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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNEI BUILDB DE.. AATION
<br />I bd.by t,rm u.dd po.Iy oaFiury fir I m .r.trpt tlm th. Codr..loE Licd& L.w for llE lolloviis ,s)fls6 7o1t.l-
<br />BuilB drl PhtsioD Cod.) Any Cily or Coln]y which r.luic r Fnir lo odru(|l, ild. orp.oE ddmli or q.ir 6y
<br />ruciE., Fbr ro n! ilsMcq lLo r.qti6 rh.4plt&l for 3xh Fnn ro 6L. li8n6d n.cEr rhr lE or {E b li!*d FlE er
<br />ro rh. ForlioB of UE Co r-tdi Lt.nr.d bw (ChryG 9, CoMils wnh S.ciirn 7000 ol Dilsi6n I of rlE B$ins Dd
<br />Pmftsiou CodG) or rll.l h. (.lE i! dat$r tncdod !d rh. tGL 60r rlE.lq.d 64Fion Ant vioLlion ofs*iion 70ll 5 b, d,
<br />.oell.ld for . Ddnh $!i6r! rh. .rDlEd ro r c'vrl p6drr of nor EoE rho lir. hufth.d dollB 115001
<br />ll, s ow of rlr FlFny, d dy orplo'6 *nh *!s6 s En sh @npdiirc wil rlo tlE *vl rd dE rt!6e i mt
<br />indd.d d olra.d 6. $t (s6 704,1. &dE ed PrD&..i,s Co<Lr TIE ( odr..loir Lic@ Lrv &€ nol iptl,lo e o*rd ol
<br />EFlFry who b!il&m irylE tlEB( 6d wlh dcruchw hituclf or hG*lf or thrlgi hi! ( hG om.rphlq
<br />providc<l ih.r luch iEFotqGi! & er indn d dofEld 6r nlc. l( to*!G. tlE hildi'B d itrFtffi ir $E *Ift oN )s
<br />of@trpidi& r,E olm EuiBE ErI lrE ,. hrrld oa ForlB d. lE d aE dd ,bl hlB s i,n.roE rh. prcrqty 6r [E p,Fs of
<br />lz l, 6 orG of lh. propsi'. 6 d(h!Nd' offios "nh lkoE d olnEtmlo @!!.nd dE Foixr (S< 7044. &!in6
<br />un ADbir Cod.r TIE Co! r-tor'r Li..e L.u, da ml *oly ro & o{e olproDdy who build! or improv6 lh6dn,
<br />md sno @drd. fd sh FljElt wnh s (b,ndo(, li.cB.d puRM to llE Cotir*ld r Liu& L!*}
<br />/*--.,, *r" t..,."** 36'/L ,/'a
<br />I hdn,,.- rlnnn u.dd Fnh, oi Fjury onc ol
<br />'h.
<br />foltuwing
<br />I h.r. nn *ill diln.in. Cdifi<.r. otCo.gr ro s.lf-lnsc ftr mrtd .onFunion. a Fovijcd tI by Scrbn.l?() of !h.
<br />l,bor Code fm th. Ffollre. o f $. wod fot vhi.h llc ,6nit ir isu.d
<br />I h!r. ..d * ill n.i.tri. Mrt6 mnFBtbn iBurm.. 6 r.qui,.d ht S.n iin 1700 oflhc Lrbor ( od., for rh. pcfomdcc ol
<br />rh. rdt f.r {hih thi Fnn i! iE d My rort6 omFE lhn iNumc. cmd &n,.l'cy.unbd t.:
<br />Poli., Nusb<:
<br />I cd!ry Oul ,i rh. pdfollrE. oloE *o& ad *hih rhn Fmn it isu.4 I Jdl ml 6phy ey F&n it D, nMnd
<br />n 3lo h6oE $trel tollEs*6 cohFrtsrion hw!of(.lilomi., odtsGthd ifl rhou[ b.(on $ti,.cllolh.
<br />*o*d'conil6gl6ntfrvn,oaofs.di6.:1700orilElltflc.dcIcrl.rdhwnhmrplyrnhlhEFnvith6
<br />WARNING: Fntu! b ts. $mt6' otrpdEri)n ota.sc ! 6l&tul ,d dul 3oqer e @IloF lo aiminll lEuhi! od
<br />.nrl fi.6 up ro ok huntol rho6.rd dollc {1100.000
<br />sdio.1076 of rh.ldor (oda inrrd ed dtom.y r fs?-, at
<br />I hd.by allirn !nd.r !6afty o t Fju,- lht I u bo ofch,fld 9 (onnncirs wnh Sdb. ?000) ofDilirkr.
<br />of rh< &anB &d PNfaioN Cole rn mr lttu ir in tull forcc rd rfi6l
<br />corl'rBrquotrttdDl!9lqE!.gr
<br />I hcrt, .ltm u'i.i pady ol Fj',r rhr rlE! i . od,udbn ladbr .sd, for lt. Ffoirje. ot (h. *o* 6r sdth lhn tanil it
<br />is.d (sd 1097, civ. c.)
<br />APILUAILDESAAAIIA!
<br />I h.!6,vrlrmlidd p.nrhy ofpdjury on of lh. aollowinS del dnrN:
<br />D.molitro. Psnnr-A.hcrG Nolinc ion r.&ral R.g(laioE ( rhL ,r0, Pd6)
<br />, R.qutcd ltirsof Mriftltbn
<br />I <aify rhn rhc arld.l rcsol,rioB ESdinB Gb.dG ..m\.1 -. nr, 4'Plr-.bk lo lha Flj.tr
<br />I cclrly rhd I h.r. rad rhir lpplic irtrlrrxin31.1l r rh.alr\
<br />'on
<br />ir .orre!. I r€ia to mmply wnh ![ Cn] ..d Cou rr.F*nin6 offtn Cny u'd Cou yro rduFtrtlrordmnc6 od Srorclj$r.hliry kr trildin!.o
<br />lr'czV,t-H-'F-t4t
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Roof Sheathing
<br />Shear Wall
<br />Framino
<br />lnsulation/Energy
<br />Drywall trl2L ll?DAttrta -+ Fi
<br />Ext./lnt. Lath 't,
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif.
<br />FINAL >w lz.zo .&,-qn
<br />Certificate of Occupancf
<br />Notes, Remarks, Etc.
<br />lboE mlbfti Fop.ny for
<br />,{Ipli..nl orAtol Si[nrturr
<br />Set Backs
<br />Subf loor/VenUl nsulation
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