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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE tD/stG.COMMENTS OWNER AUILDER DELCARATIoN
<br />I tn.hy rlfrm und.r FM,ry (,1 Fr,try rh! I m Grr{,r fn,6 llE Coi.r*loF Litnt bw ror rrr folhuin! Elsnr tS.. 7ir.l I 5
<br />AusiFr .,n Pr.f.rrhn Cd.) An, Cilt or G{n, shth E1{nB r Fmr ro .u{rEl. rxd, ,r{mv.. d.mlnn or ep.n r.y
<br />(ru.iurc. prhr x' irl i\sniB.. rt$ r.gumr rtE.rdi.{t lor ru.h Fmn tu fihi iisrcd {ar!ft rhd h.orrh. G liE.{d PuNinl
<br />lo lh. nrcvhions or rlE CotrlMtols Liccn{d Lrw (Chltrcr 9, Co@tuin8 wilh S..lion ?(xx) of Divni'n I of rh. auri..s rnd
<br />Pn{c1\r'tr\ Cork) or rlBi h d rlE ir.r.nt{ rlEEfnm rd rlE Erir lor rlE.lLS.n crcrinion An, riohrnnofsdan,031t hr.ny
<br />apprrinr td.,Frnir rxbFB 'rr .Irlalnl lo.civn Fdly.rml mnc rlt n filc tundftrl dolhr t!5fi),
<br />-1.
<br />rs o*F ol rhc rmFny. (tr m, cnrrhFr wirh $ascs s. rltn ok funlFnsrhn, wil! & rlE wrxt {d llE rciE r n,
<br />ddrLrl rondd ft, eh lS(7O4r. Bu.rBs.nd Pr$f6iir.i cld.: TlE Or rndrlirru*it i d tttIl, ro u osFr of
<br />rlE Fr''dy * lI' turtts or inI'os ilEE)i. !d *lb d(B rh h* him€lf o. hc*lf or llmulh hn m h., o*..q,riy.s,
<br />pmvil.d lhat surh nnnmEnrnri m nn inio& r olLEn nn ab li h,e.6, rhc hiklinS or iqn,EEnr ! {,H wirhin oE J.e
<br />or$ri,t{ia rrE ()wB Bu,&r wil h.E rlr tud.r ofFlvins tld lE.r \lE dU Dr rliH u i,rtnrw lrE Ft,Ely lor rh. F Inc.f
<br />t. trt .wmr ol rh. rolEny. dm cxch\ivcly contrud n's sih li.cn\cd (onir(nn t, r.tr{flcr rtr tn,F.t ( Scc 7(,l4. lrulms
<br />alrl tlt'r$d{ C,xL Thr (in rrrDf \ l-'.ch* k* dr* n lpnrytu anosffiof poFnyrln, h!il!\or inrpmki rh.rcr,
<br />rftl {lxr $dtuir fd \kh F,Fi rfh. O,dBlonsl l.cnrd luFuor h rlE (.t rklor'r l.r..t L:*)
<br />I tr .rc rfrrtrdcr Sc.rifl .ll ,\ r' (' r'trrhtr'.,trfn
<br />gof,f,E8rrgltfEiltAM!
<br />DE(IASTIIIIN
<br />I tErcby lmflnun&. p.Dlly ol F.Irry orc.lrhc n'll)*ing &{LEri).s
<br />-l
<br />nlE .rn pill minl.in r C.nifElrc ol Con{nlti, scli lnrurc f{, *o d!6 p.nqrr,i. N lr.viLd tu by S<rnn ]7tx, nr irt
<br />bhn (ixlc. ror
<br />'h.
<br />p.rforromc oflh. strk for whichlhc lcrmil t isud
<br />_lh.E.d*ill i.r'in wnrt6 tuir.Nrhn intuEn...r ftrluinn h, Sarbn l7u,.r rlE l.hor Cdi.. ft, rlE F.roffi ol
<br />rhc srl fu ehi.hthiFmii ir irsrd Mr*dkdl omFnorirn iNurrN cMia r{Flliy.un*rrm
<br />R,l(yNun f,r
<br />I rnirr rha! in rk Fformm. or tlE *ork tor *hth rhn rrrnir il i\nrri. I sh:ll n .iptty iny Fmn in u, nuEr
<br />{ .s r' tEsm $tFr ro rlE *orlci on{f,nd $n uh of Ci'fomi{.rn reN lhd dI.lrull t coc ol'F k rtE
<br />$ort.r' mmpcnirrion pm!ni'n\ of Skri,n .l7m of rhc trh, (1d.. I rhlll fonh*iln $nlrly *irh rtpE I)n,vhiohs.
<br />wALNIN(;r l;rilxE ro GuB qorkci s' .o n{Ensd ion c!!cnr! i( unblful lrd \h,ll subj.ii .. .mplorr h aimirol lrrolli\ rnJ
<br />rhousnd drrll.n Itllrr.lxlo,. n & .o{ nr.onFnqrir..
<br />i mrr ur! lnomy r farr
<br />I rlnn undrr pcnrlry rlncriury rhrr I rD l'(i*l
<br />llu\i,r$ rr Pf,na$i($ CoJc. drl my li..{* n
<br />IIr(xr],!'l( l'(r0t)(\'{nnpkn'tsihs.u n7{xrr)orl)'Lnrt I
<br />z
<br />1g
<br />I h.ftl', d,Im ui.hr Fdry or Frrury rhr thE n
<br />issEn(s€. -Ir97. civ c.r.
<br />bdin! lscry lor rrE Ffmfr. orrh. qtrt lor *hah rht Fmr i(
<br />AfILICANLIIECI,AIAIION
<br />I hd6, {fm ud.r Fnt!y ol F rr, ox oa rhc tolheiry &rbhri,nr
<br />D.mnnion P.rnir+Arhsr{n NolirElri,n kded Rquhri,nr (lirlc4,, Pd6)
<br />_R.quiEd L.rrfi .f Nair.alion
<br />-l
<br />ccnify rlilr rlE Ld.'.| ftslhr nr Elrdin8 axb.rtr rcn,rol d. r {plicabk t' rii pmF
<br />I.rdil\ thlr l[rc n l rh\{nli.n.otr rrtl nrr. rh,t rh. xhrc 'ohniurxnr hcot I agr ron'mpl, *irh tllCit. l Counry
<br />lrdmr.r d S'.rc li*aEbtiry ro
<br />rk,r. trr rtr,6_d ln,pcny n,
<br />u t-.4i,\
<br />a/tr
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads A
<br />UFER Ground --r
<br />SLAB Floor v-
<br />Rool Sheathinq
<br />Shear Wall
<br />Framing
<br />lnsu latio n/E ne rgy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lvlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enoineer Final Report
<br />Flood Zone Certif .
<br />FINAL 7-26./02)?€)
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />Sublloor/VenVl nsulation
<br />,*^*r^,, Z;.",/o/-
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