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BUILDING- INSPECTOR RECORO
<br />SITE.WORK DATE ID/SIG.COMMENTS owNun Bullt tti Dtl,o{ta ttt-
<br />I rEcb, .num u,Lr p.Mhy or p.rjury fiir I m .&.q nlm rh. cbnhros lic.n$ ljw for rh. tolowins Ero, (Sd.?03t.5
<br />Iturin.s! .nd Phf.{riri O)d.): Aiy Chy.. Cdry ehih r.quiE! . Fmi r. sn{rucr, .lra, im{roE, d.mlth or ED., |.ylllllfu,Ftub r i!$m4.lso Etrir!! rtr rptlidr tqsrnFmib fit r,Srit rr.md lhrh.orC.nti.Ed prut
<br />ro rlr Fovni.B or rr Cmkrrr't t,aa.d t.* ictulrd 9, Colmrin! yih S<ri'. 7(m or Divni.n , of rh. Bsir3 rd
<br />ProlilrD6 Cc,.) d rli lr q d. s .En+r E frDn .rl lh. lEs fd itr iL!.d .r[t Dn Ary 6ot ih o! Sdn ?OLJ br uyrppli.r forIp.mi sbFLitr rprti.. ro.civitp.Ntyormr mr. rhs tiE hrdE! & te!(t50)
<br />:i* .**..,,* *p.r, .r hy.mprnr.i *nh w.Bcr Lh.i, 6k (n!.turh^ *rn d. rh. wr .,,o r,* tu,wnmrinEdal orofcr.'l f .L (Sc.rlx4. Aurircsnd PmrshB (irt.: Th. C.dnsro.' li..€ llwdo.r ir, +pl, (o mow.o,
<br />th. Futdy wll, hiilt or hrfra rh.@! rrn wtE dG s6 q't himstf or tlrsl, or rtmllt hi, q ts oen.n+lolB,
<br />Fot&d 'h!r Bh !!,Fwns n d d.,n d nofldrd [n.t ll. bNE, rlE hrild.s d urrErd L $ld yih! m )<zorcurpldia tu O*E BoId yi! luE r hr .n orFvt! d h. r 9E dit n t hriu s inFoE UE,6Fr, li rtE Frp..ot
<br />_1, &r .xrc, oI rh. p.oldy, d .rclu v.t, .. ftins yrn ti..n€d do turod b oi{o( rh. Ftrjd tse ?o{.. BuriF$ri hnrdsi'n Cf il. m. Coik{rol I Liccnr. Lrv de\ nor irpty r, $ ow*r of nhp.n y who buil& or imnrov.! rh.r@n&d xrth sdrk r.r {ch FoFB *nh r Codsro(r li!n*.d rulre ro irE Codti.ror! Li@ Lra)
<br />I 2)
<br />NFCI-]I R ATION
<br />I h.r.by !lrlrhundcr p.nahyofpcrjuryoic.l rh. tuthrin! d..t{dtr,h
<br />_lh.E!nr lEjDrrin r Cdif.{. ofcl]u b S.r-I,M f6 k !6. onp.Mio^ r Forit i fo, t, Sdi6 37@ orrl,.titxr Cod., |( tlr Ffm. of rh. rat ki lllin ih. pani i iq.d
<br />_l h.E .id will Eid.in srLR or!.Mrbn Eeru., tl Eqortd h, SdrDr ,rm of rlE llhor Cod., L. r Ftt mE ofrlE *ql fo. *hrh rhn p..d i! irrel. M, *116 @np.Mbn tulrlr ffir !d Flt, NntB c:
<br />Polt, Nunrha._EiD6
<br />-ldiry
<br />u i. i,E FIfm or rr. *rt l( vt.h rho r.rhir it B*d. I luu d .npto, ay Fm. h uy Ms ! h h.or $ttd ro lh. HA6r'onFMbn Ll! of Crnr.mn. rrld rg6 rhr tf I ft{E bcom fut|irl o rtth.\6 rcnrp.nld.n pEvili,B or Sdln l7m of dE lltd Out , t JIjl fdhwirh Nnpty wrh rtbr pbvirioB.
<br />WAiNINC: FriluE ro Ecw wt n q'nIlG.bn owBr. n unh*tut, .td ttrtt tubrcr o .nptotli ro .tuurl D.NIar rd.'v I lnE\ uO i) o'k hunJr.d rh.ur ddol rttllx).lrNr).r n ro rh. ..! Dl.otr{E srion, d@!.r a poid.d ror rh.sdr!n 10760fr,r I'htr (d., inr.Ei
<br />,,.", b/c 100
<br />DFCIANA'ION
<br />I ltEbylllirmun.. F lryofFrjuryih.r t rn licctr!.d u,!d.r Ftrvhi.h.tClBfls,(co$mrii8 *irh S.dhi 7tm) otDivntui l
<br />ol rh. Bunrcls nxl PruI6sioc Cod., s trry ltcnE n ,n tuU fi'c lrl cf.cr
<br />aolvslllt,cItoN I FrtDtNG acItNCy
<br />I lEFb, rtfm ur!.r F r,orFiryrhdrh.EisI6d riotr torlu l8.h,Io, rtE tEfolffi otrtE wl tbr wtihrh! p{Br si.t!.d (Sc. 1()97, C[ C )
<br />APPLTCANT NTcl ARATION
<br />! hd+,ltrmu .r FBlry o,p.rjrry oE of rrEfotrlpD8&rt r.!iorol
<br />rxmlirion P.mire^tb.(o! Ndirf,db. F.&EI i.tuLri,b(Tit .tO. Pd6)
<br />RquiEd t tr€olNdfirbo
<br />4^,,,
<br />if, rh.r rlE f.i..rl Rgullbnr cgqJiu Eh.sro. rcni,vit e ft, app[abt ro rhn DDEI
<br />rh.r I hrv. Enl rh! rpplanEn ul (!E lh.r E .hotG iitomrion i! cmr. I i3r- ro (oiply * irh .ll Ci y .Bl Cou.ry
<br />ttu C,y,rd C,)unryt'.hid uFn rrr
<br />-,,r//ro
<br />Set Backs
<br />FormsiSteel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUlnsulation
<br />Roof Sheathing
<br />lnsulation/Ene
<br />D all
<br />Brown Coat
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Report
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<br />FINAL e-21-4 }"IJJ\{
<br />Certilicate of Occu an
<br />Notes Bemarks, Etc.
<br />Bev. O8'07-2015
<br />Drr. _ ('G!d.r_
<br />rh^. mdh*!, prtrFnt kr EFdp.
<br />Shear Wall
<br />Framinq
<br />Ext./lnt. Lath
<br />Ivlasonry
<br />Flood Zone Certif.
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