|
BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OTINER IUII,OET DELCARATION
<br />I h.Er'y .rtirm ud.r p(Elry ,)r F4ury rh.i I 6 .rcnl{ rr$m rlE Corrdfl' lrn( tlr rr, rlE r(nbv{! rc.sn (Sa r0l I i
<br />Aurm. .nl Pbl.*Dh C.xk): Any (iry or (i{d, *hxh cnur6 ! IEnn kr oniur. ii(, rdFt,E, &tu|*h or E;[ iy
<br />nB*lu.. Ir!f, b nr E{a.. .lg! B$et rlE {'Cl.d !& rEh Fm' ro li} r lrlEJ (&tr.r rh.' lr or slE ( laq<n puid
<br />t) lh. F'v8.nr or dE Conrrkr'! l-r.n6t t w tch{r.r 9, Co'rfttu$! * l Sdt$h'7lll) ol D,vtr-h ] of dE Au$!r d
<br />Pn'f.(Dnr CdL) q ltut lr d rhc n c(qr tlE clnrn.Il rlE b..! ror rh. .lt!.d .t.qr.n Any v.h.rofsat.n 70-ll.Jhy..y
<br />r0tlk.d lnrrl.mr subF..,trlr .prl..nr t,.dvrl,rcMlryormr mrcrh- firc hlljr.tld.lkr(l:t{I)l
<br />1fi "*, *,* *'*^y. or m,.n!,r'Fs r h *rg.r r\ rh.r q* Lrnqitrsrnh. w,x *
<br />ur. .l oroficE! for sk (S( 7(xrl, ButEs!,d Pini$inr CnL: TIE c().rBrdr! l,r.ns up dN! mr.!rlyro uo*Er ol
<br />rh. F{Eny wlxr huirlr or !rF'B rh.N'.. d! wh Jrr uh $rt h'm!.lror h.r(ll o. rhn{8h hr .r h.r iq cntokryc.r,
<br />F'vrlcdth.r su.h rnx,rmikcn or.hLJ 'rnlf.nJ n, sl lahr9try.rh.t iurt d rtskftd N hltw hrmF{
<br />ol oi0trirn. rh. Owrcr Auilcr v l hlE llE tunLtr ol ,n'vD8 rh2r h. or shc drl Rn trudi or hl'NE th. FFly f{r tlE !{rF,s oi
<br />l. r\ owmr ol rh. Ilfl'0.dy. rm . rr htr
<br />'vc
<br />ly rontrrr 13 *nh lEcncJ .dnrrD& r\ n, r.nnn'.i itr !r('i.r r S.r 70,1.1. Bu\ft$
<br />rB1 llirclrDnC'i]. ThcCd r.(ttr'1l-r.nr.l:ud€r nn rlplyb anowno ortn{rdy wh' nu,turd 'mrii,vc\ thcro..
<br />&i *lx,.odh-'kh,suhFoF!(wihr(i,nrB_.nlnrl..rrnprFunrbrh.contJlrtrrl-rcn{ljw)
<br />I s.r..'rr u .r Ss-r.n_/: /4. zot q ""*.WOTI(ERS' COiIPE\ISAION
<br />IESAAAIAN
<br />I h.Eh, rttim ufrlcr lf,ndr! oi FiJrry or or rh ,olbrhr d(lrnri,nt
<br />-l
<br />h.v. rn *,ll Erl.n . C.n itr. ol (rnE.r ft' S.lllnorc lor s'rtcr' oryE.s i'n, .r F'vd.J !q hy S.!1i)I 1700orrlx
<br />htrr Gn , tur rh. lcrlolller d, rh. *r* ntr wh.h rh. FhI 6 t$cd
<br />_l I'xv. rn'i willmflnrln workcr\ nmlttr\.nkr nnur"n... !\ tr,tutdhyS..rr l?lxrdl rlr lrh., (ikL.l,trh. p.dormr..ol
<br />rh. work1,trwh'ehrh'\r.rnnr r\ tr\r(l Mywo'k.rr lonln.nslli(nr rnnmnu. crrrr rllr,ltrynuD$.rr.:
<br />azcnny lh.l r rrE FrormL. .r lh. Brt lq whrh rhrr Fd B srEJ. I rh.U nn .r9t,y oy Fmn r ey ffie .r ro tarE $bFr ro rrE k td o.{Endbn l,*! dc{flru !d r!fr rhi L,I lrbrll tE$r rubFi ro dr
<br />*,*m' oapcn*nn pu"saF or SdD; 17(x) or rlE tlbor cdL. I tull huh.nry y uh rrEr ii!;tsn.
<br />WAiNINGT FduE ro s@ frrran lrrhFndrn .nh!l K unL*tu1 .,n th.ll sbFr u .npl,Fr ro otud Frr-.nlLr'l lih--\ op n, om huftlr.J ih,u\JnJ Jollrt (tl(xr.ilr'
<br />s(k'h:10j6 0frh. bhn crik. mrrr.{ rftj om'"'\r..\
<br />)r h 1lJnnn r) rh..o! ol.r flh. dea.r 6 prouLtl for rtr
<br />pEcldEartQ!
<br />I hcEhy d,irm un&r p.nrlry o l B ijorr rh,r I {tu lNnrJ uftLr pn,vt(,. ol Ch{ .r 9 (mmftn.,nt p h S.Lr rln 7fiXJ) ot D,vN.n :l
<br />ol !h. Au\ft* and Prulcs()n\(nd.. md y1tr.tr*N tulln,uarlc,l.rr
<br />(:(INSTRUCNON LE{DII{G CFN(1'
<br />I h.rny.IIm unLr F.tly ol F.rury rhr rrft ! r cd!{tuiir Luln!.Scry fd th. Fnllllj&i ol rlE wt tor whih rhtr Imr n
<br />nr0.J i Sa. .rO9?. Crv. C.)
<br />AIILT.CANLDECIdSAIS!
<br />I trl,, ariim und.r rE..[ y ot p.rjury om ol lh. dlow'n8 dccllrdiins:
<br />DcB'hon P.rhn$ sb.stos Nddi..ron FcJ.rd Rcrul{krni (TnL 40, Pd6)
<br />-R.truuql
<br />L.llcrof Mxrulrh
<br />Z .a,ry tt r* a"ntcllLtNm\ E!{ilo! .\h.s(x rcfr)vrl m r, 4pplr:hk t' rh! tn,Fr
<br /><l'fy rh, I h.E E.l th!. .lI r.r!. r,n {rt. rhrr rt* rh,k rrorndrn !r rmr 1 .8ft k, dnlcly w,lh rll cry.,rl Counly
<br />trilmNcs ril Starc bs! El,uB lo ho rt .o.{tukr .it .uitrrd. r.rE( vc olrh,i C y ..d Cirdy kr.nrd uFln rh
<br />rhr. nrnrk'h-J pn)F..nt ntr mlFrrnn prF,{r
<br />,\pDli.rhl or ,lE .tSismlur
<br />a2aar.r J .//r/?4C^/
<br />r,,"./-zz .Zo.tj
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />f,ool Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lVlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />1
<br />FINAL ,v ?//4 --,4 Wt)
<br />Certilicate of Occu pancy
<br />Notes Remarks
<br />Flood Zone Certif .
<br />Etc.
<br />r,.,,, / zL ' Zots
<br />I
|