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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE OWNEI BUILDEA DEIIf\NAfl ON
<br />I lrr.1, lllrm u .r FnJ, ()( rqur, rh,r I rh .eryi lmm rh. Conrsr,m' tr.^- Le ft, rlE roll)wn8 tun 1S..70-tl 5
<br />Busincsr dBl Pnrcrs$n ctrl.) Any City or Coxnr, qhrh r.qum! r Ffl' lo .o.{ru.r, .lld, i,IroE. &d'l!rh or qrn rny
<br />shcruc, rrx, k, ih rsuekc, dn) rcqnifts lh.,mlrrnr fo, ruchFim t! liL. r8*d sl.rcmnl lhrl lEor nE B hccnsd pu$rnr
<br />lo lhc FuvN$ni ol rlE Conrrrktr'r L.cn$d L.s (c]u, .r e. c{,ntrBn[ eilh Salbn ?UD ol DirEn,o I of rlr DusiE$ ud
<br />P,DLisp"r C,ri.) ir rh,r L d *lE B.rcqx ilstitD [t llr bdB , rlr rlk*.tt .r.ntrx,n. Any v*,l"lb. or Sdt'n ?o] I J by ..y
<br />.mlH tu. Ftul sbFl! llE :nol.. lo. uvrl FMllyormr B,. rhr. nvc hutrlBl Jo!,st (t5@)
<br />_1. .r owr orrlr ItUFdr, or hy.mplirre3 vrh ${.t d rtrtr $L @n{EMDn. vil Jo 'lr vrt dn {E rurE ! nx
<br />r.nol or .fl.ftd for $1. I Sr ru4{, B$m.s i.d PxrLskrs cdl.: Thc co.r.doi s Liccns lrq &Es not rnnly to .n o*ftr of
<br />rhc F,p.ny *lx) trii!.ls or trqFrts rtENn. rrl wh' tks ruh krd niB(lf or hcmlf or r}f,lth his or h.r own .q t'F.r,
<br />Itl'v!.lctl th.r ruh mFnwnlr c ni rt4lald.nitd tu d..ll r$M, rll ti! ]uu q utrnNmn is:'u eilo or Jta
<br />otdrrllk1rn. rlE O*ffi Bulll.r r t hrE Llr hr&n orF)vnB rh, lE d ilE 'lll d t itj d urFrE UE FqEry Iir lh. FrFE or
<br />_l d.rcnfl ,nlc, Sdrn_. B & P.C. n ltd @fun
<br />!9Af,EBri:sAuflltarl9!
<br />DECI.ATAIIOB
<br />I h.r.hy.lltrm undcr JEndlyolFrrlryonc oflhc nrk,wo8 d.rhntons:
<br />I h.E.il qill Minrs r Cdd...lc of CoMt l,' S.lf-Insur for $f,16' .u{ENrhn. ., Frvrioi for b,SatM l?mor E
<br />L.t . Cdi., rr{ rrE FfmE. or r,r t{rt ftr virh ltE Fni 6 irnEJ
<br />Ih.Er vnl mi.lln !ort.^ .lr'p.nsi'nn hsulm., 6 Eguu.d by Sdrhn J7m uf llE L.nn Ccrc, tor rlt Fl()lrrB! ot
<br />tlE *lrl ror whth lht Imr u asEl. My *0116 d,mF.r ron insur.kr nEr !n F li.y NnnEr e:
<br />S \r{c {vv'Jql{ztq3 llLolzl
<br />_lr.d'lyihrrrth.Fr,orl r.orrh.workftr*hrhrhtrlxrn r tr\kJ.l rhall R cm!!!y rtry Ftun r rny tunft,
<br />y' .\h)l8om ruhrd l,' rh. utrlda (onvEnsarDn lrwrdfcal,fomb, lBl dlrc. rhr rl I !buL] IBominhrrr n, rU
<br />*ork.h.oaFns'ri,,ntR,r'\r,trsolS.dn,nl7O0olrh.trhtrC*1..I{tr|I,,(nhwirhcoryl,qrrhrhrslrrv6rrs.
<br />WAnNING. tr.ilurc
<br />'o
<br />eur. rorkch' Lirtr{E6rl|,n cov.
<br />.N,l fft. ur t'.8 hunlEJ rh'urnd dollr, (llm.u)o)
<br />seron ]0?6 ol rlr t lq or!. ar.Er.,tj .ftrey I fer
<br />Ll subj.ll .n.q'bld t, siniMl F nir Md
<br />rr co,isEurin JE3.r ! It vrLJ tor rh.
<br />rlzlIzt
<br />I h.rcb,rtlun nl.r p.mlry o, ncrlry rhrr I rm l[ctrsl u,rlcr pfl,vNoh o, Chrflci 9 (onrnEfrlr8 w h S(lr)n l(X()) nf Drvisnr l
<br />ol rh.8u\ft$ rnl Pnf.srnr C,xL. rl hy lkcnr tr m luD ln( i cll(r
<br />,'**".n*' C- 31 r-MMNu'*.r 1 6q qct
<br />,l 2l zl
<br />I lEr.t'y .ifrh unJ.r lEuny of Frry rh.r rlEr n . 6rre1i,n
<br />Nkr (sa. J09r. civ. c.).
<br />D3 tf.B! nx rlE lEntxr]Br ot rhc *d n, wnrh UB Ft !
<br />AIILISANLDSCIJSAIIA!
<br />I hddry drm uBLr Fmty or F lrlry om ol rh. nnt'wh8 &.hdrhl
<br />Drml'rDn Pcrn sAsb. or &{ a.rx,n F&kEl R.B!Li &.r (Tll. ll(l. Pd6)
<br />R.quu.J Lcllcr olNolnt!1i,.
<br />l.d',y'h.' rlr Ltj6.! rqrLr,,N r8{,nn3 r$c*xrcm'v d .mlrd't h rhl\ pnrFl
<br />,$-*,ry,r'., r r,.'" ..,r ,r'o .pr',
<br />orJEL.i Irl Sr.rc bwrEli hi h,hr
<br />rh,vc mnromJ pmlEny fttr n\ra-'ru
<br />rro,mr,'. at:(llEr.I rra k'oq yv'lh.ll C'ly.Bi County
<br />h.Eb,rurhnrcrrprcrnrrn!.\,,1rhtrC yarJColnr,h.nr{uFnrlr
<br />AoDli.:nr rA!.nrSiqnrlue
<br />,.*..12
<br />"L
<br />N ot,< scr
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />SubllooriVenVlnsulation tt tr I .y
<br />Boof Sheathing ,5177|lt tb
<br />Shear Wall a
<br />Framinq
<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 />Ir
<br />FINAL (tEl/ht 'ffitl
<br />Certilicate ol Occupancy
<br />Notes, Remarks, Etc
<br />--)
<br />ID/SIG.COMMENTS
<br />_1.r\ u{r'n ih,ropdy. im.r.lur^!ly.onnrlrfl3 w h[.cnr,]to t,.n' n, .onntu(r rlr nn,J(r (Sd 7(rL,lluim$
<br />.urlthsvnC(xlcThcCi,nta(ntr'\l-'..n\.lls,nf,t'xrrplrbanown.roltrof.ywhnhtr'ldrorimtn'vcrrh.r.n,
<br />un'l wl$.dnrr!([lbr{(hpn)r(rs*haCtrird.l,'n9lf,cnscJpur{urnrrhcCi)nrra.rrrl-i.cn\cLs)
<br />,^,. . tfztlzt
<br />Pool Fence
<br />Flood Zone Certif .
<br />fffthln
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