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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWN'I BUILDEf, DEI,(.IIIATloN
<br />I lrr.l,y rituh urkr Fdly ol p.$ry rhr I m .kq{ fmh rlx Cod*16 l-r.n. bw tor rtE lolbvq r.in tS.L 7011 5
<br />Burtrs .!tl Pn'r.(,,. clrl): A., Ciy or O'u y vhrh GluEr : Fna 6 d,nntur, !hd. 'r+ruw, &mllth d rcF( Dy
<br />{rudr, rn*k' r n\!4!. $ Eq!6 rrE.0d.dr,(lkh p.mr h a).. n!*tl {d.mnr rh.r lE or ilE ! l{.n<l rit,ur
<br />b rh€ pnrv$r,nr .l rh. Conlncroar l-i(.nql trw l(1unr( 9, CommE-.u! , h Sdrrn 7@ of Drvnsn ! .r rlE BUIE$ .[l
<br />PmLilKrns Corl.) or rhar h. or \tt n .r.mor rh.Elion {rl rh. haas tur th. .rk8.d . r.n{ikin. tuy yiohirn of Sqrh. 70.r L5 by y
<br />rptlic.nlfor.IEmrlsuhJ.!r!thcsprlunrI'rqvrlFnalryotmtfr,rIh,ivchunJrcJJullrs(5tm).
<br />I..rowrcrolrh.|r'Fny.rny.n{,y..rwirh*rac!$lh.r$bdml'.nqrFn.wiu&rrrwdtrilrtE{BrEtrr
<br />d.ildl or ott.rd (tr qk t5( 7044. Burm\r !i! Pnn lsDhr CoL: T]. Ci'nr&loir L{.hc L.* dxr , {r'1, b d o*k of
<br />rh. F{Erty *h' h! 1. ( ulI'n'Ei rh..q- 8l *hr LlEr uh sr* h6cf or lrEI( {, rln{lh h,r d lEr 6w. .mlhF.s.
<br />Fovrl.d rh.r suh olFrl/'ffi. e nr d.nlcl, ofl..1t tu.t Ilh.w.rh.h{ !E or lrIrcErn i.: *.fi6mFa
<br />ol otrI,Lrtn ft osE a!&i *dl hak tlt hln.orF,Ed rhd h.ordrJn f, h ld,$roE dE Fldy lrilr F4orof
<br />_l, r\ owRrnr rh.IrnFny, rnNrlF,kly(odr&1 i*ihl'..n:-l.oirikroi\n,(onnru(rrh.pn)r(lSc.7l}l,l.lrrfts
<br />J Pn,lc$M (in,. lhc (in rrrrtr r l-r.n\c lr*Jo.r ndr,ptlyr, rno*n.r o, I,n,tt(y wh(, huilJsor l6['n'vc\ rh.rcon.
<br />.nd *hn (dilr\l'tr ntrhF'j.cr w(hr(ifltrrr!(\) l(.n\.d llurn'!d r,rlk (i'nrruntr s ljenk llw)
<br />_l mcx.m8 u.d.r 5.d
<br />!a8f,8&!.CAUlE!5AIlO!
<br />DECIIf,AIIOT
<br />I h.Et'y .ltirm un&r IEEIy of F,lry oF ol th. li l'*r! &.|!.tbn.l
<br />_l hx!. x w,llnumrlmrC.d'li.r.orConr.nrt,S.ll-lnrudr({*.rkcF!!6IinrrrNn.$provi lnrhySck'nl70O.lrh.
