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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS
<br />Forms/Steel/Holdowns
<br />Set Backs
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subfloor/VenUlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />-4fr'\
<br />FINAL t l4l?,o 'fiad,,E)/
<br />Certificate of Occupancy UL
<br />Notes, Remarks, Elc.
<br />OWNER AUIII'ER DEL'AIAflON ,
<br />I lEr.b, rrm u.& Fdr,of Frury $, I mddF frln UE C.trro tiqe tre fot th. folbwi,S rdn (Sa7011.r/
<br />Busin* .od Prol6lFn Cod.)r Any Cny or Cor y which ..quiB . Fhn ro conlocl. rlrq, ieprovc donohh or rorn ro-,
<br />r^<rc. Fs ro is i!.lG.. .!o ,!quc rh. sfpla&r foi dh Fnt lo 6L . .isn d trtur thr lr or dr ! li.d!.d F,&t
<br />ro th. FlvirbE of rr. Conrsroi! Lk.ni.d t r (Ctlpr6 9, Cotudrs *nh Sdion 7000 ot Divnbn 1 of 0r SUuB rt
<br />Pbf6on! cod.) or rhd h. or rb. t qdF $at'om od lh. b66 for tlE rllq.d dmBFn any vioLrion ol Salio! 701 I J b, o,
<br />.rrlkur aor ! Fnn sbraL rh. .r'9liur ro r ciyil Frt,. of mt tuc ln& nvc hund,.d dollrt (tim)
<br />l. s osE orlh. FtrF!,. n ny crplo)@ wilfi rqd ! rlE nk@nFErior * drtlE6trndEildGi!d
<br />in6id.d orolIdld fo, nL (s<.?044. BsilB od ftDf6sBCo&r Tn Co,r.(oi li.o& trv&6 nor +rrlrro e6rd ol
<br />rt FoFty *,rn hil6 d npro!6 'lEal\ En *tn &d,En srl him.lf or h*lf or lhFrst hi! d hd 06 6qhlE.
<br />Fsribl rtd $ch inFoEEr, e mt na.Ld dotud for rl. l[ how. tlE brilda d inF.o@r u $ld wuii oE tc
<br />of mnpEion. rlE ol,ia Buil,a will hlw llt hrln ofFlvio8 rhi h. ot rhc dil @l hiH or itpo€ $. r@Fy 6r tlE ptrlo* of
<br />l. s o{E ol rh. Fspory, d ciclaircly o,tr..rss $llh li.aual otud6
<br />'o
<br />odnd llt D.Dj.rl (Sa r0.l,l, &!i!B
<br />!i PrDkim CorLr Th. ('onrrdoir Li.@ L.w &6 rct .pely ro e o*c o I propdry *ho blildr or imDrcvd lhdo..
<br />lnn who onrE.|r lor luct Fo.rdr! p l. Co'irrr.ro(, lrm.d FrBd io fi.Codtun s UcN t B).
<br />I uc\utr,pt utrdo S.arn'n .8 & l'C ldrhG r@n
<br />worxEns co Pr\s TIoN
<br />DICIISAIIO!
<br />I rd.n, imrm !.da p6rxy of ,EJ!ry on. of
<br />'h.
<br />rolbpins &(lDlioN.
<br />I h.v. drt *rll m.inrlin ! Cdrificltc of ColEar ro Sclf-lEuE for wrk6 cooFelio.. 6 FDsdGd for hy S*lion 1700 oflh.
<br />Lb(, ( ode fd rh. FfM. of rh. vmt for stkh rlE pqhr ! scd
<br />{O4 n^. -o *r, *.,* *.116 conpcEdnr ,tu Ea ! Equd b, s<rtf, r?m orrh. L.nor cod.. tor rhc pdoffi or
<br />rh. wl lor wh{h th! F !n ! s,.d M} worl6 codFEdb. iM. ffi dld rolry Nmba R
<br />l* Uny:rqql hg."csE Ttfrvra^cet J.,r.^
<br />\*..*".o, e+zBgZZ L\pc
<br />-. I cdrrirha r lh. Ffolll@. of th. eorr lor u[i.h rh6 pcmn is is!.d-1]nrl ml dpby Dy Fsn r Dr 6ffi
<br />$ s ro t<oE $bin to tlE *o.t6'comFqDr LE of (.litom( ..d *c rhi it I sl$uld b<om $ti6l lo llt
<br />s.*d compor.!rcnpmrE6NolSdDn:l?00olrh.I.b Coda t rldl, fonl$rhomfl' wirh rlEx pE! irioc
<br />wARi\lNG rdle ro G@ wtd snpqd.n ov6.8. b unLstuL rd rh.ll etixl e .rnpbt€ lo cininn Frrb t d
<br />itr'l l'rnd up nr oe hunjr.d rhouerld ddlld rtl00.0o0). in.ddnion lo th. cor ol coftFelion, d&ugs B pFvidcd lo. th.
<br />K $
<br />DECTaSAIIO!
<br />I h@b, rllm u!'.lq p6riy of FliJrylhr I u lic6!.d undd Fovnion oac|l.!i 9 (offirs *'nh Sdnn 70OO) of Di$b.l
<br />oa llr BciB 6d Pmftrlios Co& d hy li.@ L in tull foF. !d.8i.l
<br />/,,,*,,,"" -- 4'\* tzlr</rc conrr.c(or. C "J?, G'*r'"j'"G.
<br />cox$f,llcr0!-LEllltqlc[Ng
<br />I hd6, crm undE Frx, olpdjury $n rha. it ! onxtudb. lad,lg r8@y aor tlE FfollEcc of $. wrl tu rith lhi! Fni b
<br />i!!u.d (S< 10e7. Cir. c.)
<br />APPI ICANT DTCLAIT,ATION
<br />I hcd, ,IIm u.da Fuhy or FJUD rm of ilE follo*i.! &(ldd o."i
<br />D.ruh.n i@ir.-A5b..d Norni.dirn l.dc.t R.tuLlbE lTilk 40. Pd6)
<br />_ i.quir.d ljrrc ott{dftrs
<br />- I csrrfl lnn th. HGd r.8dn6B Egldin8 6b6or .ft1.l !c n qrlt bLlolh6 p.q6r.
<br />tfi cd,ry $, I hlvc @d rhl!.Flklrioh ad r rh.r rlE ibov. intoruto. i!.016r. I r*G ro @nply Rnh llr cny &d cou y
<br />.rdina6 .nd Srr. l,*! Elrra ro trildin3 coldrud'o uhori4 r.?.qdti!6 oathit Cny dd Couly 10 orid ur.. dr
<br />abcr. Mrioo.d pEpqly for iNpeiion
<br />r\oy^l€
<br />,"" ,/Zy'alQ
<br />Pool Fence
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