br />LI hrk !n!t wrll n!rnr.!n F*.R' mmncnraron 'Bur!rc, a! lqltcd hy Sd hn .t?00 oa rrE hhd corr., 6r llE FrfoiNE. ol
<br />llE eorl for whth rhn p.mi n n$.d My *(ksl .oqrn!.rion in:!m. si.. .rn p.lby numhd e:
<br />.-.. ' SAc^\e€.-,-a t. a-"-o",-r-o'q243\3-l-zo2-o .,. C)6- !3-zo2l
<br />I en't rlEt in rl. FnoBE. o,llr kl,t rry *hth ihn Fnir i\ kr*d. I rhll d.iploy.ry Frr i. uy ruE
<br />$ 'r ro h.<om obFl 'orh.ull.6 oqr.dhn Lrs ofc.lifomir ud *r lh.l if| should tE oftn rerrotb
<br />wortcrl .onrEtrqrion rtuvnioB of S.clion l7m or rtE I rh)r CcL. I aElL 6nhwilh orlply wilh thoE pmvnion!
<br />NAnNIN(; Fnihk k, sur. f,DrI.( cotrl!ndion mvdlsc is unbvtul. .tn nrll slbrrr .n orphtr,
<br />'o
<br />dim,rl FExis lrl
<br />.'ril ltrr\ rf t, o'r h!'xlEd rh,uluxl &,llrr rll(t).lrr)r.
<br />S(rir 1076 olrh\ I-fi{ CRl.. nrrcn a ..rrcr_\l$\
<br />rr",., - \\- O5-2o2o,rppu.-,, 9(
<br />Df{::tt8arl0!
<br />I IEE$y .fiirm udcr FMny of lErjury lhd I 0m liensd ondcr FDviri,i otchlFro 9 Go.mxin8 *nh sdion 7m)) ol DivGi!,n .l
<br />of rh. Il$ir$ nnd Pr.f.sbn! Cod., .rt my lr.e t in full foN url .ffal '
<br />\ L-l
<br />t \ l-os- zozo K
<br />saslBucrlrNtEDaclcrutr
<br />I hcEby lrnm udcr Fulry of Frj!ry ihd r,Er h a s,nirucrirn kidin, !8.8, (n rlE Ffornlrc of rtE *ork ro, *hih rhir Frnii i\
<br />k!-d rs( lo97 c'! c t
<br />APPLT(}i{T NECI AqATTON
<br />I ffiy lllrm und.r ldrhyolFrjuryorc olrlr rolb*in8 d{laEri.tr!,
<br />O.mliri,n Prmtr A End Ndir(diin hd.rl R.guld bnl lTirk {, Pan6)
<br />-RcquiEn
<br />lJrlg o, t{irifrrion
<br />-l
<br />en ify lhar r lE L{csl rcslLrirs Essdins r+.(or rcnDv,l m nn afflkrhk to
<br />'hh tmFt
<br /><A cdiry rhd I h.w E d rhii qplic.ri,n !n r. rh.r 0E ttrE inror n or.d I rs6 t, conpryrnh.llCiy nn Coury
<br />odinamr and Srrr. t,*sElarin3 xJ h!
<br />.hov€ mnrnmd lormy lor inrtEili,n
<br />^pgrsr
<br />or
<br />^16r
<br />siorrF tA
<br />rcJrcenrrlNs ofrhrs Cily rnl (i)unry b cnts uF,nrtr
<br />l'emilR n.he I prlnl )r X ieA\m6("An.
<br />n" r l(-p!- 2j2o
<br />Set Backs
<br />Forms/Steeli Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation ffi/tffi
<br />Roof Sheathinq | 't3'2(tfeo,aDs€yI
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coal
<br />Ivlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enoineer Final Report
<br />Flood Zone Certil
<br />I I
<br />FINAL t ll,1 l2t aw)4 'tKt
<br />Certilicate of Occupancy t
<br />Notes, Remarks, Etc
<br />Rev. 08.07-2015
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