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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNDR EUILDEN DELCARATION
<br />I lErcby .rrm und.r rEolry 0l rr,ury rh.r I d .rcrpr rNm tlE Grrrrh l-$nc trs (n rlr folb*6e Er$n (S.. rul I 5
<br />Uurinc\r dd t\or.$n,n Qn.) Any Cir, or C.ud, whih rcquid\ r IErd l,' r..(rucr. rlid, i.{row. d. ni\h or Ep{t 3ny
<br />iMlm. Fin t, n! i3su!E, ole rcqot.r tlt +pli{r IM rkh Frmn to fit d riErn ir.ftnr rh, lE or dE i! li{n!.n l[rsn'
<br />ro rh Envti,nr of rlt Conrdd s l-icnrd L* ((]I.tlln g. (oomftin8 *irh Sdrion 7lx{) oI Dirtirn l .f ilE Businc( lnd
<br />Prrctsir.r Cdl.r .r rh,r tE Dr sn isdctrnr llEElmmlnd rhc l,arn ror rh. dk8.d cr.mPtion An,violirio.orselDn7oll5by,ny
<br />rpplar.r ror . JEmnr ruhr.lr llE rpt'liom ro . civil p.Bh y or ftn mE d.. 6vc hrndnrj dolL,t ( 35{I)r
<br />-l-
<br />.r o$E of rL rnDFny, {, 6y.r{,br€r snh u!.1.r rlEn ok conlEndi'n. rill d, rlr qd.d tu rdlE ir rx
<br />ihrc k or nnaEd li,r €L l se 7044. Busir$ lnd hofcsi'rn\ Codc Trt Coftffrois I tcnt L,w do.r nor $nlv r,' 6 oe*r nr
<br />rh. F.Fdy eh, hiildl rr rrF,6 rh.m.In *h *6 uh qrt himal,{, Emlf or rthu8h hir or h.r o*r.'rihFi
<br />tftvil.d rhr( ru.h irtmEm r G 'x id.Dd.d or ontld fn sb ll hrtrw. rlE huillrA.r itrIlreEnrnr ir $ll qirhin oE Jtt
<br />ofdnt brra rlE ol,Er $uilld will Urr itr h,&i of lrvin! tlu lr or {E d,l mr hoill d rymE t E F)?dry fo. rlr FIFE or
<br />-1.
<br />a\ o*E olrh. IxorEny- m.r.l!\iv.l,.onkdin8 sirh lt.ost conlrdo^ tr cDnnM rhc lr))cl1 lS< 704i1. Bunrcs
<br />ad t\ot:alin (.i.: Th. (bnr-bar LtcnE Lr* des rn 6I,Ily ro rn o*mr.l tmlEdy *ho ttitdr or impiln.( !h.G'n.
<br />ind *h, conrdhlor r$h F,j.ir rnh r Conrtul,ir laro€d purud rorhc('!drd.r'r La.nE lrvr
<br />;:""1 )srllr
<br />l[l-L.ltsrra)
<br />I h.rchy ullirn uMcr |xnDlrroft{rjuryonc orth. nn[,f,q n.chrnri,n\
<br />-l
<br />hlw ud qitl minrlin ! C.nirkd. orconknr to s.tf.lnrurc tu *rk(r conlF..rion. rs Frviicd for brsftrio..1lm ofrh.
<br />riEx C.n , fo rl: FrlGnrN of rlr *dl rd lhkn rh Fnn ir i5iucd
<br />-l h.E r'! *ill ruinrrin wort6 omF.sli'n iFrrrr.. r\ Gtuiftrl bt strthn 17(r)otllt Lrtd Gxl.. ror llr FfodBt or
<br />the wort r'or which thir pcmit r ks.rl. My qorkc* cotrlrnqrirtr in:uda. cMhr !d Flic, n!ml'.t &
<br />Poli(y Nunrbcr
<br />-ExPtcs:
<br />-
<br />l.dify lh.l i.lh.IEformr. r,fll! *ort i(tr whkh rht Frmii i! krucd.I ricll n .(ohy lnt IE.$n in an, Mftr
<br />$ !i lo h.Nm ruhr.l ro rl! wo*6 omFMsn Lrs orctliLrmn. rd ts@ rhd irI .llrld tE(r lubFr ro rrr
<br />m.tm.or{rnqrionptuvirhnofSdthnlT(nofllEL.htrOnc.ltldlronhsirh('r{'ly*ilhlh.tmYiri,ns
<br />WARNING: t.!tuE k' sE vortcB o,nlherion owEs. ir uLetul, .d !n rur,F1 s.nphF l0 siminrl Fdi\.nd
<br />cnil fin.\ u! n, ok hunirt{
<br />;::qllig
<br />th(i^,trri,1,,1|.tr\ r( llxrirr)r r ,t,t , rh. .rN of.onp.n$n,n. drrD8.s !r rovil.d f(, ltr
<br />tt!I.B,rua!
<br />I lEEtyrrrtiond(y FMxyorFrr,y th,l I im rf,rn<rl u cr I'I,$i,. orChrflt
<br />oi rhc lrurinc$ onil Pn'lcsion\ Cod.. ml my li.cnc ir lullnrceelcflccr
<br />rminS *irh S&lrr rUXr) oIl)ivai'n r
<br />rl)lullllJll]lt.LEllali-aqElrcr
<br />I ltrb, rfrm u'i<kr FEll, ol Frjury lh.t rhE t r on{ru.li,n k.di.8.$ry tor Ut Fr(ffi of rlE sirt for rtth rhir Fn a
<br />hslcd lscc 1r97.Civ C.)t ndd r Nrm
<br />AIELUANI.II&CIAf,AIII}!
<br />I hdrlly,Im uftld FMXy.fplrruryorc olrlt folbr'n8 d.{lr.rlni
<br />l)cn$liri)n P.rmirr \h.{or Norificlrbn litlcrul RcBular i,'nr ll irk 4). Pd.,
<br />l{.,ttr,(J 1.1tr ol Nor'lnrir
<br />Icdrlylhd rlx ftncrrl rciuLii,ns rsu]nrs !\tt{o( runvnl.rc R r 4'I'lrabL k, rhi! l'n)jd
<br />l..nitylhr I ha\r Ed rhi.eppla,ri,.ltin.rcI rlEltrnrinfondhn 6c,rd l.sKloo'n{,lywnhrllCiyrdCounly
<br />.dinrRcs lRl srurc Lj*r rchrm8 r. trildinS sl h.(hyaurh,n,c rcrcenhrvc\ .l rhr Cir y e i
<br />lhrrc mnriEd lforEny
<br />ApptLDt o. Alt.l SltB
<br />PmllF rm (pri ):5 ar,d ra
<br />{r-l Ir
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf looriVenVl nsulation
<br />Rool Sheathing
<br />Shear Wall
<br />Framinq
<br />ln su lation/E nerqy
<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 />Enqineer Final Report
<br />Flood Zone Certif
<br />FINAL Z 7/r,t///?3r/,1/z-/a,
<br />Certif icate ol Occupancy
<br />Notes, Remarks, Etc.
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