|
x
<br />OWNF,T AUI LDI!I' I}I;I,CA RAI'ION
<br />I lEElt ' rflirm unld Filky ol tE ry (hd I m .!..rir rbm rt (ttrfr1(n Lxrnq I js (tr rh. nnhrrg rcN'i rli\. r{rl l 5
<br />Busin.rs rnd Pn,f.(ioi Cqll Any ( iry dr Counry rhi(h rqoir\ r F,dir r, a,n{Nd. rh.r. iqr v.. ,L,rnirh rlvr .ny
<br />!dw.|lrtrhr\ r{rN, !le, EqniE! rh. rnnlilnr r(tr.uch Frmi h fiki qFrl {d.mni rlFr rFor \l! n lf,.nv llunurnr
<br />ro rlr F.rtirnr of rll (lnrrroic Lt.ne! bq (Ch.!r., o. collftrinr *irh Srrir Trrn,/ Dtrtri,i 1 ol rlr llu{ir( !.il
<br />fir{.r.i,nr CftL ) o, rtd lr., !h. is.t.n!x rh.ELomddrkh*ir r'trrh.rll.E.d.r.tr{ihtr Anyvi{,lnti'tr ISRliinTlrtl It'yany
<br />.mliid ntrrFnnir r{bFittli +Ilarflr'ro\ilr.ml}oln m{.ihr lirr hddlrJ.t lerilirrl
<br />-1..r.*E.rrl'F,Fny.(mt.q'h}!6*rhr!3?(fi
<br />rh.tr6ko,qriqi(.r'Ud,rh.r'iti rrlI{n(mnni
<br />id.RLd or trr.rAl ntr rtrl. rS( 7r)44. lluijk$ 3nd lh,Lsint C(xl.: Th. (t,nr*.i r l.i..n. l js *Er fr{ ipt y k! o N rr .f
<br />tlE FrFy *8,lxittrl4qmEr rtrr.'( !,n *hI d,- q.h sxt him.lf or h^.llo, rhnn'Fhitr,, h.r o*n.'qttry..\
<br />pn,vil.d ri0r \u.h iqhKEn(mhri . Ldor,'trftd6trsL ll h'*.rr. fi. rxillrrt irFr.ftd6( sahn,r!r,
<br />of (rq,him rlr oerr Bu lr u l IEE rlr t!rd...r,in*iu rEr lr or {E dn d hitl ,r irllmE rrqnlFn, i, rh. nrF,r ot
<br />-1.!r.$i.rofuh.FotEny,!m.t.luriv.ltcrflrfrrinr*nhliai{nc
<br />aior h $nrM rh. IirFd rSr rl}u. Bu(fts
<br />. t Pn*.n'.Crd.: Th. Coit*kn's l-E.n{.1-r* d,x\ ar nttl} r. ino*n.r.fnn'r.nt wrn, hurldsor trnnn'f.\ rh.r.Dr.
<br />trrd *hr co ffr I'n q(h F,Fdr sirh tr Od.don!| li.nqi F^ld r, rh. (i, rlrd'i l.r.n<
<br />I .n .r.mlt !nd.r S.ci i,)
<br />th.r.h! nnrnruirr lr.nrx),n Il
<br />_lh.tr.r'xl$'lrm'ir,nnI('.i'rid.,,r(1itr.Iris.rIintr.t!4tr,,t.^(!trnFtr\,n r\ I)nri,kd n( h! S..ri(n rlr olrh.
<br />uhn (iil. f,tr rlI Fntr.hB. ,,r rh. sDrk fr, rnrh rlr Fnnr i trsal
<br />,hI.ml$illnE'nh'ntr!,k.^on{in\drr'i{,rft..i\kqutralh!Sarir\Tn,olrrrl-xhtr(i{k.f,,rh.Il.If,tr xfr..l
<br />rh. krk id Ehiehrhii ti.rnnr i\ i\u.d Nly$ork.^ onn n!tri'n in\urrnc.otrfi inlt,l!) nonrn , r,r
<br />-l..nify
<br />rh! in (h. F.anrMk. nf rll Etr ny $hirhrtn Frm, n noal. I rll n .mphr in
<br />!r .i h t:d'r {hi< !' th. * *.r' rnrEnd hi lr*5 rr (-rhn,trix, rn agr.rh ill\hrulllEo f,{,hr.cr r'rlr
<br />*' n. Li)nrE.efu)n lln)vii,ii oa Sdi$ !7rr, ! 'r rh. I
<br />IIARNINC FtriluE h €cuG htrt.6 (anp.n{rirn n
<br />.nil fin.{ trp !r DE rrrd..l rh{{id d(lh^ rtirr).rr
<br />ih{ ( 1xk l rhr[. n,rhrrh.on',lr\ {{hrh
<br />.r r'.' Di".'ltrrLr'k\ rnd
<br />r. 'n lri n ni rrr (.{ 'n (1 drns3.1.( nn'viid n! rh.
<br />S(rhi ro76ofrh.l-.htr C({1. i
<br />utctaBAtlQ!
<br />I ltEhy tralim urr.r ,EMrry rl n lrrry rEi I i6l*N.rt (nt.' In)!i\nn ot (lBrif e ldrnr Itrh s..ri)n Trrrrr ll)trni'n 1
<br />nI rh.0tr{n.s rnd Pn'L(\h.\Ctil.. drl.D lk.ns n in tullL,.. s .ll.r
<br />l-ietrr Numt'.r:
<br />-
<br />(0!$IBnslllr!.J.IAilNulriEr!
<br />I lrEhyffmr Lr Fui y or lEiury rhd rlEE h t conrMhi lndiiE ni.ky f'n rh. ndlrminr. olrh. "nrli,tr trhi.h rntr Fflni E
<br />is.Ed(se .llrr7. civ c I
<br />atrl,ttAr.tt tcltaAro!
<br />In rlby.fm udkr rxnri, otl.riory oft olrlI fdlo*inr d.chrdiont:
<br />D.nri-r P.mii A(h.{$ Ndirrcdnn laLrll R.ruhir.rTik.rr. Prn6r
<br />R.rtuiEJ ldkr r&rif.din
<br />_lcdifyrhrrllf.d.[lEiuhn r8'dr3.srrr.ir.mrltrft riq'ltx.ht r,rhnIn,El
<br />_l cd,fy rhi I hltt r6d rhn irdidtr,n dn {d.rii rlI xhr n r.d l r3,(n)coridy u rh lll (n) i*lC!(nr)
<br />.*nrdi!.!of ihFcirylndcoudrnr.nrd Frrlr
<br />rrnE mn(i,xJ Imrtnt rd r
<br />Applk.dor ir.nr srrn tuR
<br />SITE.WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />R oof Sheathing
<br />Shear Wall
<br />framing
<br />lnsulation/Eneroy
<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 />Enqineer Final Report
<br />FINAL 6-/9-2D /L Lts ,uf/O) eery
<br />Certificate of Occu pancy
<br />Notes Remarks
<br />Rev 0B-07-2015
<br />zao,144 4 z<_e
<br />BUILDING- INSPECTOR RECORD
<br />"nl'nik.(tr^d SrI.l rwi Ehins r, htrllins. n{,udr,n. xnl
<br />,",".)-7]- ,ar4
<br />Flood Zone Certif .
<br />, Etc.
|