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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS O\*NEN BUILDER DEI,('ARATION
<br />I tE tr lllm unds Fn Xy or Frlur- rhi I h .r6rpi tnn lh. (ndtu6 Liu& l^ for th. foltowrg ,.&. lsc 70l l t
<br />Bsind srxl P..l*on Cod.): Ary ai'y or cou , *hich r.q!ir6 ! Fnil kr on!tu<l, .kd, imptuvq dsmlilh or lq.n dy
<br />{Brw. Fr to irs ;.umc .b. rcqri6 lh. 4plicor for sfi Fnn lo fik . isEd nnarc rhd lE .r {E a licosd F!$!r
<br />r. rh. F.vLbN of rlE ('ofi*m 3 Lads.d l.* ((u$6 9, Com4in! wnh S.dion 7i)00 of Divlion I of llE BBiB {d
<br />Prof*ioB CodG) o. rhd lt o nE ii.x@pl lhr.noh.nd lh. blrii lor lh. rlle.d c!6'gion A., vhl,liof, of Sd irn r0:r,5 tr dy
<br />.pplic.d lor r Fnn i!qd3 tlE .pplir$l lo r cir il Fully of mr @c lhr. ft . hu.&.d &lltt {ttOO)
<br />l. & o*m oarh.ImFry, or sy mdo)6 snh s.s6 s th.tr sk sn{Etrdiotr silld. tlE trut d ilE rrrlr b hl
<br />idd& or.froql f( gL (Sa 704J, [i,ii6 Dd PioaBioB Codc: TIB codrdG s Liw t^ dG mt q"lr to d o$E of
<br />rh.F)F1y who tril& o' imrr.!6 rhG)tr dd *ho.L63u.hsolt hirorlf or h.*ltorlhmush ha or hd offidployd.
<br />FoviLd rtd txh hrroroEr! E Dl iddd.d q ofi.d 6..l. lr.lbr6r, rlr tr:ildry d iEFw.rEi i' -ld stlo E rt
<br />of omptlhtr rlE ()$16 &il& $iI llE rtE hldor olFrrrs rhi lE tr tE dn d hrld r rp.oE fi. p.DtEr) frn ilE F F*or
<br />L E osE .r rh. FoIEry. m d.lurn.l) codr..tinr * nh l'..c.d .odmioN t' onrtud llE Fri.tl (st. 7or4. &6iK
<br />rnd ft,t sni ( odc: Thc Conracror'! !-ic..r l..e do6 not aprlv to d o* nd o f fiop.nr *ho blild! or imprcvd lh6oo.
<br />.rn $ho drddi an ut Foj.r$ Inh. Corii&r.(r) la@.ri pldd rolh.coffi.rs Liw l.*)
<br />Itrcre0pru.J(s(lnn
<br />Drr. (rn n.r
<br />$ oRxIila ('olrPf NsA lroN
<br />DIOJSAIIO!
<br />I hq.l,r amrrn trnd( Fmht oiFjr,r_ on. of rh. rollo$rnr &.lrn(n 6
<br />Lu\t rd *'ll mmron. ( 6liarr..lco'ffit ro S.lfi@r. for wt6 onFBiirr a FrrlLd ao. ht Sclio. l7m of rrt
<br />llE (Ddq rnr|n Ft'lr1@c oath. $dr for $hich rlE Fnn a ns!.n
<br />lh!\.lrdrillmi' lin Boil6 .ont.Nrhn i@nt., 6 r.{ut.n b Sdbn lT00.tllE lirE Co&.lor rh. Ffffi.of
<br />lh. *ort( atr $hi(h lhi pcnn n is!.d My *.rld conFNtion ic!@. ffi6 ild Brlky rumtE d.l
<br />,.,,., ffr.^C (ttctS 21-1t 1Y\
<br />ur,- n-,,-, \,^-z C z qohQL'l)rltfatq
<br />lrcni$ rtu inrfi.FrolMnccof th. work for *hi.hrhisFmir ir qu.d.l.hll nol6ploydyFsn ineymmnd
<br />$ a ro b<oft cubi$ b th. {r,Id' omFs.lio. hr! of(ilif.mi& ud .sr lhd il I rhould h6.m $biEl lo lh.
<br />*ort6 @oFBr6n Foltio6 of Sdnn 17@ of rlE lrtu ('o<le I !t lL fodh*nh .onpry snh rhor pml iiod
<br />WARNING: Frilur. lo EUc trtrtd' conp6Blrion covr.s. i! uh$tul. 5rd rh.ll JuhjEl d 6ploF lo omiEl FEhE sd
<br />cnil fi6 up ro on. hundr.d lh.uerd dolld! (llLx).000). in .d.,irion h rh. c., oi comrEs.lior drms6 a proril.d fu lh.
<br />S.nion 1076 of llE Llbor Cod( dd!, ind donEy,s fc
<br />,.,,.'i o lz t/ /lq ^rr.-r,- D 't I
<br />lll l \\lIl ( (,\lR \( l!'R
<br />I hq.6)'drm ui<|.r F[hy of Fju..r rhd I m li€Lr.d u.& Frki,n of ClrFa I lsnljrdins * ih S<rioD 7000) of Dn i3hn I
<br />of ln asilB &d PNadioE Cod.. !d hy lt6e i! t lull hrc !i clYd.
<br />,.'."'."ar". CIO
<br />D.r. \oiZtt/11
<br />7rL
<br />\1 |v tn'+ Sclct'r
<br />(a!flf,.1](rl0!rt!Dl!cac!!rI
<br />I h6.r,' !,IFr trnrts Fdq olFju4 rh, rhd. n !.odtudi'n Lndin*.rtr! ror lh. Ffollre. of rhc \ml for $hth thi Fni i!
<br />i!so.t! (sc 10q7. cn. a )
<br />A[[[I(A.NI.!ESASAIIA!
<br />I holt'! lrrm unds rF xyolFruryo*of llr fnuotr inB dELrd ioN:
<br />D.molirion PsmiG-AllBki! Non6.db. F.dd.l R.g!|.! i)ns ( lnk 40. Pd6)
<br />R.qun.n l.lld orNdi6.diln
<br />I csrifyrnd th. f.d6al r*lhlh FgEdinA atdor rm.\!l c nor irplicanElo rhn pmjdl
<br />l.o1'brhdrlh rrridr[hrllt)lcirk'nand{ir.rhd rfu ih)r. 'nfi]nndrn i1(o'rd ln!r(n).onrd!sIhall(ir]xnd(iun)
<br />.dinrtu.: Mi srrrc li{\ r.ldintr k, buillio3 cotr{rudk,n. ud h.'cb\ aurlrr,d '.'1i$m.rtrs olrhn ( itr. dtl ( ounr\ ro 5(6 uFnrht
<br />,t{r. trn r n.lF,,t fl\ li ' r\Frrin nu'ti.$ - . 9,
<br />rpprr.-r-,r",,sr-r.^ W44L l( ,",, l -/zq / tQ
<br />Ptrnirft nr me (prinr ): Oqq, tt Vtir rct t
<br />Set Backs
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Roof Sheathino
<br />Shear Wall
<br />Framing
<br />ln su lation/Ene rgy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Re port
<br />Flood Zone Certif
<br />FINAL n lb ItI D*nlot ^t* E7
<br />Certificate of Occupancy tt rl
<br />Notes, Remarks, Etc
<br />s
<br />'"**.rr.O
<br />CIJ]
<br />Forms/Steel/Holdowns
<br />SubfloorNenUlnsulation
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