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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS O\,NER AUILDER DEII'ARATION
<br />I hdclry 6mm und6 polhy of Fjury rh l an .ropt fton rh. ( onl,.cloG LE.n!. Iiw lor lh. louowing l6.n {s( 70.1 I t
<br />Bo.ind .,'d Prof6io6 Cod.)r Ary Cn, or (oudy $hkh r.qoir6 . Fmil lo sn!rucr. ahs. inp.ovc damlirh or EF, o,
<br />rMue F$ ro its iM.. rlo E+iE rlr 4'pli!n lor sh Fnn ro frlr . 3i9!.d nio6r rhd ,E or ilE it li.s!.d piM
<br />ro rh. ForEbd ot ttE Co.rl,-td ! L@trrd tr* ((}qd e. ComftinS $nh SdFn '7000 of Uvi5b! I ol dE aGiK 6d
<br />FrlsioN (td.) or lhr lr or !h. b dmpl tffioh ed rh. h.sis for lh. !lh.d ctdFio, Aiy viohrhnofscl6n 7011.5 ht xy
<br />.pplicaDr tor ! FBir sbjEl' th. i@lici ro!civilF lty of ml nor. rho fivc hu.dr.n d.lffi (lrm)
<br />-1,
<br />s o*c olrlE FDFrt, o. my mpblc [nh $.96 B rlEir $L ohgolti,n. *'ill &r tlE *qt tld th. rirlw 6 r'r
<br />fidrd.d or o,Iq.d td 5L {Sa ?0{,1, BuiB Ed ProfdFB Co<E 'Irl. (.o, ncld't LtaE L.$ &,6 ml ur,r+ ro d o$c of
<br />rh. FlFy *ho hrill or inP'o6 lr,qor .d *lD dG *r! H* hin*lf o. lE*lfo. lhmuah hil o. hs om mploy6,
<br />providcd rhd !u.h improvmE e not itn6'dcd or ofrasl for s]. lf. howaq, lh. hlildin8 or inFo\ffil i! $ld wnhi. d.. )@
<br />ofcomptrb( (E o*G B{il& *i[ IEE rlE hr&r otF.\ilB $r lEorJE dii Dr hild or i,qro\. Uc FDFIy 6. r p,poFof
<br />_1, s 0\16 of $. F.pdr. M.rclci!.!, conlrdin8 $ irh li.md.odr.d{u r. on!ru.r lh. lr.l<1 (sd 7044, 116!6
<br />dnd Ptoftsbtr ( odc: Thc Conlnct.f. Licd!.lr* dod nor.pplyro u ownd ofprop.ny wfio buil4t or imprcvd lhaon.
<br />!6d who cnfltr3 for ru.h Fotds whh . ( oed.(J) lla.d poauln lo rh. ( ont.drx'! La.M l rs).
<br />, u.xmd uxb Scrih .1, &l.C.rorlh6'.&n
<br />D.t. Oinr \\oRtfls coMaNs rlo
<br />TEC|AEAIIAB
<br />I lEcb, rilim uitld pddr, of FJury oE of rlE follo$in! daLrdioB
<br />I hav. tur! *ill nEnnain . cd ilical. of( r,lMr to sd r-l$ur. for \{u k..' onp.nt.'n)n. a ptuvid.J for by Sdioo 3 7(x) o r rhc
<br />I lhor coiq aor rh. Ffoffi. of tlE $ o.L lor uhich rh. rETn ir ie.d
<br />I trr. rkl r ill mrinl.in w*(r 6nFslh. iGtr., 6 rqun.d bv Sdion 17c() of rlr L.bo. (i'd., tor tl' Ffollrl.re ol
<br />h thB p6nn ! ecd M, *o dr itr. i6u n(. cdir an Fli.y Nmt'6 e
<br />E er- f7 -t-/?
<br />lcdiiyr[d inrh.pdfoflninc.ofth. !o lor rvhich rhF Frmil 's 'sn'crl,I sh.llnordnplo] 3n! rEson ia ony Datrnc
<br />$ N to b.(o'rc lobier ro rhc elt6'coniFelio. lrtrr orcniao .sr rhar it I tholld t cor 3uqd b E
<br />f.nh ih .{iq } \'nh lh. pr.filioBtrortG' omFs.rsnFovnh6.ls..rirn.tTmolrlE l:bor c
<br />\lARNINC Ialurc ro sft $ort6 smpddion
<br />.irn tu6 up h on. hundr.{ rhowd dollc (ll0o
<br />tul- r.d shdl sbtd d draloF to aimiitl Frrb 8l
<br />lo rh..oe of .os!.Nrion. !m.n6 c p.6\id.d lor rh.
<br />".,., /- zz-1?
<br />I hml,yemnDlDdE pdfllryol lejurr rhar I m pturhi.n.r('hafl6 a (cou.ocr! \irh sdiDn 7000).fl)rision r
<br />of rhc a$nKr Md Ploasi,N Cod.. &d my ln.e ir in lull rot. turl.ficr
<br />6qP q=
<br />D.,. l-?a=lf A,4-
<br />I hebt amrn lndd p.n ry or nsjury lh8l thft i! . con!
<br />isu.diS< 097.Cir C )
<br />ladi.s rsft, ao. rh. F aol:Mc. ol ln ssrt 6r*hf,hrhiFni ir
<br />AIIIICAILDECIj8aIIO!
<br />I hrd, .fm u.d- Fr.t, of Fjur' oE or rh. follo*'ns d..LtdirN
<br />I).nkn{ion P@n3-Asbcr.s Norific{ion l.da!l RqlLrhB (T kr0. Pd6l
<br />R.qu(d l-drdolNolifi .dion
<br />-l
<br />cdifr rhd rh. Ld.r.l rquldFN Bhdor rdorrl e. mr rpd{.bk ro rhir Foj.rl
<br />l.d'frrhir I h:\.ft.d rh'3 h.rrh..t$rcintunnd(n,'s.or.d l,slero.ompltwirhallC(ytil(ounD
<br />ordinnn.6 md 516r. tjws r.lnin8 iotr, ud hscby aurlnyr. r.Fsrd i!6 of this ( ny Md Counlylo ord qsn rr&
<br />ru,v. MtFrcd poFny lor
<br />\pplkinr or l*rnr Sifnrrurr
<br />l'r' ii(nrn((prnn): a
<br />a. /- z2-f7
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />Subfloor/VenUl nsulaf ion
<br />Roof Sheathing l,(.r.{-e Vwiltri 1 ;rn t, eu1 3z)
<br />Shear Wall U I
<br />Framinq
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Ivlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />FINAL N4'lrq )i\1nt,tut 7rY\ )
<br />Certificate of Occupancy 't t I t o t'
<br />Nolqs, Remarks, Etc.
<br />IE
<br />{t ut
<br />SLAB Floor
<br />Lic.MCla$:
<br />IAtJM{\t
<br />I
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