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BUILDING- INSPECTOR RECOHD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDTR DELCARATION
<br />I h.rt, .r,f, !.ild Fi.xy ol F,rry rhr I e .r..ifl nrn rL Cdir-r6 LtF* t w for ft lollort r$. (Sd.roll.J
<br />Busik$ !n Pmr.sirn Cad.) An, Cit, or Gnllr, *nth r{lint a Fm,l ro .nMnd. 116, n9mE. dcmlirt or EFn u,
<br />rhrru., ,,r ro ns isslN, .ls Equircs rlE {,plit ror iun Fmi ro nt i risn rl rlll.mi rhd lE or tlE i ltcn*d Fr$.,n
<br />r. rh. Fovirhns ol ilE Conrrkrol! Lh.nkd b* (Cnlprcr 9. Co,tmEins wnh Sdion 70(D ol Divnio.:l of lh. susims &d
<br />Pmf.ssh.r G'd.) or thcr lr .r rh. n .r.i{,r rlEriion rd rlE hrii 16r rh. tlL8.d .r.q, hn. A.y viohlion or S6tion ,01 I 5 by uy
<br />rppli.rnt for. Fmil b|xls lrE rpplkMl lorcivilFMlyoamt mE th$ nvc hudtcn &llas {trm)
<br />-1.
<br />u wE ol rlE FoFnr. or n, cnplojd3 eith *.,6 .r lhct -L orFd.tr *ill 6 tlE wt rn dE ourE ar ml
<br />iddrd.il dn,r.nd f- .l (Sa r0a4, BNiEs !n ?rDtdo6 C.d. TIE Cdrrxrd. Lj.ff trr &.. d @lr ro m M of
<br />rlr FDrary -ln l!il! 6 iFrle dsE( rn *ho d6 nri hit hilErd lrEll d
<br />'koua!
<br />his r nd oq.t+htrc
<br />|rovi&i rh{ rEh inqovurnr! e d ir6i.d do6old rq sb lf. holtG. rrE tliBra d nlFffiln n roB ethin m F,
<br />ororpbrb(llEOemrBuil&rsilllrEdEh!d.nofpberSdE,!dslEdu i hi! or inplM dE plDtsiy for tlt Frtrr or
<br />_1. d ow or dF FDFny, d.khl3iEry.otu(ina *irh lxcn:d conrrxlm r0 n,ndnxl rlE F,rs (se 7(x4. BuiE$
<br />!n Bderdn Cod. Th. C..rE d . Lmr- trr &B ml {,1'lr lo u o*E of FoF.ly *ho boildr ot ir?bct rtEron.
<br />..n sb orfr.fd *h FnFr wlh. Cotlddlr) lirEn Flud ro rhcon rrd.! tj..e tr*)
<br />_l an .r.nfl uod.r Sdr
<br />lvaBf,lrs:rautEtiarraN
<br />D!!!AA{UAN
<br />I lrrcht.rjirnu cr FMlty olBr|Unom ol lhc i,lk'sn8 {krluntonr
<br />I h.r.d will Did.i. C.nlf.nc of Corlr ro S.lf-lrtw ao rd.ld oip.nri,& ar FDvild fa by Sdliotr lrm of dr
<br />t hor Code tq rE Frro or dE w,t ld *nin lh Fmir i is,.d
<br />I htE rnd *ill tuit ain wod.r! on{EBrii,o. iBu!ftc. r. raNirld by SdDn 3100 of tlE Llbq C{dc. fd rlE pdfoljs. or
<br />rlE work tu *hi.h rhis pemir it i!{.d M, *6*dr driFnslhn in$ffi. ffi. !n polit nonbq e:'Acz t4nrrc.^c 4^)
<br />-I
<br />en'ry rlrl i. dE Fn mm ol rlE srt lor vhrn drr rE mi t iq,.n I ih.ll d .tploy ry p.t$. i. uy I4E
<br />s .i r.' b.<tr $hixr ro llE {1116'@nFtrdb. Lw* of C.Ift,mn. .,n t8E dl.I if I rlr,lld bcoE s6Fr ro rl!
<br />*nt6' dirp.Nriin pbhlioB ol S.din.l7m ol[r Lrts Cod.. I tEll. tdhwirh onply wih do3 pmvtuiN
<br />W RNINC FliluE ro GoE qrtcd con{Ens.tion d,Bd8. Lr unhwtul, a sh.ll $bFt d mpktlr to simiNl FBII* lnd
<br />civil fiEr up ro otu hundEd lLuud dolles (ll(n,o(x)), in rddnion lo |h..osl or co.r{Etrqtion. d.mgc! u pmlijcd for rh
<br />sd nrn 1076 .f rtE Llb.r c.d., ifl.Err d ltffy s fs(*Po
<br />IICTJSAIION
<br />I tftby .rm udcr Frblly or Fr!r, Oc I d liur.d ui&r FDvirirn of Cn Ind 9 (onftmin3 *ith Sdrbn 7qD or Divirbn I
<br />or rh. Burims and Prcf*riont Cod., r,n hy ltcE n ir tull loc an .lf6t
<br />e+u r.icnkNunr.r:' lO5So34 t
<br />'tf@ra ro!$f,ltclll]u.LldDlNc.AgEdut
<br />I h.Eby !! lirm undc. FBlry oa F lory r[sr ih.E il , $niturbn bdinS .8.rt tu rlE ncrfornwc o, rlt work ln rnkh rhr Fd K
<br />h$cd (sa,.109?, civ c )
<br />atPLlcavl nrfl rt rroN
<br />I hd.by .n'm u.& Frhy or Frry oE of l,E folhwinr d..l,rrirn., f
<br />D.mhio. Pc,mar-Arbci6. t{dlfxdbn Faddrl R.8uldbnr (Tilh tO. Prn6)
<br />-Piqui,.n
<br />Lcttn oa ui'dfrdbn
<br />-l
<br />..nify rh.r llE ed EsrLrmr Elslirts ab.id lm,ql m d {t a.l* ro lhB Fain
<br />6r(tr,, rru t r.r. .l rh" +pld.n rn r{. rhd rE &E intdmli n i. otrld. I .rr b onply *n[ dl Cil, r'n Coutny
<br />i,rtrNt .,n Surc LB ELrlt ro b.lldiq clrdrErnl! r,n Er.by rulDria EFcsrrliB ot lhir Cily.!n Cou.l, lo dld lPon 0r
<br />ih,v. mnrrnd pft,tEly for
<br />ApDlnr orAxrntSixnrtu
<br />(ltris [1, t 't
<br />^",rlLL"
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />Roof Sheathino
<br />Framing
<br />lnsulation/Eneroy
<br />Drywall
<br />Ext./lnt. Lath
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Fleport
<br />Enqineer Final Report
<br />Flood Zone Certif
<br />I
<br />FINAL t2-qtu >e#o
<br />Certilicate of Occupancv I
<br />Notes, Remarks, Etc
<br />Rev.08.07-2015
<br />Shear Wall
<br />Brown Coal
<br />,*,**A-y' 4...--
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