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BUILDING. INSPECTOR RECORD
<br />COMMENTSSITE.WORK DATE
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loorNenVlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framinq
<br />lnsulation/Energy
<br />IDfryalL',10v /-/7EpE Z/a/rown Coat
<br />/lnl.L,gffi (qxt
<br />{u0Ll
<br />Masonry ---..-<I fi't /1.b"',1a41{-a
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />F|NAL 2/3/2t20 t\/4 /0q
<br />Certifipate df dccupancy
<br />Note/ Refrarks,Elc. A
<br />OWN[R BUII,Df, R DEt,('ARATION
<br />I n6.b lftm unds Fut! of p6iu')-, lht I d .r.qi filn rr. CodrdoB l]ctr L,q fo, lh. aolhrins 1.d. (s< r0l I 5
<br />8lsitr( and Frol6ion ( odc)r An) ( ny or ( ou , trhich rcnutr6 a Frn to co61ru(, tlr6, iflpo\., dqnolGh or EInr o,
<br />Irucxtrr, F6r tr, irs isuMc.. rlro rcqut6 rhe applicur lor rucn p.mi h lilc r !i8n.d si.r.1Mr thn h. or slt ii ltmkd pufut-
<br />ro lh. Frrap6 of rli ( o.kkor s Lk.N.d tjr (( h.pl6 q. ( onmtrinr \irh s<lio. 7000 of Dnnirn I ot llE Bd'B !I
<br />PFfaronr Cod.).r rhd h. ot sh. i! dcmF lhs.liom dd rh. harB f.r lh..ll.8.n dftIrion Aoy v'ohltn or sd1$. 70 i L t^ mI
<br />spplic.nt for a p.nnil 3ubj(r! rh. .Dplicer ro . ci il !.mlty ol not rnorc lhtr nr. hunJr.d ddlla I l50o)
<br />,
<br />I. ii o"E olrh. Fotdt, or my oplo)d u irh ur36 6llEr $k.ontlMn'n. qill & rtl tr(t di ltE c rr'
<br />inrqrLd or ofi6d lor sl. ( s( 7u4. Busind ed Pr.fdioN ( odc 'llE (i,nlrrcr.i! Lic@ I r* &d nor appl, ld d ou n( .a
<br />rlE F!l6y *h' t!il& or trr{nr6 rlE6( ,rt tr tn &6 kh $$.1 iimrlf.r h<*ll or ihrouih tu3 M ho .m .nPl,rtc
<br />ro\ r&r, rhr! su(h imF.\€ldr G ml nonql or olEd tu qk ll b{aa. rlE tlilli'lg o, itrFo\qd u $ld wihm m ta
<br />olcoq,Lrt,n. rh. ()trnn Bxild.r will h6!t rfi. htrda ol Forin8 thd lE or si. dil ful tlild .. inp$. th. Fa,Fly ftr lhc psrr,e ol
<br />l. B os,n6 of rh. F.Fry. m Bclciv.ly.o r.clirs uilh l,cna.d .oir,.lots h mnfud rlE pr$F (s( 7Or4.8csd
<br />and Prokibn ( odc: Thc ( onldror'r Licd.l-.w dE mt arply lo & owrs ofpr.pcny *ho buil4r or imProvB ths@n,
<br />sd *tki odd3 ir sh EoFr rnh r Co..rxro(rl lto!.d FllrMr ro rh. (-odr*lr't l-aoE lr*)
<br />I Mr.\crnfl trnJ.rs..rk,n
<br />D.t. O'nd
<br />110R|(trRS. ( ()nl?El iS TtON
<br />Dlct 6xArt0!
<br />I ha.b lnim undd p6uh) or F,un ok . r rh. foltt$ nx d.rhdFN
<br />I h!\. rnd wiU @imri. a cdinc{.ol(-oNal to S.ll-lBur.lor \Frltd' .omFsion. c Folid.d for bySdlion 1700 oath.
<br />l,bor ( ode tM llr Ff(xlll,G of rh. *ort ld "nkt rh. pomir it i$.d
<br />I hav. and will n.intain \rort6 conp.Bation iNurrnc.. $ r.quncd hy sern)n r 700 oi rh. I nbor ( odc. for rh. p-fnrmM. of
<br />rh. $orl aor$hi.hthir Fmn I iqd Myu'ork6 comFBdbn i6ud...mir ad policy nlmhq a.
<br />l..nilylhrt in lh. Flood..oa$. worl for whi.h rhk Fmil i3 i$u.n. I shlll.or dll,,, ey P.Eon in tny dmna
<br />e B to lt.o@ rutid ro rh. wrl6 ohFlrhn laut 6f Cdifomi& t a*R rhi ill shuld t.otu!bii{ !orlE
<br />*n&6 omFdion F$ tioB of S.crinn 171X, of rlE ld@ Code I 3hll. fdh*nh otrpl! u nt thot t,.\i.ioE
<br />WARNINCT l&ilurc ro s@ sortd @npaldion co!6,g. i! unlaL_ful, dd thdl subid d mPnrF lo mdEl FEIi6 8,xj
<br />cnil [n6 up ro.n. hu6d'd $.us{ doll6 {ll xx)l. in dl'ro. ro rh. cor of.of,D.rullion. d&asd a p.6\id.d f.r tlE
<br />s.crirn r{176 0f rh. tltn code inrod &ld t
<br />I pquD rhrrl&n I'rds{ undd ln rBnn {q(otrnnc .'tr! tr rl, sNli.n 7(xr(Jrol l),\'sknr
<br />(itd.. id my lk6e u in tull
<br />((/ 20( t \3-
<br />I h6cby nmr und6p.n.liyoipdl ylial I
<br />isuaj(sa 10q7.(tr ( )
<br />hnding lsdcy lnrlh. lqfodincc ofrh. trlrt lLtr *hichlhB Frmil t
<br />ATT!ICANIDIiCT.AIAIIA!
<br />IH'yiltm! cr polhy daFllD om ofrh. follosins &(la.tio6:
<br />D6knihn PmB-Asbcnd Norifi.dr. F.&.l R.Xul,rioN ( 1nE J0. Prn6)
<br />R.qut.d 1..(6 of Nditudnn
<br />.l s. ml ippl6.bk lo rhs I'.ld
<br />'nforidi.. ir.dd l,Eclo.onFlr rnh t[ ( iyEd (-ounl!
<br />lby ruthomc kFddrng of lh! Ci y ,nd Counrt ro dE $.n dE
<br />t( / Zolg
<br />Flood Zone Certif.
<br />ID/SIG.
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