|
BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE rD/srG.COMMENTS OWNER BUII,I'ER DEI,CARATION
<br />I ha.tv .I&'n unds F,hy of Frjury lhll I m .tdF fmm ih. Cnirdd- Lk.M ll* ftr r folhsi,E to5n lsa 7011 5
<br />Buin* 6nd Prof6ion Cod.): Any Cny or Couily $hi.h r.qut6 r Fril lo oldrud, .ha, ihFore d.mli$ or r(P.; s)
<br />rlrudue trior to nr isueq io r.q!t6 rh. @pli.er for 3uch Fnn ro fik r i,E..d ni.t!5n rht lE or llE i! lk(d.d F6gr
<br />ro rh. F.vb(r or lh. Conr.croir l,icd!.d L!f, (Ct,B6 9. conmtrinS snh Sdbn 7Om oa Dn iri.n ! of rlE BBi6 ird
<br />PNfsionr Cod.) or rhri h. or 3h. i! adB rhdtliom ad rh. t ii! for rlE llLscd crdFio. An, vbldionofs.dbr 70ll tby&)
<br />.r,rli.ant for 6 pmn $bj.d! lh. .pplicrnr lo r ci1 il pcn.h' .f mt mc 0E nr. huhdr.d <hlld ( lt@)
<br />l. a ow .a'h. FoFdr. d my dplolB r irh srs6 B rh.r $k omFEiion. riu & tlE rql rd llE rnd@ ir mt
<br />iiod.d orofl<.d fn xL (Sa 70,14. B{ir ad ftlfdi,B cod. Th. (h rd.arl-t.eL.wdd6nor@plyromo{c.a
<br />lh. FlFry *b blitl d ir$.lrs 'lEE( ftl *ho &E *h N.t hirulf or hoelf or tlmush hir or h6 osr mplor.6.
<br />FoliLd rhd $ch inFoEEi! G r{ inrdi.d dolIa.d nrr st l( lrudc. rlE hrilding or irymvnEtr i! $ld {ithin oE 16ofonpkbtr ,E (,*!6 Aoil& nill hsv. llE hrd.r ofFolins rhd ht or .h. dil Dr hrrld or EqFE dE FlFty 6r tlE pupo.. o,
<br />I. a o*n( ofrh. roFry.6 cr.hincly codrdi4 $nfi licdE n codrdGro srdtu.1rlr Fni.a1(S< ?ul,l, &6N
<br />and n!6nn (t(lc: t h. Conrdo.r l-i.d. l-.* &6 ht .t?ly to n or nn ol Fopdry l.h! b{ild! or inpro\ 6 lhFo..
<br />.nd $ho odd! for *h FoJ.dr *irh r cod6.1o(t) lilE d poeun to rh.Coilrrdoir LtG l.u)
<br />I m (mpl u.dd 1i6lion
<br />D.l. Orr.r t\ott(ffsi( olvPH\sA f i(ri
<br />DIS.AAAIIqT
<br />I h6.h) sfiirn trn&r poah) oaFjuD o( ofrh. follo\inr d(Llari.nr
<br />I h,r. id r ill tui'n.i, ! Cqrifrr. ol CoMl to S.ll-lNr. for { o 6a.omp.Mion, s F.\ id.n ao. h, sRrbn 17tx,ofrh.
<br />llhor Cd.. tor lh. Ffollrlff. o f lh. trolt lor $iid rhc Ffrn u i.rucd
<br />I h.v. dd s ill nainlsin u,ort6 conFBdiof, imur.n... s r.qut.n b Sdio. ! 700 .aih. l,bor (i)d . fo. llE Ff(ruG of
<br />rh. wort f.i which lhi! Fdn a Ls.d My rort6 omFMio. iMrdE.Mi.r ftl poli, numbd rc:
<br />lolicrNumb.r Frptr6 I
<br />I cdlit lhll in lh. pqfomncc of th. trork for uh(h rhi. Fmn n 6su.d.l3h,ll ton mphy.ny Fren in Dr f,e6
<br />e B to tE .m. shjd !o th. $0*6 comFfnn'r hN! of('lliaomi& od .*r rh ilI lhould tE(oft 3uli.( rollE
<br />u.rl6' conFdrlion pmvsioB of sdion 17(x) or rh. l,h,r ( o<L. I Jdl. Ionfi\ nt snl,l) tr ith ltngmvilioB
<br />WARNINC FNlua lo suE s!il6' ro,.rclsion o16+. is u.hstul. drl rhdl st!<! dnphF h aimind Frhi: Md
<br />cnil ,in6 up !o oe hun<h.d rhd@hd {tollG (lloo.o(x})- in .ddithn to th. cor oa 'ffi-"*'"""*Saron \076oarh.lrh{ ('od.. inr6d.nd dodb r lG !-,0_ )?Iffi@r
<br />I h@ht dlm uidd p.ilXy otFjury thi I h licq*d un<lG Ftrrth. of 6! a elom,tRins *'nh SElior 700{) ofDivtb. !
<br />of th. BciB dd PrefBioB Co<k ad my licru i! in tull aorc rn dt.tt.
<br />WL,,@au?\j.-,-"-f Vtv[vtf-5oldL
<br />CaIiIa.ITCIAIII:IDINGIGII(I
<br />I hd.b sllrn untn Frh'.fFrurrhd Ihd. Li ! co6lrudir L ina !xo( tu lh. praon.ancc or lhc Lvorl t)r \rhich lhlr rEnil 6ir$.Jrsr 1097 cN c r
<br />AITIICANLITS,ABAIIA!
<br />I ..Erq lllm u.d6 Fn.hyof pdjury on. of
<br />'h.lollosins
<br />ddlranoni:
<br />l}nohhn l.mirr-A:h6r$ Norirqrhn r_aldrl R.sul.l'ons (Tnl. r0. I'an6l
<br />R.qunal tiia of l,ldifi.liiin
<br />rl \di$ 'hd rh. Ld6.l rcguld i.B EBd'n3 ard,. rm\.1r. r{ q?lrrbk h rh6 F.rd
<br />14.d,6 rhd r lE,.Ed'h' ipd*r.i in q.r.,hd rh. !rn, c ,nromn'. ! c.trd r lxra ro c.mpry w har (-,rylid('ounry
<br />ordin6N6 .nd Sbr. I r*a r.k i,p ro Liildin! codtuct'o( d r.rr!v a!nFof lhn( (land(o'nr\lodrFtrF,nlh.
<br />.h\ r ]Mr n..d p.op.n ! fin NIEt$n
<br />arr,o, - a*.u 4,*-,*" F
<br />U*-r*^ rrnn^r, Vd\h
<br />-+l +\ ln
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />D all
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />uty Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />oloJlb/r- AIM:;T //-4-/,/" o;
<br />FINAL //- t/ -t <I,LL,,,re,",..s xD
<br />Certificate of Occu pancy
<br />Noteg ReTharks, fitc,I /1
<br />Subfloor/VenVlnsulation
<br />lns u lation/Eneroy
<br />/ul'
|