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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNf, R AUILT}ER DEI.CARATION
<br />I h.r.hy rllim unkr FdIy,, Frrury rh, I m.k!.fl foh rh. G'drf,n,n' lrtnr Lw for !M nnb*o8 r..rin (S.r 70ll.5
<br />ilrn.s !trd Prncsr). cd.): Ary Ciry o. (ounry wh.h r.qumr . IErmrl b d,n(rucr, .llcr. rm0rurc. &m,lxh or rcpu rny
<br />ntufuE. F)r (' rrs 6sa!. rtkr rcnurr rh. 4't'l. r in tBh Fmr n' tik: rSka! n{ffir rh:r lt or \lx tr L.!nd tlNrd(' lhc p.oylnns ol rlE Conr8rtr r l-icnqi l,w rch! cr q, ComftEin! * h Sar.n T(t$ or D'vnu ] or rlE Burm( lrl
<br />Pnif.!\$n! CoJc) or rhrt lr d rh. r.rci{, rh.r.fmh.nJ rhc bl$ li, rh. rlke.d.r.hFbn. Any vk ddn ol Sernn ?01, ll i, rry
<br />.0plk. lnr.Fmi {hrcrrllx rfiit.d ro . crvrl FEny or Dr frlE
<br />'h.n
<br />I rvc hu,rlE{ doll,r (lSU))
<br />_I. & owE of rh Fof.dy, or m, .mJ*,F.r *nh wr!6 ( rh.r !* .ur{E.r{ ir. *Ul rb rh. srt .,1 llE (urE n r
<br />ui. di or ollcrd r.r qL (Sc roa-a. BulEs .n l PNrc(-ir CaL Th. Codrr(r r lite t:v d&r d rJ?ly h o o*E or
<br />rlF F{Eny yh h{Ui( r !tF)E rlElq. r[, *h, &B qdr url hhr.lt or h.Rll dr rhbuSh hr or lEr oen chfhy.c!,
<br />trlrviLd rh.r skh trr?r$Emdr @ n, dalat ofidEl ftx sL. lt, lDM. rlE h{ 1!! n ltgsErd n $! rirhb iE F{
<br />ol .Drq .ri'c rrr o*Er Bullld -lll luE trE txr&r ol p$vh8 lhr h. or srE drl mr huitj or u,{n'( rhc Fopqry to. rlr F4o* oa
<br />I. rr o*hr ol rlr F,Idy. rh.k l!!rtl! .o r&ruu *ih li.nrJ .o rkt8 b on{M rh. I,.F1r rS.! ?(xl. Bulms
<br />rd Pnn.$rr(iilc lh.(tnlretn'sl-(cn!cl-Jwdocstroropl'lvn' .wncr ol F,p.d y rlr) hr,U!o. imtr)wr th.rs'n.
<br />rtul rh' codkr\r$r!(hth'Flr*[h.(i) h(rnnn lf,.n*ltJt^unr !,!h.(i'nr.(u r l-rc.cL.u)
<br />_l rm .r.mF lLkr Sat!n_, B. & P C. n thtr E $.
<br />o-Er
<br />-
<br />wotl(FRs' conlpa!sartoN
<br />tlEct aE6Io!
<br />I h.r.hy rllrnu lcr FuL y ol FJury oE dl ih. nnb*bt tLLl!.t i)ni:
<br />I h!v. an rrll mrdd . C..rfr.r. ol cirMd r' S.ll- ImuE l hrl.r' !r'r!r.s, r'n. .! Fsvrtdl lor h, Snri,r.l7mo(rlr
<br />tjh, (ittd, for rh. p.nolnh. or lh. ro* lor whrh rlE Fm L< !u.d
<br />I hf,v. rn(l*ill'nrurrm wo*.r'ro rp.tr GqurcJ hr serrrn r7(xr or rh( khr cdlt. i(trrh FYl.rnBc I
<br />wortcB (,mFn\,r'n
<br />'nsurrr. rxft.r drl F,l(tnunh.r Nl
<br />1 Fu..r,:-or - rq5
<br />-l..nrfylhrlhlhcpcnn.M.olrlE*orklnr*hrhrhrnrn
<br />n lsru.tl.I tlEllmr.n9l,ydy FR,. o.n, lMw
<br />$ ri h h.{om shFr (' rh. srln' strIEns.r k}. lrwi otCrl'iom, !fl1.8r !h.r dl rbold lE oE suhieci ro rlr
<br />*olt. urr{Enqr$n pmvtrbnt .l Srtion .1700 of rtE tihtr OiL. I rhrL ronh*ih rarltlly wrh rh,E FrvirsN
<br />NARNIN(; hrltrr. n, ccurc wttrlcr .oDpcn rnr udvcrrsc $,'l rn(l nr I nrh,lrr itr.tr,tl!,!.' b.r r 'rl Flrhr\ rl
<br />rn riEi tp n, oE hunlr.l rh)uqd ihnla (a((r.{Xro)
<br />{:'t'4'"-"^z=\
<br />I lrrby !finm und.r Fn ny of lErrury ill, I m l&lnrn undcr F'vtriror Ch.flcr I (a,nftBmE *'rh ScLli,n 7(fr)) orDivrn,n J
<br />of tlr ltuiin$ ril Pbf.n.nr Cdl.. In my h.n{ h r luu ftlE! arl .iler.
<br />,.,."..","..6 C\1 t
<br />z-<T-tT -,x
<br />coNsTnu(:rro* LF{DlNc A(;Efi(1'
<br />I h.rchy rlltnr unlcr Ir n{lry sl p.rjury rh, rh.E N !.{trdru.rirn Ldut rt.hy ld rh. FrlomEr. ol rh. *ort f!tr *hin rhB Fflr r
<br />Riuql (Se. 1097.(!r C ).
<br />AIILISAI{LDECLAAAIION
<br />Ih rryJrimrftLr Fnilry ot FrIn, otu or rh. hnbrrg J.(Lnik,.r
<br />Dcnx'l rn Pcrnnrs^sh.dor Nd'l'r!k,n Fc&'rl Rr3trldhn I l [1.4r Pd6)
<br />_R.qtrmJ lr(.rol Mr 'urrm
<br />I .cn(y rh.l rE fokal rc3uLlrrr Er.,tl[r .\tErnx Enlv.l e E{ .rrl..6b n) rh[\ lfl)Fr
<br />_l.d yrhr l h.k rr.l rhrrp i{r I 13r( k,(uhnly Bnh.ll (iry.nd (bu y
<br />o,dtr,,11.\,unl srrr. l.$\,.Lrtrrr ruihtrr.r.I,.(nrrr,r.\.lrtusC(y.rlCdu yn,..truF)nrh.
<br />!h,Yc rnrhmJ rr{xny l{tr
<br />ADplirinr..,\r.nl Sismru
<br />t,l.\A
<br />a-1.(-t{
<br />Set Backs
<br />Forms/Sleel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf looriVenVlnsulation
<br />Rool Sheathing
<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 />Flood Zone Certif
<br />FINAL
<br />Certif icate of Occu pancy
<br />Notes, Remarks, Etc
<br />r a Frrd.J lor tlr
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