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BUILDING. INSPECTOH RECORD
<br />SITE.WORK ID/SIG.COMMENTS Olt'IiEN EUILDB DELCANANON
<br />I rErchy.ffrm !idc. FnaI, or Friuly th.l I h.tutr{, from rlE Co doR Li.ttrr trw ror rtE fouo,i.g E.9(se.r01l.Jt
<br />Busin.s od Pmfcsion Cod.): Any City or Colnry *hich r.qunB . tEmt ro @n.lrucr. rh6. irprcvr, d.mlirh or Fp.n my
<br />shcrN. |iir h il! kruer, rl{ rcquiEs lh. rrpltri aor such Foir ro fiL a sign n nftmnl Ih! lt or nE i! lk Ed pas.,rt
<br />lo llE FWnbN of rlE Conturq 3 LhB.n Ua (Chlprd 9. Conmrhs ,nn Ssrior 70O of Divitbr I or rlE BuriE$ $d
<br />PEf.rtion! Cod.) u tlIt lE d nE b.rnP| lhdtun lrr dE b..ir ror
<br />'h.
<br />dr.B.d .ra!+dD &, vbLt.n oaseti{ 70ll.5by..y
<br />lpplt. ror.FBnsbFrrrE lmlic.nr rorcitilFrlryoamr mEfi& 6E hudEd dolLrs (15&).
<br />-1.
<br />us owmr of llE l,oFny. or my .ngloFr wirh *ls.s ar rh.n $b orqEtrsihn, *ill &, rh. *od ltn lli dulE i.\ mt
<br />in..d.J ur or.rcd fo, elc (56.704,4. Busix$ und Pnr'c$ions Cklc Th. Co.kr.ro. r Lic.ns trw dNs nor .pdy ro r owftr of
<br />Lhc phFn, wtrt lds or nr{n)B Um( lri wh' drE sh h* hinscll ur ltr*lf or rhmu8h nk d h.r o$n cnq,h}E!,
<br />prcviLd
<br />'h.r
<br />ruh ihrmwtu e mr iidi,.d dofiqsl fd st t( lr)trlB, tlr hriuns.r itrIrMrd n $lli prni. c )sr
<br />o, oItr,Llia rlE OrEr Buills vill llE ill hri,.i of Fovru rld ,r d {E d'd ,El hi! c irFtrE tlE !&Fty ftf, t E Frlr ol
<br />_1, !sowrurofrhc p6p.dr. !ncr.lu'ircl, conrNrins Birh li.cncd ro.rocbrto c'nrru.r rtr Dror.r (Scc. ?(X4. au.u.s
<br />sJld lh,li{rirn Codc: Thc Conlroctols Liccnsc Lrw drEr rcr lptly h !nown r orrn,l.ny wh. builds or imttuv.r th.reon,ed who ( ktsrM ruh pn'Frs wiih r G'nrmtons) lic.nrd Fununl ro llE Conrr&1olt Ltcns t *)
<br />I m.rcnl0r udLr Sdr.n
<br />D.r.: O,Er
<br />wort(Ftrs' (i)MErN.(afl (lN
<br />DECI.AM.III]!
<br />I h.r.by.mfln u.d.r FnlhyorFjuryom orrk n'ln,*ins dabrrrioni
<br />-l
<br />hrE rn willoinllh. Carif.rr. of CoEnr ro Sdr-lM ld wt6 otrp.dbtr s Flvid rn by SErir.1700 otrt
<br />Ilbd c.d., fd 0E Ffoffi olrll 6i tn qhah rh Fnn ir i,stl
<br />_l huv. !'rl w'll mrinrri. sorlc( cutrllxns i,'ni.\uruNe.!src,tutr,lbysetionll7o0 frh. tibot Codc,li,r rh. JErfonMN. or
<br />thc work lar *hi.hths pcnnn r\ isrkd. Myworkcn on{Ensrn,n i"\urrNc.ricr ul poli.y numbcr uc
<br />I..niry lhrl in rhe p.rformrcotrlE ao r$ which this lErnn n ntrd,I sh.l! mr .mtloy .ny IEr$n in rny lDM
<br />s tr lo t oE subF b llE mrt6 6,rp.r!!rio, hws ofc.lilomil. !d ryE rh"r if I rhould tE@tu iubF{' ro tlE
<br />&rld{ on{Enrlbn pDvilioG olsdion l?m.r E tlb6r Cdlc.I rtlll. tqlhsnh oiloly $lh rh,.pftlnl,B
<br />WARNINC: F.iluE
<br />'o
<br />s@ Erl6 orFrEllir @al!. ir urLwtul. dn shll abirr & dtploF ro qinir.l FEli.! &d
<br />civil limt up
<br />'o
<br />.E h!trdrcd rlbugd dollrE (ll@.@o)- in rddli,n to rlE cor or co.r{En{ior &dS.t B FoviLd fc rll
<br />Sdbn 1016 of rlE lrbi C.n . idci !n xhEy\ a6
<br />D.l.: .._Appuor: _r(.rNs-ED(.rrNTa,(.rtrn
<br />DECIIIAIION
<br />I lmh, rrnm !ftr.r Fndry ol Frrr, rhd I u liurcd un&r Flvirhn ol ClEfld 9 (orumiIg wnn Salion ?flD of Diviri,. .l
<br />or ttE BuriB3 rrd P&fcl]bN Co<lc- ud my li.trE n in 6iI roN !n dlet.
<br />I$!TB!CtrOdIEDI!GIGE!!1
<br />I h.rby .liirm ud.r FDlty of tErr} rhd rlEE is r onsMi,n bfrlin8 ng.Ry fo. rh. FrorllEm of ilE wL ror rhth rhli F nn ir
<br />issucd (S.!.:llr?, Civ. C.)
<br />AIIIICANI.OEI;I.AAAIIO!
<br />I H,y lfm und.r Fnrh y.r Frrury om orrh. rrnb*iis d.rldarion{:
<br />D.mtni,i tlrnirs Astrsros Notificarion Rdcrul Rc8ll.tions (Tirlc ({). P.n6)
<br />-Rcqur.n
<br />tltrdor Mairrdrir
<br />_l .difr rhd rlE fdi.d Erlllb.s E8ntinr stErtor Emrll e mr lpplt.bL tu rti. FlAl
<br />-,lLcniryrhd I h3vc rcud rhn rlfhdion 0 (!'crh!' ih..bovc inrurmri,,n is.orc.r lrr.reio.omtlrw htrllCity,odCoun'y
<br />ordiMrc$ ond Shrc Laws ElrinS ro buildin8 con{d.rion. drl h.r.by {rhri,. rrrcsnr"rivcs orrht Ci'y lnd Count, lo cnr.r uFn rlE
<br />8tFrc nEnri,E l tmtEn, ror inrFrti,n pu4,oes
<br />,rpptcsl o. ,\p.nl SkuloF
<br />P€mile .em. I prinl )l
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />Subf loor/VenVlnsulation ill
<br />Roof Sheathinq v#t/^/Dkrill '^ffi [
<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 />Enqineer Final Report
<br />Flood Zone Certif .
<br />/1lt.J,l ,z
<br />FINAL 't/u/t MUtn WY
<br />Certificate of Occupanc Iv
<br />Notes, Bemarks, Etc.
<br />DATE
<br />UFER Ground
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