<br />lllxtrC, .. ntrrh. p.rlormrnr.ol rh. wnrk l(* *h(hrh. Fmn L\ 6rucJ
<br />I navc.nd wrllmrr rrn *orkcra .omFn!.r0n rniurrkc, rr rquirJ hy SR.'ri,n 171X, oi rht lrbor C,rL, hr I hc ncdn.mrc of
<br />lk work li'rsh.hrtuFrmn r! trs'El My worlm (dnr'.nrriion u\urtu. rrFr,r! Frl.y numb.r E:
<br />Cair:-
<br />_l(.n,lyrh{ hrh. F,formtu..trlr pork n, whrh rhn Frmr r 6(kl I sh.llhn (sployanypc,son 6ahylMrr
<br />qr !s ro h(om utll(rr i) rh. woA.G (,mll.n\!ri,n l,*! ol CrhlomE. rnJ rgd rhr n I rh,olJ h..or sbr.r ro !h.
<br />uo*c6 .ompcntlri,'n ,n,vsons ol SNrx,n .t7 ) ol rh. llhtr Cutc, I lhxll, tudhw[h comply w(h lh,s i' ,vFirN
<br />WARNING: F,zrluE k, rcun mrkcr .rfrp.nrrrr)n ovcrag. s unl.wrul. .nd lhall luhicr .n cmtloy.r t' mnftl ltndlks r.d
<br />0vil lin.r xt i,, o'k lrurulrcd thousand d.lldr (illx),lxxr), 'n ddiron t, rh. uorl ol .onyrn!.lion, dxroBcr * lln,vrl.d ntr lhc
<br />S.cron.10T6olrlr lrhr(ixlc,or.rc{.nd{t'my\f&r
<br />D .,_ ADdlsl:-
<br />ulEMlDlntrrxacmS
<br />DECIABAIIO!
<br />I lEEhy .lrm undcr r'.M!y of p(rjuy rhr' I .h lru<n ud.r Fsn{En or C'n pd I ((,limEin! wrh S.!tr'. TUloJ or DrvIrFn .!
<br />of rlr Buitr.r .rrl Pn{ori,nr Co&, .nl my l.cn{ F u tull toE! all .ltcl
<br />D.l.:- Conlftlor:
<br />(-(IITSTNUCTION LENDIIiG AGE-N(\'
<br />I lIi.ht,fm unLr FMlr, or |F Jlry rh{ tlEE n. dn{ur.n LDlx!.!.E, tu rlr Frlillrre. of rlr *rk ld uhrh rhs F .
<br />trre!rse l(,7,crY. c )
<br />APPI I('ANT DFCLARATION
<br />I h6rt, ,fim ud.. ItUI y ot Friry oM o( rh. dl'*'ry &{LFr rns:
<br />t}.mli,n Pcm,r-A(h.{oi Norif.rlx,n F.&r.l RqrLrrn (Irh 40. Pd6)
<br />Rclru&J lnrd ol fldrfrrM
<br />I cdrryrh.llE lcd.rJrc3uh!,n{ ctdm! r{lrrol rcB)vrlrr rt, {flr Ln,rhtrpn,Fr
<br />l.cn'lyrhnrIhlvrn rhH rfi,lf,rxr inl ddrc rlrn thc xlr'vc 'nntrnr Ntr r(otrc(r lr8rccn,.ohtly* hrll(\!yrhdC unry
<br />orJ'n,k-c\!&lSranlf,*\rlir,nen,hudrnecntr{d(nntr,rnlhcrcbyatrrhtrr.r.,n.rnrllrvcsolrhtrCiylnd(i,nryI'cnlcruPnlk
<br />rhvc nxnrnn.J I)'oltnv ntr nT.cronpurlr,k\
<br />Applnut nr As.nl SkmluN D.(.:-
<br />PditFEmrDrtrrr:
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation -*)Rool Sheathing tlpla T&n"4"tr
<br />Shear Wall rf I
<br />Framing
<br />lnsulation/Enerqy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lVlasonry
<br />Pool Fence
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />FINAL tlMlq 7n R^4e/l 72/
<br />Certificate ol Occu pancy ut
<br />Notes, Remarks, Etc
<br />Litc8. Cb$: _l-{cn{ Numhcr:
<br />T-Bar
<br />Flood Zone Certil.
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