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. BUIiDING. INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS r)\\ \t R lI t)t H t,l tr \x\tx)\
<br />I h6.by .ifm un& Frlry of pgjury Ihi I m .x.fr/ 6Dm rh. Co'nucroB l*ce lrw {o.lh. followi.g .al. (Scmll.,
<br />Bs'n6 sn Prcfd'on Codc). Aly Cny or Cou.ry *h.n r.quiE t Frd ro odtud. &a. ntProrq {beln d rqn &y
<br />.r.!.iu. Fs lo irt n le...&o E{ri6rlE Sli.sr for sh Fnn lo 6L. ri8lcd {iaml lhalEorJEitlt4.d pied
<br />ro lh. FoviebE oI tlr ConE*ld! Lto!.d trw (Ch.flc 9. Com4inS wnh Sclion 7000 of Divirion I of ln. Buiffi Md
<br />PEidioE C.d.) or th.r hG or ih. ! a@g rha.6om 6d rtc bas far tfi. .lkt.d crdplio.. Ary viohlon otscrb. 701 I .5 by sy
<br />4plicd aor!pdhh bjdrlh..p?lic!' lo.ciril Frlyof ml mE$.n fivc hu,!dtq, &lla (tjm)
<br />L s ow of rhc FDFty. or n, mplorE enn ws36 6lh.n eh compqsdFn, will do th. wort od dE niErw b mt
<br />ifloiLd or ofrd.d for sd. (S-.7Ora, Bc(B ed trcf<ba Co<L TlE c.ddd i tj(@ L.w &q nol Tpry to & o*E of
<br />th. FrFiy *ho hril& e lrsDE tl,q !d wlD d6 $d' wll [itrlaor lE*lf or Omus] hn d h. om aphyq
<br />Fpvir.d lb.r $ch ieFo€E{!e d i!6xl6d or o,I6.d 6r sl,I[ hoM. tlE buildrB o. inprD\ffi tsld wihi. nN ]6
<br />of@nlPkiotr tlE O*E Bo't a wiI hlE |lE brds' ol provilc tlri h. or lhc dd @t hiu d i,rylE l,r. r.rFi, ft{ lh. F!F.. of
<br />l, s oM6 of rhc Fopdrn m q.lurv.l, codrading wnh lk.B.d contrd.6 ro mrdrud rlE Frcl (S<. 70,!1. tlailB
<br />!d Prob.im Cod. Th. Co rsroi! l,{.M tt* d6 tul .9pU lo & o\rc olrropdy $b6 buil& or iDpr.v6 llE@(
<br />Md $ho .odrd! for &.h Frjel wirh r Contr&1o(r) li(dE n pulMr to rfic ConlE roi3 Lico& L.v)
<br />-l
<br />d .idF u.d6 Sdb. . B. & P.C. for thir @n
<br />Ih(.: Omn:
<br />]LABIiEf,I:(AUTEBIAIA!
<br />DICIASAIIq!
<br />t h6.5, rmm !.d6 FDhyofpalury on oath. folbf,nB &rh,{iodl
<br />I n r. ,n will uinuni . Cdiaer. of co.$r $ S.lf-lEU. for !ort6 NnpsEnnrn. s Fovii.d lo, by SdEn l?00 ollh.
<br />l,abor CodG. lor th. Floll@.c of rh. *od lor *,t!i.h th. Fmh ir iru.d.
<br />lq hr. ..d will msinrri' wort6 .onFNrion iNurM.. B t.qut d by sdrion rToo orth. tibor (td., ror rh. p{lomdcc or
<br />lh. *ort aor wnich tht p6nn s is.d. My wrt6 conpoldirn iBljfu. (md d Fli., tuntE E:
<br />Lr
<br />o.rr-, tD'l z I
<br />NB cairy rr'a i" rl'. p-r"*. oaih. worl ro, whth inir Fftir s i"u€4 I lll.ll mr mpby oy Fe. 6 e, n.E
<br />$ d lo baod $bjd ro rh.6id'e6F.aaon lrs! of C.lifohir,d.aE rb! if I nbuld haor rbal lo tlE
<br />wo d' @npo3.rbn Flvirio6 ot Sctior 1700 of $. t !6 Codc I {dL fonhwilh comply wirh $o* FovirioG.
<br />waRNtNGr FailE ro !4@ wrtd' onFurior covarsc i! uila*tul .nd ,h.ll $!er E ogloF
<br />'o
<br />ci nn pdris od
<br />.Ml 6.6 up to oR hErlEd doBad {k'llrt (tl0O.00O). in r.Bnion lo *E con ot @DFGnio( drn ad a Fvit d lor llE
<br />sdion 10?6 of'E L!t'm Code inlsd dd dlotrr's lc
<br />,,,., \ 2g rl
<br />DDCIrtrlAIOrl
<br />I hftby .fim un<b !6.t, otFj.ry ltr I & li€!.d @dr Fowbn or CtF 9 {offiirs wnt Sclir 7000) of Dnitb.3
<br />of rlE &!is od P,!6.b6 Cod.. &d dy laca 6 b tuU hc !d.frcr
<br />c10 913lSra
<br />o",.. t L8 c.,-"".!rvrr'lff soiar
<br />calllalqlrq!.r[lDllclcEl(I
<br />I hslbt .fim oidd Frtty of FJU,, lld th6c i ! otr{ruclioi kndiry !s4y lor lh. pafoili@. of rh. worl for which rhn pami' b
<br />i!.{d (s6. 3097. Civ. C.).
<br />LEda t N.e:
<br />-
<br />atfucAdr.D[cldSArlo!
<br />I hd.by.&i ulda panly olFjury oe of dE blbstB d..!..rios:
<br />DqDliti,D PaliteAtldd Norilic.r6. F.ddd R.3uldio (Tirl.40, Pan6)
<br />- R.quftd t-ar6 otN,odftino
<br />-l
<br />c6iry lhn th. t dqal rcguhioE cSrdiig 6b6lor @ot.l rc mr +pli.!bL to lhi! poJcr.
<br />$9 .-,O ,a , * * ,oo lpdilion &d !rd. rha uE .bov. i.tomurbn i! .orn-! I l8c ro NnlPly vnh dr c y ad coury
<br />.rd'nnnc6 rl Srarc lr\rs rcb.n! ro .onntudio[ ,rl hd.ty lurhorn. r.F.6d ir6 o f th! Cry .!d Couly lo olq uF,n tlE
<br />!bor.,Erion d I,opd' fo.
<br />rnt
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />hrlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />F-lood Zone Certif 1l/ trutlntl5ryrglij/tlkVlfrt,'/b
<br />U t:l lt
<br />FINAL ll'/5/ilf [ruffi\t '.6
<br />Certificate of Occupancy
<br />Noles, Remarks, Etc
<br />\
<br />% --*!'s''-]l.mhN Bn.(prlnr):
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