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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Erection Pads
<br />UFER Ground
<br />Sublloor/VenVlnsu lation
<br />Roof Sheathing
<br />Framinq
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lvlasonry
<br />Pool Fence
<br />T-Bar
<br />Handic ap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />Elpod Zone Certil Ir'Lnfifiq5 OIFfiM W4IilIil.//
<br />FINAL hlblru/u-atw
<br />Certif icate of Occupancy II
<br />Notes Remarks, Etc
<br />OWNER BtIII.T'ER DEI,CARAIION
<br />I h.r.$y affirm uftl.r Fcnalry ol n riury lhot I lrn.rcmpr fn,nr rh. Codr t(n- Lk.n( liw ror rh. follosinS ft!{rn (S(.70:ll 5
<br />Bunn.\s td Pn,rcso. Cd.) Any Cily o. (ounry Bhrh Eautcs . Fn ro n'n(Ml. dl6. iqmvc. dcmlth or Epr,. ..y
<br />{M1w. Fn to [. K.lffi.. rlq, rquiE. rlE.t ltsi ftn \Eh Imr t lik r ri8ftrl {d.!Mi rhd lt or rlE ir litn<i l'olsd
<br />to rh. F,rEiJnr or!h. Conr,r't, ! t,i(nr.d l,s (Ct4r6 e. C.mmftin3 r'irt S.crirn ?(xD or Diviion :l of ilE BusiN{r.nd
<br />Prni$ions Codc) oi thd tEor(h. i{.r.npl rh.rcfiooEml !h. h!!n turh.lllcscd Ex.mtrirn. Aiy vi,llrionofsdJ$n70.ll t by dny
<br />rmli.&nl for!I'cmil rubtrr rh. eprlicrnrror.rvilp.tulryorB fr,r rhx.l_rv. hundftd doll-s($t(I))
<br />_1. a! o[8. olrlE lroFnr, (tr my.npbF.r Bnh f,.86 11rh.n $k NqEndion. willdo dE krt.rn dE rdm n d
<br />inrcd.n or ofl.Ed fr sl. ( Sd ?0,14. BusiBr lnd Pmrdrionr C.dc Tlt ftnrrloii l,itnr Lr* &E! mr {,ply ro m o*F o,
<br />ItE tmtEny *rn' huildt or iqrew( lhc6n. ori wlN des ikh *o* him..ltd hr€lfo. rhr'u8h hi! or h.r oqn.mfk,yc.i,
<br />prcvilcd rh.r swh iqftEm.h e d hrc i.d uofidrd ti, qL l( h'rtw. tlE l!'ld0a m rFtrEr.r n sld *,thin om )q,or.wrl{in rL ()*E Buitl.r *iU lrE r,E lndar ofForrg lhr b n nr dn mr tlit q i,pmE dr ImFry tu dE F,FE ol
<br />-1.{\n*ncrollltpmpcny.0n'crclusiv.ly.onrr&lin8rilhli..n{dro
<br />rufln ro con{fl.t lh. pmr lScc. ?(x4. Bunm\s
<br />att lhia\sin GnL 'rh. C.nr lofs Li..nk lr* d@\ n lmly ro m owncr ot pn)Fn y sho buikl! or improki rhd6n,
<br />rnJ riE orrB--h tr \Nh rloFdr wirh. (i'nrdons| l*nrn p{rud nrih.codr&ntr'r Lir.r lr*r
<br />lurcicnpr u l.r Sarii)n_ _. tt & PC LrrhN n.\rt
<br />Drl. (rxfr.
<br />llaBli}:&I:co ftdsalla:
<br />D}:IIJXAIIIJ!
