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BUILDING- INSPECTOR RECOBD
<br />SITE.WORK DATE ID/SIG.- cotltal/tENTs OWNER BT'ILDAN DELC I TION
<br />I tmlry .ifnn un&r F ,x, ol F.rr., thn I d .r.ftV nqn rrE Crn$rr6 Lirc t s lor rlE rolblh8 las. (sd.tull 5
<br />BGiE$ r,n Pmfcri,n Cod.): Any Cily or Coury ehih EquiB. Fnn l. coi(nEt .Ia. irylt, &mli. d EFir 6,
<br />nM@ Fir 'o "r isum. .L. E{uiB th. .pplElln ror trh FnDi io lik r ragmd il..Mt rd lt or ilE i! larrsd Fm[i
<br />b llr !.DvtbN of tlr ConEld. ti.aEd Lw (Cl'{rd 9. C.nmrina wrh Salirn 7(U) ol Diyirbtr I of llE BuiEs .,!d
<br />Prcfcsbn! Cod.)or nrl1.d E n.rcn!'t rlE romnd rh.ldi! for rlE dlc8.d.&trliio Aryvt.lbrofsdb.70.r!.5byuy
<br />.p, t.,r for . Fnn otirl! lL rppliol b ..ivil rE lyof 'd mE$r fiw nu'nEd dollrt (lr&).
<br />_l .t oft,6f rlE FoFnr. ( mr.q,loF! *irh hs6 ! rlin s! @nF6rbn. riu d, th sdt !n dE -rdE a d
<br />inldxLd or oficftd for d. (Sa.7Oa4. Bu.ifts! lnd Pmfc$ioB Co&: Tlt Cont do, s Lien* trw &E mr r,ltly lo u owrcr ol '
<br />rt FrrEry rl, tlilt n itrlt6 rlEq rn uno dE qn *rt tielf d lEElr d tllold hi. d lE oh .r4byR!
<br />pn,vil.d lhrl $ch imFrmnls G tr ir drlcd olYdd for 5L lf, howE, llE trilin3 m inrmltfrnt ii Fld wthii * Jat
<br />of sr!&iin tlE orE E nga will trE llt hf{dr ol Fovlt ilr lE d rcE dil d tol! d ilp.m dE FlFry 6r llt F,FE of
<br />_1. a uwmr of rh. IhFnr, rn crctusiv.l, conk'd in8 wirh lic..rd r.nktut,^ ro .uNrud r h. pnrFr (S* 7lli4. Bustr$
<br />!n a\rasiin An Tt Cont-'oa! Li..nc li*&6 mr.mlyro.noeftrotprcFdy*lb bu dr or inlprori ih.rbn.
<br />rtrd who (.nrru.c for ach Eoj.a'rs f,irh a $nrtr(is) lE.ql pursmrro rlE (bnlmcroi\ l,ieo\c ti*)
<br />_l rfl crcnpr und( Sdri.i_, B & PC tor rhn ftrsn
<br />D.t. Om..
<br />worl(rRs ((iMPE\isiTrar\i
<br />IICIJEAIIQN
<br />I rEEby.firm un&r Fn lryofF.ruryoE or E lo&,s!B rr.cl,,.lrns
<br />I lIE !n eiI Ein.iD. Cdiifr.rc of CoEnr b S.r-lBE lr wrtsr'oqErEri8. a FDvij.d fd b, Sdrion lru) of tlE
<br />Lrbn C.dc. ro. tlE pdfollre! orilE mrt rd rrlih rll Fnir ii irs!.d.
<br />Ngt*., *u *,".. *rt 6 omrEN.rnr iElrrc. as ,!t!ir.d by selbn r7@ or rrE Lbor
<br />rh. f,,rl nr *h;l' rhh n(rnir tr nun ilr *fltc^ .o'r[
<br />.-.,
<br />^ffieWArlzs4'V1
<br />crir rn F,lit Nmh..
<br />Cnl.. fo' rh. Jtf{'furc of
<br />ltlzon,,*,*:,*.5DquU2D5 ,--,,..\t
<br />$9 -nO,t, t,*,.,.rmr. oIrh. sort ru,hrhihk p.rst ir $u.ri. I lhnll mr.np!'y uy Finx in ry truE
<br />v' r h lEom qhF! ro r,r *trt6'mnp.nuhn h*s olcrlilohn. rd r8G dtl if I rtnuld tE<om n$l6l lo rlEq)rl6l onFdqri.rn ,rovtioB or S€rirn .1700 or r! L,lrr Cct, I trl. nrih$th 6n!r, uirh rls* ptuvnb.s
<br />WARNING ts!,luE ro Em "rt 6 d,Fn kr. .$m8. ii unlrwtuL .d shdl subr.d & onploF l. mi lIEEiB In
<br />ciil fiEs ut lo oE hu.dFn lhour.,n (hlor (!lm.C[)r..onpcn{liotr d$r8!s n EoviH for lrE
<br />DFClltlafilN
<br />I tmby .ffm un kr FMlry of FUury rhd I m liuid ud.r Foviihn of ClEpls 9 (oltmNin8 rnh Saliotr ?0@J of Ditnion l
<br />of rlE Burifts .rd PrrdioB Co<,., !n ny lt.tre n io tuU foN .rn c,I(r.
<br />C\D Sb
<br />,r"," \-! \
<br />-Li.!tr€
<br />Nutr*Erb\)lZ0 .*"*". v\\/t
<br />(l,lirrBl:slllnilAillliliJtGlrY;r
<br />I h. rc$y rflirr unLr Fnrhyol tf,lury rhJ rhrr i\ !con(ru.ri,n Lndi"! ugcty nn rh. p.rion,lm. ol rh. worl hi *h{hrhi( Fnn[ (
<br />trucd rs( .r(D7. (ir c )
<br />AI?I.ICAIfDIIIJAAI1O!
<br />I hdtt y drn' ui{t r F"aX, of Fhry om of tlE {ollo*in8 deLrdrioni
<br />D.mlnion P..hir-AslErra t{rrifxlion [.dd.l Reuhrbnr (TnE lo. Prn6r
<br />-R.auird
<br />Ldtcr of lttifrrin
<br />-l
<br />(.nirylhd lh. tu nl EtlLriI. rlg.dir8.rtE d lmv.Je d qli*l.
<br />'o 'hn FlF.
<br />tl?"-,r, * , .- * * rp?li.rti. rn rG lhi rlE .trE hiotum k dnd. I r8r r, o'pry wnh dl cly rn cou y
<br />n.dimnE{ oM Slolc liws Ehling lo trilc '.f..\.Nd[r ot rhn (
<br />'rrnklCounryt).trik ft.rimd p^'tEly rn
<br />Appuol (r /r!al skur{E
<br />\
<br />.,. \L\"0 l?s"
<br />Set Backs
<br />Formsi Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Sublloor/VenVlnsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext.i lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Beport
<br />Flgod Z-one Certif .^,^ ^ /.tl/-Erdar6,5 //*//d/L UWtzt ,?d'r'
<br />7/4PQo lll'2t41 VtrT
<br />Certif icate ol Occupancy
<br />Notes, Remarks, Etc.
<br />Rev 0B-07-2015
<br />FINAL
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