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BUILDING- INSPECTOR RECORD
<br />SITE-WORK OATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUl nsulation
<br />Roof Sheathing / rz3-/1 2zrst )€.Os'2:)
<br />Shear Wall
<br />Framinq
<br />lnsulation/Energy
<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 />Engineer Final Report
<br />FINAL \\z{\\q A,tlt{t\)
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />x
<br />O\INER BUILDER Df, L<'AI TION
<br />I h6.!, rrm uid6 Fdlt of Fj!ry thr I o ddpt fr.m fi. Co icl6- Lrc E lr* aor rhc folloriry ,@n (58.7011.5
<br />B6ind lrd Prcfdion Cod.): Any Cit, or Courty ehi.h rcqund . IEnil ro odruct. .ltr, inprcre dslbh or ,qtir dy.
<br />rNdue Fs to nr it ueq rho ,.quic tlE .pplt4l for !u.h Fnn ro fiL a sgnal nr6El lhd lEgr.lE t licqir.n Ptlld
<br />r. rh. FovtbB ol !n (onrrrrui L,6r.d L.r (Ch.F6 9. Contffiins wnh S.dhn ,000 ol Dlui,n I ot llE &!itB dtd
<br />ft!16hro Co&) c rh. E c nE ir.t6q rn6dro6 rd rlr hG! for th. dl+.d dsnFion aryrioldDnofselir7011J bt oy
<br />.pplicdt Lrr r pciit tubldl3 rh. ,!rli.sr r. r olil pdhy ol mi mr. ll$ fiv. fiun<ltd dollm (t500)
<br />l. s oma of rh. FlFry, or ry dnplo'6 { nh * rsd s rn t sk mmFMio.. wiU d, lL *st t td dE ffiw it mt
<br />ilrod.d ( otrscd tor iL (Sa 70,|4. A6i,B dd Prof€.bB Cod.: Tt Cdrn.rri l-rdc L! &€ d Iply lo D ow of
<br />rh. F!Fr' s'lD hlil(i s nqorE llE4 rd *'tb dE kh \st hrela or lE-laor rlmuah hi! 6r lE om dplot!*
<br />Fvit d rh{ Mh imFNalEa @d nd!.t d q olH ftr eL ll lnrid, dE hiildlr n i"p.$qEr n bE *rh,.k t-
<br />otconptlion. rtE Oqr6 Builda will h.tr tr. hfdor of Foving thd tE or nE dil ml hild or imFlw dE FnFry for dE FIFB of
<br />-1.
<br />! orG of rh. FrFrt. o dclundy coMi,ts r nh kdE d .. rero6 ro odtud tlE FoF (Sa.70.14- t\!i,6
<br />{n Fhh.inCo&r Tn Conrr.cror'r l-i.e tl* &6mr
<br />'9plylo
<br />{o{raof Fop.ny *ho boildr.t inprorBfid<'..
<br />&d $ho oflrsfi lor rBh For.dr $it . Codfton.) la.tricd p{crEtr lo rht cod.rcld r Lkde L.w)
<br />lrn,r\orfl u (1.' S.\rtrrr rt ,{ l'( l,n rl'A,.r\.tr
<br />l).r.
<br />*0'l.6 coDlmalen in\u ,r..mis &llr,licynumbs {r
<br />Eaaf,tf,s:(lrutn$arja!
<br />I}I;I.AEAIIA!
<br />I nd.h, amnn unJd p<nolty of p<jury onc o tuh. lolkN 'nr ddltuatn'ro
<br />I h!v. -d *iU minriin. C6rifr.l. olcoisr ro sdfiM aor qlllst comp.n.rio^, 6 Fvi<t d h. by Sdion lt00 ottlE
<br />trbd C.da for lbc Fftu. orlh rqt tu( *nth rlE lahn i! i!!.d
<br />yJ.+i-FJl,,,-l
<br />hi\ . dnd s 'll mrinrJn qor[.c comFs.r irn iBuraoc.. 6 r.qurci] hy Srisn r 700 .l rh. tjb.r ( od., tor lh. pqfon@.. ol
<br />1o?Sl -Zotf
<br />.z'z-\1
<br />/o.5'11
<br />r.dify rhar in lhc rsn mnc. olrh. so,k for \h(h rrm tedir r I sn.ll n.l onployany p<tun in mynmn(
<br />cilil nn6 up ro on. huod,.d rhou$d doll6 (ll(x),{l((,), in addirnri t) rh. coi rn c@rioh, d, 36 c Fo\idd n{ lh.
<br />e s ro bdoe lubidr lo rlE rvta omFMion hu! ol Cslilomi. ed lsc rh, if I rholld b..om $b<l lo llE
<br />rprt6' ompc1nn FolirioB olsdiion l?00 orrlE ljlF Co<le I JdL fodnenh 6mF\ u nh rhr F)vitb6
<br />$ARNINC: Flilrrc ro @. wrt6'odFstDn Fr6+. b u.h$rul !d sh.ll sbj.tl & orploF ro dibid.l FEIE rd
<br />s(riotr:1076 of rhc l,tu (idq inr6Br md il'Mq*'r rd t
<br />t!L!lJ&\rL
<br />I h@by ilIm uldd Funy o aFrury lhr I e licdE d !.dd pmvilioi of Ch,pts 9 (mmmins f,ft Sdion 7000) of Dn tion l
<br />of rh. BunB od tDlsioa Cod., d ny lic* ir in full tora &d.,Id
<br />c3n 2TlLLL
<br />l.'L L-\cl Y",...,".(/d<
<br />I lEltt rIm u!.b Frly olFiury Gr ln@ it.e.rinxtbi rrdry ..dy tu tlE Ffttffi of rlE *qr 6. u'iin lhi! FEi i!
<br />isu.d (S<. 1097. Ci! C )
<br />AIIU(AII,DECIJ8AI'QN
<br />I hddr'rtrrn ondd p6.hy oa pdjury on. ofth. followiis dalelionr:
<br />Dstul ion Pm s&bcrd Norific.rhn t.d6al Rquldioro (lill€,10. Pin6)
<br />Rcquncn tnE ol f*rifriion
<br />-l
<br />c6rif} r hal rh. lq.t6d rcsulllnrB c!,.dins shGros roolal d. tu, qlpltablc lo rh6 Dn .<l
<br />_l cdr 'fy
<br />rhd I h.!. Ed rhn +pft.lnrn
<br />ordrl]c6 ..d Srd. lr$ r.hi4 ro t(illli
<br />s.ord I orrerocomplt\rnhlllCilytni (in )
<br />kF.dd n 6 ollhB Cnt .rd Coudt lo drd !tr. tlE
<br />.to\( ,Brn)n d Dmp-r) for
<br />ppli..nt or ,\Bml SiBn.iurt 1- z2-11
<br />Flood Zone Certif .
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