|
BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE IDiSIG.COMMENTS
<br />Set Backs
<br />Formsi Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf looriVenVlnsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framing
<br />lns u lation/ Energ y
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lVasonry
<br />Pool Fence
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif .
<br />FINAL Ilt ?/l/f ul' \-/Certif icate of Occupancy
<br />Notes, Remarks, Etc.
<br />OWNER EUILDEI DEL(-]\IATION
<br />I h.Eby rlfm ud.r Fuly ol Frrry th, I 6 crcqi rNh lli Codtul6 ll.nr l^ (ot rlr folloroS E.gr rsa-ml l I
<br />BusErt .nj Pd.son Cdlc, a.y C y or Cou y *hrh Rtum. . Fmnr lo (I,nnrud r!'d. rm!!.E. d.mlih ot rcr.tr .nv
<br />nturh, lrrtr b d. !*uB{, .le cquNr rtr {tlrd tu 3Bh p..n/ ro liL. .4Erl rr.l.mr rh,! lr o, rh n IHG! F!tud
<br />b rh. lh)vtn.i df $. Conth._.tri LEIGI ti* (Cn Pcr 9, G,hmso! s h S&tbn 7000 o, fr'rtron I of th. Aurr.t rnl
<br />Polc$r,ns Coj.) or rhrl h. or sh. r crenPr lh.rcln'm ud lh. h{i L, ihc .llcS.d .ictr{inn. Ahy vFrLi ion ol Ser bn 70:1 1 .5 hv rtrv
<br />.fl udnn.Fm $hFc llE .I'f,lxu o . r'v'l p.rx y or B, mE lhu liv. huLlr.l.I Lrt (15{{r).
<br />l. r! owmr ol lh{ p ,Fnr. or my.,ry,loyes wrlh w.sd fi rhe t a,l. comFns.l i4 wiI LtD rlE krr lrl uE .turr it n
<br />lrnLi or or.htl fd qk (Sd.70,1t. Buw$ t l Pn,f.!ri,nr GrL TlE Cod.krd'r ljfic lrr.lEt d .r0ly ro s o*'mr ol
<br />rh. FrFny *hr l[rli or lqnrk d*lM, {rl wh, &B s h *rlt hms.ll or h.rclf ot lhn!8rl hB or trr oM .rl{'loy..r'
<br />fiuvil.d rh.r 5eh 8yn'EE t e [! id.nldl r olldql ld {,.. ll h,kE , rtt t ,llo3 ot r|lroEnrrr i: slt wirhu oE ]ta
<br />of(s?lla rh. O*Er 8ullrs v l hrw rtI t n,.n ol Frvrr3 !h, h. tx ir drl d hdl d lqnrE tlE F'rdrv ft, rh. F P.a or
<br />-L
<br />.\ orxr ol rlE F tErt. m cktunEly.!nlr*163 *(h lf,inkd $dr&o6 to (nr&r rlI tn)iar (hL. 7(x4 Burtr(
<br />.tri h,l. sih Ciri.: 'I'h. conkttx r Ltcn!. llw d*r ftn anrly n' - deffi o, roFnt *tx, hurld! or !mpttv.' rh.Fn.
<br />i.d who uodn kntrruuhF*cBw h,Gnlnulo(o lk ns'l plrnd n,lh.(dnr.Lloi! l,i.cn( hw).
<br />I rm.rcm unLrScur$n
<br />D.t
<br />-
<br />]IOSAEES:CAUIEN,:AIIAN
<br />rEct aEauq!
<br />I h.r.hy rrltrnund.r FMllyol Frrry oft ofrh. nnlrue! N(LDlrm!:
<br />I h!\' lvl - rll Mmrro a Ccn d 'clrc
<br />ol (irs.trl 1,, S.ll ln\urc ,,tr wo*c6' ('nP.nrrri,n. ei pn)vd.d l{ hv S..r n l7U0ol rh.
