|
BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steeli Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framino
<br />lnsulationi Eneroy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Depuly Final Report
<br />Enqineer Final Beport
<br />Flood Zone Certif .
<br />FINAL 1--$-zt 0-O ts
<br />Certiticate of Occupancv
<br />Notes, Remarks, Etc.
<br />OWNM BUILDET DELCARATION
<br />I kErry.r.m udd p.n lry ol Fr,l.y drd t u.Ew t6 {E C]ffim lirir t f, for ll* tolbs.U lg$tr (s<.mll.J
<br />S6iE3. .rn A!r6!i,n Col,: A.y Cny or C6u y *tah Eq@r r Ftrn lo cqrr^!l. .rd. nproE .lmlirh n EFr i,
<br />shdu( prior ro irr issue, rl$ EqliE! rlr q,plisl ror.kh Fmi lo nl t ri8ftd rltrcrnr lhd lE o, dE i lic.Nd F,sd
<br />r. rlE FDvirios of llE Cmlrdmt Line.rt L.w (clrprd 9. C.ltEmir *lh Sarbn 7qD oI Dlvisbtr I ot lh. BuriEs rn
<br />PrDfcnbns G,d.) d rlur lE 6 lrl i! .&r9l (ffioE rn llE bli9 tor llE .lls.d .raqin 4,, vnlrbn olsctih 7Ol1.5 by -,.prlt. for ! IEnir $bj6r! tlE ilrlicd ro r .avil p.dx y dr mr fr,E fii nvc lIUdEd dollrt (t5m).
<br />-1.
<br />!t o*F otrl! FFny. or my.,?k)Ei *nh w.8q.r lh.n $t @nF.t'.tbtr wi! dd l)i wut tn dE $EtE it ml
<br />inrdrld orolY.r.d lm rt isa.?oat, Busi63..d ProlBi6 Co&: TIE Cdrndr'r l-!tG t rdBd@1,buowEof
<br />(h. Frsir elr, hrltis d -q,n6ltEmtr. who dG.dnw hid€lfor h.eladr tmn,h hi! rh.ro*n.mplolt6,
<br />pmviLd rhc tkh nFDEdaeld i,rdrlGdnofisd ftrrL.lt EEs. dE txiur! d ntFffid i! bE qlhii m rsr
<br />ofo,{'tri(a llr O*d Bdlb wi! lrr t}E h,&n ol Fsvit 0. lE d tE dn ri hild q iqrtr dr FFry ft lll F FE of
<br />-1.
<br />lrow ofll' FsFry. mcrcbrircly <nrslhs wnh ltctr d.o m6 b odru.l tlE FtrF (Se. 7ora, BBiE*
<br />!d PlrtuirCqL TlE ConrElor'r Lilr 1,,do.r u rpplrro uorE ofFoFny eho bnild! or itr9tuE! tlErdtr
<br />Md who ontus for Mh FoFlt *nn I ConE ro(.) lirnr.d lUr$.I( 'o
<br />rlE CodrtG'3 Licce tl*).
<br />_l u.EnF un ld Sali{-
<br />IO8f,E8S:COMTEIAIIqN
<br />AIJ:IAEAIIJ]!
<br />I hr.by .rrm undcr Fmlry of Frur, oE of tu rn[6v!B .k{lrdb.s:
<br />I h.E.,!d eill milrrh. Cdl!f.r. of C.Eor ro s.lf.lM fc eort6 orI.rB.bi, B FoviLd tor by Setb.l?m of dE
<br />t-dB C!d.. (a llE FfdIrc of llt *at 16 di.t rlt ,Bir i! t$.d
<br />A h!rc und ! ill nuiitain workcs ..nf.ns{i,,n iNursE., !s rcquicl hy S(r i'h l7O0 of rh. lf,hor (-oft, Iu lhc P.rI*nuEc of
<br />knl ,or *hih rhir p.mir k irsEt My *rrd onFdDn NuJlN ffir rn Flty nuhtq G
<br />Ionq>s1azc{ ,.",
<br />-l
<br />ccnify rhlr h rhe Frfortum. or rn wod( rd vhah rhn Frnn r R!u.d. l lhatl nor .nFloy r.y Fls in t.y lMffi
<br />$ I ro tE6e sbF{ r. rlE wdt6l orp.trt r ior livr ofc.lifomir. dd r8r $d ir I sbuld beom sbFr l( Itr
<br />wt6 oqENrbn FtrvnbB or S.crio. l7m or dE blrr C.d., I tdl. fonhenh @npl, lirh fta Ftvaffiad rhrll ruhF.r rn dr[|b)n ro siniEl Fdlir trn
<br />.'dl fikr lll] r) utrc hutr{lNl thouvml doll!'s (Sloo.rxx)r. i', rdJii{rhc (o{ ol c'trn|Etrern,n. d ulcr x\ prov .tl l{r rh.
<br />se'rn lo7a I rlI td.r c.d.
<br />*-,lr-lzl'z-.
<br />IICEIIED.CONIXA.qIIaDf{IIBAII(N
<br />I hftI\, .rm ui&r FMlty ot Frrury llu I sn laqF..l ldd Frvir$n or chr,rd 9 (oltmEi,! wnn Sdrbn 7m) ot Dtnat. l
<br />of rh. Bu\ifts rnd Pl tcBhns CorL, an my lic.M n in tull foN un cl'(r
<br />K boo
<br />u1;1'<1\P< r+ Ho,r<
<br />CONSTRU('TION I NDIN(: A(:FNC-Y
<br />I lrEh, lifmu,rlcr F lr, or Frjlr, rhd rtrE Er6NMb. Lndin8.8.Ny fu th. Fn'o{lllae (,rrrr$orl nr lhih rhis Frtml i!
<br />iinf,d (s4. 1097. civ c ).
<br />ATEI:ANIDEIIJBAfITd
<br />I horiy.trmu..tr F.rh, or Fi,r, oft of
<br />'lE
<br />folb*in3 tk ![dbn.
<br />D.mlirhn Ernit A.b..rd riorilFdi,. F.J.nl i.ErLl[tr! fril ,D. P.n6)
<br />-R.quiEd
<br />L.rrcr ol Ndiftdi6n
<br />\ETWflfr
<br />Rev 0n-07.2015
<br />-l
<br />(nit lhd lL tu .rl Esuhh.t E .iliq r$.dd rmvrre d tpplid't lo lhir loi!.r
<br />-l
<br />.diif, du I lIE En rht tptli.rbn rn rdc rh.r d. .loE hfomrbn n Lrir.d. I l8r io @wl, *ilh .U Cty d Couuy
<br />onbrN! in SE!. t wr EhiE ro 6uildin! @dnuretr od h.rdy dhdiE rEFlsrriB of lhn Cry 8d Co! y ro o'd '+.n tlE
<br />.boh r.riJEd pmFry fG nr.fl"ne.eg4 -/\ /' -))---.<-_..- \ *,. tty'z horrdh-r or Aror Sl,ErE t,.|. .-LZ_L--\--\-rmrrc,*rpano:\rn rb - rre k' .
|