|
!
<br />BUILOING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS owN&t aulll,t)a rru&{lurroN
<br />I tftty afm unL. Frlry of Frary rl! I D .Enpl lDn tlE Gddl6 lirB l.v fn rlr tullovins ,wn lS{ TOll J'
<br />Ausrn.$ .d Pr.fc$irn Cnd.): Any Cny or C,rny uhri Eq!rcs . Fhi t. snq .r. rd, imimt. .kmlirh, r+.k m, 7
<br />!.ntu. F!, ro nt (w.rlr.EquE!drt'?lirdrnr(hFdroftLrs{Md md lhi lEd tE i! lf,inrti plr'd
<br />ro rh.omvi.io.r orrb C.tu*rni l,ic.n.cd I* (chip{.r 9. c.mmNin! wnh s6rrn ?om 6f l)ivhi.n I ol rlE BuiE$ Dd
<br />ProLsDs Cftl.) (th.t L 6 rlr !.Ef,tx ttE.liom.!d tlI b.alfor Enb.d.e Frtr An, bLrboof lhs?01I Jh,oy
<br />(pl'liclntlorrr.mnsu$FcnDEsllliqnrto0crvilnMhy.rnormcrhdnliy.hunlr.ddoll-r(l5U)).
<br />_r, ri .*kr.lrlE t'trFdy, or my.f,plor.s s(l q!g.sr rh.t vik omp.ndi.n, {illd. rlt s,t.d $. {Mc n n,
<br />ddrlal n.r.nJ ld qL (Sd 7O+4, But]Gr .nJ ftDrdr@ Crl.: TIE Codrrrd! ti.n* tr* dE! d lpely ro s owr ol
<br />rh. I,{ky wtD h{rd! or ilIn,B ilEmo !d who &E *n x, hiN.lf or lEr*lf or ihtuuah hn or h.r oen.mrhF .
<br />provid.d th.' tuch ulr.nEmds E r, ir.d.dnoll.Ed rm r.b li ho*€.Ilt llild4 ( lrp.ocd'I ir sE rh{ m Faol(d{,lai\ llE ()*Gr auib vill luE E hn!.n o,lrovl|I3 rhd lE or slE dirt d hoitl or inFr Jr FoFty ror rlE o!rF,. iI
<br />_1. 8 ovEr oritt FDpcty, 6 GrcLrivcly co'rds3 *irh lic.nql .odrkB ro (dru.r rlE p.lFt (Sa ,O44. 8lrirs
<br />!n hrC:r,Ci'd. Tn Co croi! Lh.ns. t *rkEdrrtlrro offi ofproFnywtb borHror rn{mE tlEd'r
<br />rnd *t5 codrdr td lch FoF.6 *nh r codftro($ lt.tr!.d cusd b rtE crtue.ar t.ite krl
<br />Itr,.r.m u .r Sfriirn .B rtPC in, ths r.rr)n
<br />gOAf,UE:g,D4l1ETAIq!
<br />DICIA8AtrO!
<br />I ik.hy .flirn uid., ltrhv or n riufl oE ol rll 6ll rinl rL.Ld $N
<br />_l h.E !n *rll ninr.h. Cdifrn. olcmd b S.r-lle lf qqr6 .!nFdio4 ! FDv*n for bysdn l7mofilr
<br />litu Cod.. lo. rll 16r.n1l8. oI rlr sli tor *hin
<br />'
<br />lE Foir ir iskd
<br />,lh.v..iduillmlinrarn*o.R.onp.N0rionine.!nc.,,!F{uir.ihyS.urpn:l?molitEL.horO}d.,torrh.pdfllmB.of
<br />.lE krt fu lhkh rhn Fhi tr iqEl My $cl6a orp.ME. Bur: qir rn lllry B,r'lE !.,
<br />(ffi
<br />Poli.yNumrE:JrtiB
<br />_l cdi y rh, i. ilr p.rfom@ ol it vorl tq *hicl' iti! Fnir ir i! .d,I rhnl d.i9r,, r.y p.retr i, e, 'ME$ a io b.r.ft:ultj.s r. rh. qrta 6np.Mk'n Lwr of Ctlifon( !n.r@ rhd rr I druld b.@E $bFd to rlE
<br />sdiaj uomFdri[ p6rnioB ol s4riri ]?(l0 of irE bhr Gr.. LEII. fdhpirh oiply wnh.hos prcvBbE.
<br />WARMNG FniiE to ru 6t 6 @tr+cB.lnr @E rr. i! uLvtul. !d nll {6j.t D .!?loF h si,Er F.Ia &d
<br />cpil l'r*r u! b oE hundrd rhourld d.llB (llll).ttD). m .d!nio. h lh. co. of conp.utidn. dlnl!.r & pbvn.d for ill
<br />Sdri'n :1076 of rtr t-.6d Cdlc i d !d rlfty r ,6.
<br />LICEIS@SIINISACIUT
<br />DECIAEAItrX!
<br />I h.aby rm.nlndcr D..rhy.fp..jury lhd I m ltctrBd und.r pmvEirnol Ct{rs 9l6mtueii8 *nh S.dhn ?0fir) ol l)ivhhn l
<br />ol rh. ANuEr !r, PDtdrra CuL. !,n hy li.e i! 6 tull lm! rrl.fiR1
<br />co!fllllcrroNrtdlMrol:llcr
<br />t lEEhy nfm udlq FMly ol Fify rllr rt-" ; r omrn toains +*, tc rtr paromre of rlE xrt lor rni.h rhE p.!h, !
<br />irrkd lse 1u97, civ. c ).
<br /> PPLICAIVf DIiCLARATION
<br />I ha*t!trmuBr.r Fulv oaF.jur, oE oalh lolSro! &r,.hria,
<br />Drtu,lir ion P.mik-Asb. os Norificrrioi r_.d.tuI R.xul ionr(T 1..10, Pfi6)
<br />-R.quic!
<br />t t.r of !*ri6orih
<br />I rdrry rh&(ll f.d.6l r.g!l!r Ddr c8!rd,n3 litrrD. Enr,vil sE hi rfl f,dbL t, rhn tBFr
<br />_l.d'ry rhd I tuE Md rhir lpplirrionui {rr. rh.r rlE sbE infomrion n !rGr.I r8ft ro (snply *i(hdl Ciry.nl Counr,
<br />dnuls.i tri Srr. lrer EllrB io hrilirt .@ru!rb( rnl lEEhy ruhni. EFrddiB of ihii ciry rnd Cdunty ro .ni6 uF'n rtr
<br />ehnc Enhrn lln,Fny ftn Br.di,n p6Fs
<br />Applor or Atar Skul!F:- llir
<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 />lnsulation/Eneroy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Cerlif .
<br />FINAL
<br />Certilicate of Occupancy
<br />Notes, Remarks, Etc.
<br />l)tr._
<br />lrgr._ c"nr,c!ar._
<br />I
|