<br />Lh{ (irlc frtr ilr Frlo'@__..f rh.!o fot*hrhrh.Fn r r.u.rl
<br />I hrv. r J w,ll hrinrr worlcrr.onD.n\rnon nnurakc d\ RI'trcJ $yS.(rdr rTlD!n II'c l-a6ff(hJ. n,thc p.rlormrfr.nr
<br />rtr *hrhrhr Fd*! !$cJ M, rgdld .ln{rnqlEn(.lr^ \ ( Yr".\8uru.t.mr .,rl F i.y nudf,r e
<br />-;1c.1-11
<br />nr*,U*
<br />l..nriy ih.r tn rh. F{ortre. ofrlE }ort it whrh rhtr F.nnr r ssuJ- I rh:ll .t{tL,v .nv IERrn D rny murr
<br />$ s t, h.o,E iuttitl ft, rlE *its LrnIxNrbn lt*! or C.lifom[JJrl .8R rh, 'l I dloll lhom obFl ro rlr
<br />m*.n' LlmFnrrlbn pn,vsi{,nt .f Sdlrrn Jr00 t the l/htr C{r1.. I !h.lL n'nhw h .onply slrh rhns pn)vs$n!.
<br />WARNING: I!tuE (' Rm uf,tcn' .onr.nsr$n .tvo3c rr unLs6ll. ul \h ruhj.rr m cft0trv.r nr dnwl FMIB lrj
<br />rN,l fms up b or hunlr.d rlx,uqDi Lnnls (tll$.{Xlr. h dJdin tr lh. .nr or Lurtl dsrnn. J.dS.i r! rrovrkn for rlif
<br />Sc(rifl r(,la !'lrh.l-rlltr (nd.. ri.,.{ rtrl
<br />_ rEotSallo!
<br />I t*Eh', rllm uoLr FrIy ol FrJUr, rfi, I m ll. ncd ud.r F*Lri'n of (ll.{icr 9 (.r'ncE'n8 P.h S.dM 'llo) of Dtvs-r I
<br />ol th. Bustr$.Jxl PrulcrsioFCnL, r^l my lt.n€ s h lullt,tr!ui.lt.t.
<br />s1{. e,st
<br />(
<br />gq!$ltlcuaNudgNi-acElra
<br />I hcrchy alitn n lcr FnrXy ol Frrury rhrr r h.rc n r eonn*-rrrn Lndrs rS.Ny for rh. Frl ltrls. ol rh. *olt f!tr wh.h rhtr Fm[ k
<br />((.Jrs( lrrr? civ ( )
<br />lrdLir A.ht (:
<br />-
<br />APPLICANr DE('LAf,ATION
<br />I hctry rnin uolcr Fmlt y ot F.rry oB .l ilt i,llrwn! d(,rd.n.:
<br />D.n,l nn P.rm lA\ltnos Nddr..rnn Fcd.r.l R.sllxrrrr (Tdk,{1. Pd6)
<br />_R.quwn lnrcr ol tkr,frrrr
<br />I (cn,tirtur rh.lcn.r.l rcsol,u,n\ Rssdhs.rh.(o{ En,val rr tur rFnlErbt t} rhis ljn'Fr
<br />I.rnnyrhdIhlw6rdrh6aPplE.(ion{ind.ihrrtltrh'Ernntrmrx)ntrxotur.l4Nn,Ltd{yrnh.llCttvnrlCou y
<br />dnhrn!.r rd srtr. Ls Ehrh, trlluLliu! .oo{ru{x,n .,r.1 h.Eb, ruhrn. rcF.Ei rtitt of rhn Cnv .nd Ct'unrv ki 'nt" uF n lrr.r.,**".*,rp",n"rr,"f,fr..r''*- _f - gl _\ (
<br />,rppo*, o' n".n, st*-,u;'p D.k ---\---j-
<br />".-u-*r"",,/ " f ":L Cr^ ', A
<br />8"ffi
<br />L
<br />T-Bar
|