<br />I hcrchyrrTnmuinrr pcmlryor p.rrryo or rh. tirllowin[ ddrr)rion\
<br />I hryc rn $ill nuinrain r Ccnifurc of ci)ornr nr Scll lnlurc ln sorlrr' !l,.r{Ins, i,n. K Frriln lln by SNr ih .U(l) of rh
<br />tjhn (ixlc, for rt Fno'rEN ol rlr rvt lr *iah rh. Fnn ir i.qEl
<br />.$t"" -, ",u .,.", *, tcR ( mn(n$r trr ,n$raftc. 11 rcqurcd hy sdr bn l7(x) or lhc |jhtr (hilc. for rh. ncdrtrroN. or
<br />'ri.*c'If,1$hilhrhnn(qjrr.rlucnMy*Nlnsmmntr!,rtr,nrnrurftcrMkrrndplrynumhcrm,--, HarLK..l Fccnr,,n,.*,,57\^'t\V\Gr+'t\< .-n,,", I\-\-?o26
<br />-l
<br />(n'fyrhrt itr rlr Frf.rMr. oIrhc work frtr u'hah rh6 Fm r nik!.I rlEll *{ .,r9k,y ooy JEmn in&},M.ffi
<br />$ I t) t!.$m \rhFr b rlr $irrda mtr+.nsri,n hN r or(.lft'mia. rftlllN rhd
<br />'f I fi)nld t cor !ohF! b ilr
<br />ur*.h 6qEni.rhn povirilnl or sdio. 170(, of !h. Lhx (rie,, sh.ll, fodheirh drnlllly wirh iho{ thri<rn(
<br />WAnNINC FriluE h wur. wo.k.i! cory.n\lln'n ..vcrolc ir lnlorful. Md shall rulrrfl an .n{l,Fr lo dmnrl rEnslric\ lntl
<br />.iv:l ft{i u,) i(, ok hunJEd ihousnd dolhr ($lrx,.rxxrr. r indili'n nr I o{ fl (,trnI{nlrii,tr,. ([tr1'Sr\ r\ prri].,1 r(, rh.
<br />N....rIi 1076olrh.lf,htrCdic. ini.E< r'J r(rEl (
<br />"",.,G-tl'ztzo Lr(F\St.j) ( 0N I',R{( ll)Rl)lraarra:
<br />I h.rctry .,rrm unrL. Frh, ot Frury rlEl I M lirnsd u,'d.r Imvirir. or Ch.Fd 9 (mmirB $nt Sclbn 7(m) ol Diririon :t
<br />ol tlE Busm$ .d Pmf.rshB C.d.. md my lk.nc i in rull frn€ 1rl .lINr
<br />II]!SIBU{:Uq!.IEdDINiIGEBII
<br />I hcE , .rrn ,rLr FrLy ol Frr! rld llEE ir r odd1r,f, Ldh! .8.8, lor llE Fn(mN or llE xrt ,o, Bhah dri rffit ir
<br />isrEn ( sN. 309r. civ. c )
<br />ATILIIAILDECIdXAIIIIB
<br />I hd[by rmm und.r rd.X, ol lf,rJUry on. .f rh. folhuing dc.lr ri,ns
<br />Dcm,lnK,n Pcrnir\ Aihc{orNnrific.t6n Fc&rrl Rqubrx,nlIIirE!o. P!n6r
<br />Rcqnr.n k(fi of fdiilrrtr,n
<br />I ciily rhd ltE ,.d.ol E8lbriJn E8gdin8 .srE{os rcm,vrl .E mr qnlicabk t, rtir rrmFc!
<br />7lfcdiry rh,i I hw Ed rhr .prla{ i,. lrn {dr. th{ rrr rtl*r irromr ri h ((,ld I .pr ro on?ly *irh rll Cnr rn c.lnry
<br />oilindk.{undSrnr.ln*rftbr'6!t'hoikii.Scon(tudn rl h.rchy rurhtrrc rrlr.{nrdir.\ ofrht Ciry rftl Counry r) cnts uJ'.n rlt
<br />rh)rr nrtrri,nrd I[,tnrry 1,, i'Nn(rr!r
<br />^.'1-
<br />,,",,(-U-b zo
<br />,tJ!
<br />Forms/Steel/Holdowns
<br />SLAB Floor
<br />Shear Wall
<br />lnsu latio n/E nerqy
<br />',,:":b:i i *#'*?"**,,,'#g Enfr @c,-
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