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BUILDING. INSPECTOR RECOBD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNFI BUILDET DEL(-ARAfi ON
<br />I lrrl, ronn uftLr FEty or F.ru.y rh, I m .r.n$ tbm r,r (..drrriF llN L:* tor llr rollowoS rc.$n 1S...?0.! l 5
<br />auslFr iJ Pnndt,n CuL): Ary C y .r C({nry }hrh Glum . IErn (, d'nind, .Xd, lnl|rE, lrcmLih or EFr ut
<br />neNE, Fr{ n' r 6s8.. .li} r.1rue! rlE 4't rer ,itr tuh Fmr ro fik r r{rrl {r.ftnr rh.t lI or nr ! lr.N.J pomd
<br />b rh. a6v(r)N or rh Conr&bis L.t,.rl l:w (ch.Fd 9. Conmhmr *rrh Sdron 70m or DrvrM I ol rh. BuliEs Dl
<br />PDl..rkrnr C,{.)orrh.t hcorrh. ic .r.q rh.Efmh .nd rhc $6rir ad r,r rlLl.d.r.mpl$n. Any vrLli,n or Ssr!. 70.} I 5byuy
<br />applicur lnr r ljcmrr nrbi.ch rhc dpl,lic.nr () r (vr I p.n y or.or frtr rtun rrvc hundGl doltB llt{$).
<br />l,.s o*Er ol rh. FDFny. or my cmtl,,tc! wnh w4.r 6 rhcr $L (mFn{r$n, wrl do lh. *tt rtl [E ntuim 6 n
<br />lnojli r{ o,lftd n{ slc i5d.7{x4, Bu!m$ uJ Pr.f6rn,N cdk: TrE (ljnt&roii LEnE L.r dt ni {d, ni o owr ot
<br />rtE Flllny eh' t{[rr M rymB lh.B4 .rn *b drs *t c-{t him(ll or h.kla or rhmuSh hn q lE. ow. .rI'l'yc!.
<br />tn vrLrl rhn ir'fi uqbmds e nr ddldl d ofia-l (* {L ll tDsq. r llrtlu[ tr irF Ecd ! $U *rtu G Fr
<br />oflwl,ldrnrltohrAn.ldwJlh.ErrEhhl.nolFUvnB dlEor{rdllr,lndl,rsrFt tF!Id,rd r F[Jrsor
<br />l, tr\owkrolrh( rn'P.dy, sn.rrluivflyrodrr!r0-! wnh lrcns{J( iJ!t,\hLsn(tulr th.!n'}-(rrs.1 rl}u,ll'^rtu\\
<br />rRl thlcs{,n(inl.: lh. (i)nrkntr \ l-r.n\.1.r*,nf,\ n.r ritlyn, !trdsncr dl Or p(nywh. hu'ldr rr trnln)rc\ rh.rcon.
<br />rnd who . ntrr\l'trnrrhrB)jc(r\rnhr(inir rtrrrh(cn$Jpur\trr n, ih. ( ('nkr&r\ Lrctr{ l,r*)
<br />I lmckn$ un,crsek,n lt &PC turrhnt:\,n
<br />tvaaatiEs:t0uf!$arlr!
<br />ITICIdSAIIA!
<br />I h.Ehy rlltrn un&r FMlryol t'c.Jury oF ol rh. trll,*h3 delnErlnr
<br />_I h.v. rnl *,ll tu,nhm r Ccnrftar. or (i)nEnr ri' s.ll.lnsurc l$ wrt. .on{xnrron..s prDvrLd nn hy Sdltr).l?OO.tth.
<br />Irtrr Ci c, nr rh. Frt{llfrM of lh. wolk ntr whf,h rh. pcmir s rsu.d
<br />l h,v. rd wnlnBrnru *ork.'a .o rtxtr\,rk,n 'nnrrn.... as rlrtutrc.l hy S.rrx'n r7(,(r ol rhc Lrhr C(ir, lnr rh. lFrl munc..l
<br />rlI *ork ntr rh.hrhs Fm r (suJ Nly *o .F'$nqxnerKl. 'n(urrtu.
<br />(d.. rlj F)lry truhh.r r.
<br />I rcn'lyrhli orE! ltrr.rmtuc,,1rh. $.rk |,tr whrhrhrF.s,r tr F$.J.I \h:ll tun .hl*'y lny !.r'n r rny nsnmr
<br />e, 6bt^Lonx s'nF_rh rhc *orkrr( $n!^-h\rr('n l.wrof Crl,Lmh,.nl rSrc rhrlll I shrultl h.roft {rhj.crt)rlr
<br />wolkc6 (.r.Ii nlrr tr)n pNlro ofS.dtr)n r7(Xltrr rh. uh*C(r1..I \h!ll, ndhw h conpl, *irh rlx$ Pn'vtri)ni
<br />WARNIN(; Ir'lu( !, €ur. workcr( !.nl'.n\rlrr $vcnfc r unla*lul. rrxl shrll tuhj.tr .n cnlPL'ycr ft, !tm&l p(uti\ rnd
<br />(N,l lln.\ xt r' m hutulrcd lhoulml ioll$ (lllxr.ixx,r. rn !JJ(n,n n, rh. .rd ,'r rnnltnr.fur, innu3.. .s prrd.d tur rh.
<br />SclrDn rl!76 ut rtE lrhr C.d., ht.({ u! rr.my ! 1..(
<br />UclE$D.CqNIEAlnl8
<br />DECIJSAIIO!
<br />I h.eby aflnn uEkr FMly oI tErJury th! l .m lNntn lBl.r povsDn dl ( h. q9lollftEn8 snh S(irn rml) of DNrDn:l
<br />ol rh. Iruren mJ Pnrasenr Cdl.. anl ny lrc.nr ! r fuu foN. 8n .lG.l
<br />SI!IIA.L!:UO!LLEdDAiG.AIj.EE(}
<br />I lEtshy.lltm urkr FDhy ol Frrnr, ih, rldc !. onntuLiu knl6! r8.tuy fttr rlE Frf,m. o, rtx k)rt ft, whrh rhts Fmr !
<br />APPT IC'ANT DECLATAi|ON
<br />I lEtrry rltim uutr ltn, o, Frrury oE.t rlE loulwn! &tL..rbnrl
<br />D.mlrhn P.rnrl^3lEdor f*r'tud$n FGL,.l R.lolzr.nr tTdk,r0. Pd6,
<br />R.qutr.J l.trcrol t*r 'rarr)n
<br />l.cnlly rhrr rlt I.J.rrl R3rlalonlRfd'i8 r\tr{or r.n)vdlI. nor.pllubk b ihr prFt
<br />l.cnnyrhdItuwrc.dihrrnpli.ark,nIrlnrr.rharrtFxh,!einlnmrtrn^udEcLl.I!38locomrlywirh3u(,lndcolnly
<br />onlminc.{ MI S'.r. ll*rEhrinst' hu'Uu!(n(rudrnl ml h.rh!luh,,. r.ll({n' Bolrhl\Cdyuxl(i'uiryk'.n'c.utDnrlr
<br />('""*'
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUlnsulation
<br />Rool Sheathino
<br />Shear Wall
<br />Framinq
<br />lnsu lation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lvlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certil
<br />FINAL Zlhtlt,t'1,'4nirrd,e)
<br />Certif icate ot Occupancy UI
<br />Notes, Remarks, Etc
<br />D.r.r-
<br />uu! (sa .t{rr, crv c.).
<br />lrdt r'r N.m
<br />t,t/rz/tq
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