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BUILDING- INSPECTOR RECORD ,J;7
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNER BUTLDER DELCAIATION
<br />I h.r.by .ff,h lnkr p.nrlry or Fr,lry rh.t I d cr.qr iiom tlr Codftrn' LEtrr liw tn llr nnh*ins E.en (Ss 7011.1
<br />Alnmrr Dl P.ol4u'n Colc): Ary Cry or Counry wh.h ,.qut$ I IEmn lo u,nrruur. rlrd. in{nrk. &m l'th or Fl.r dy.
<br />nru u.,pRtrroi! r\ue.-.,,l$ GtuE.lh. qlnlE. ror.klt Fm n, nb ! ]r!*rl n.r.mnr lhrt rE.r slx u 1f,..61 pulrd
<br />h rh. Atrvi,rnt ofllr c.,nrtutr'r LEn€J t,* (Chrfl.r 9. GmmE68 w(h Selrr ,GI) or D'vn.. .! or ilr Bur6i.rl
<br />Pn,l.*r1CqL, o. rh.r lEtrrlE N.i.iq'r rlE.tiNm.,rr rl.t h.ri, &trrL dks.ll crn$fi Ar) vi .rir ot Sdbn ,0] I J by y
<br />rrpu&r lirrFm $bFh rtE rptl,qr ro . civ il n mlt y ot mt mE rhrn ant hutulr.tl dollr! lS5lD)
<br />I .r .sm olltr FDFnr. q oy .nFl'F.! *(h *.8.r ri rh.( I't d,trrFndi4 "dt J0 r& k !n E <rlE . nx
<br />darlal c oficEJ tu sL (Se n,44, Burm$ rntl ProL.siff (ii.r TrE C.ntrur'r Li.tr( tr* d*r nn +!ly n' q o*mr ol
<br />rh. FIfiy wh! t t\ or uBh6 ih.B,n. .nl wk! &H lhh k hmr.lf or h.*lt or rhFu8h hr or ts own .rltlby.6.
<br />nmvrl:J rhrr lBh hpo\tliMs e nr.raridl so&Fi ltr.,. ll. hru/.c. rlrln rrB d rFEr.r B ott *fiB(r Frof(xll'ldm rlr Owrr Bur&r *Jl hrE rlr t d.. of In)wla rh.r lr u *. Jil r, tn or uitxoE rh. FoFdy tu rh.IrrF'rof
<br />L aowErot rlr Fqinr. dc\.biv.l,ront,arin8 rih li.neJ drr iFlod'n{rud tlr I'ui (se.7044, Burmir
<br />{rl Pnii:slrColc:ThcContrtuk'it-,c.n{lr*d,E!nol.pnl}b.no*h.rofnroFnywlEt'uttlt.rrmDroy.trh.r<,n,
<br />rnd *ho LlntL1r tu ru.h F,jck wllh. Gndo(r |rcnBl punu.ri r)r|rconr-ktr'r tr.ftLq)
<br />I mcxchpr uftL, SE-.rtr'n_. B &PC ntrrhBrr(,n
<br />WORI(TRS' CONIPENSATTON
<br />DFCT {T T'ON
<br />I h.tby rftrh u Lr F.Mt,.l Flr.,om orrh. r,nbwDs d..hdbN:
<br />-l
<br />hrrc rn! wrll mnl.o. C.nrrrtk of Consr ro S.lllNurc ftf, s,t6' .r,mFndr4 s llrthl nn t,' Satn l?(r) ot rlE
<br />ll6lr Cql., rd r,E Ffdllrs. of rlr qxl fq *ti.h llI |Eid n lrstl
<br />I hrv. ,nJ *rll mrinrrh *ork.n cdhFns.rhn nruhB.i .! EquEi by Sdrin !7m ol rh. Utir CdL, tor rtr Ffmr oa
<br />tlE Hrk fM wrtrh rrB Fm( 6 lqxtl. My xxt6 .r,n{cNr!n hiu.s! ts.r lrj Flly .umb.r e:
<br />CuEr:_
<br />-!rr,ftr:
<br />-l
<br /><dni rh.r
<br />'n
<br />ilE Frrorng[. .r r wo.t t, *hrh rhr Fmn s 6(EJ. I rh:ll mr .qlloy my Fe,r b s, mErs r( h h.$m \ohFlr t' rh. vnl.^ llrr{Ensti)n LwrntCll i,mE.rhlr f , \hnrll hcconE ruhis h ltr
<br />s.rkeri (nnprtr\rrrtr,f' v^r,n\.1sc!rr)n lrlx,!ilrlrt-,'lu(irlL..I bnhwih u'nDly wnh rhM InrvFi)nr.
<br />Fr rn cq,k)wr h lrunNl Fulrs a'rl.
<br />I 'l rincs w h' or huhlRl rhrurlrl .!rll.h (!l(x).(Ixl), ir ol (Dnll'(n\!rtr,h. ,]r'uic\ r\ tn,!klc,l nn itk.
<br />5c(r(n 1(176orrhc I rritr C,rlc. trrcr({ JtrJ rrtrm!',\ trr\
<br />DF(:t ITATION
<br />I ltElly ilim u,n r p.dr, ol Frjury lhr' I d lrtn<rl uoi.r FUvsion ol Chll,ts e (.r,mmftha lih S.dr,n 70m) or Drvarx,n .l
<br />ol riE BurE{r .il Pnrtusirr Cod.. url ny li.nE is h lill fu{ .nl .lT.cr.
<br />D.l.r_ Cont
<br />COI\.STII]CTION LT\NNG AGENCI
<br />I h.Ehy rl1irmxndri Fnany ofFrjrryrh, rhe n..r'niturrtn b oSaS.D,nnrlEFrtollllerotrlEyrtttr*i.hrhrFmr6
<br />RiuJ (Sr lm7.(iv C.t.
<br />APPI IL]AIIT Dr.Ct {RATI(IN
<br />Lr.id'y .nin u Lr Fnrlry ot Friuy ok or !h. rolh*rs dcLlu.r[nr:
<br />Den,l sn P.rm l Arb.(d! Noilfrir io. F.,lcal Rct ulor krni tTd t. 40, Prn5)
<br />-R.qu!d
<br />L.(d of tlt (sri)n
<br />_I.d,lr rhar rlE Ldcrrl E3rLrr'.r E8.ntn3.nor twrln e nx {rn..nh ro rhn noFr.
<br />-l
<br />ccndi rh.l I hivc r.!Ll rhN rmlrrtxr
<br />oniulNcs lntl Sritc lr*r nbrm8 !ohr'!n
<br />rc rnltmuron ,s &a( I asre t' .oDply * h rl! (iry .n! (ounry
<br />r,kt ol rhn c'iy !n coudy n, 016 uFh rlE
<br />.t[v. EnlrEn |,$tEn, fd hsl^1-i
<br />,lpDli.{nl o. AE nlSipnrlur
<br />Sel Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />l9.ol Sheatning Jo/JJI I Fzdz /rq
<br />Shear Wall
<br />Framing
<br />lnsulalion/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />T-Bar
<br />Handica p Beq.
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif .
<br />I ,4)
<br />FINAL /bp7,)Mftac 4U
<br />Certiticate of Occupancy
<br />Notes Remarks Etc.
<br />Pool Fence
<br />D.L:-
<br />kid..r AJ&.\i
<br />-
<br />ILt :-
<br />=
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