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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drpvall
<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 /4tt? z -)/Zl.1vqz-x4z-1 )
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />OWNEN BUILDER D1I,(-A ttATION
<br />I hftby aIIm unds pqalry of pdjury rhd I in .rmpl tum th. ( odr..rd, Licc^r l-!w for lh. followh8 r@n (S{ 701 1 5
<br />BBin6s !d Fo,iB.n Cod.) Any Cny or Coudy f,hth ,<ut6 . Fdf,ir !o sdrud. !hq. improv.. & olnh or q.n dv
<br />3rtudue rior ro ils isu4!. al$ Equir6 lh. tpplitor lor .u.h Fm{ b lil. . tisncd rd.l6r lhd h. .r $. it licaE d Pur$rd
<br />ro rh. Fovi!6c of E ConEeld! L'@nsd li* (( hlplq 9. Comocint wilh Sdion ?000 otD'vai{.,1of rtc BcilE ud
<br />Prcf<ioB Co&) or rb{ lE orsn. n crdn,l lhqtftun !d tn hGi! for rlE dl.s.d qoF{. Any rhld io. of SElFr T0ll5 t1&,
<br />.tirli.er aor ! Fnir $bj.(l! th. .t'pl'.mt ro r cilil Frh y o f mr mrc !h.n li\. hu.dr.d &116 ( t500)
<br />l. s ow of dE FoFrr. tr ny mdor6 w(h Ers6 s $cn $k ompddion. \ill &, llE rst .rd 0E iidE it tEr
<br />[rdid.d o,ofiq.d a sL (Sa 70,4,1, BuitB od PtllBi6B Cod.:llE Codo.rr! Lrdg L.* &6ml.rPlylo Do\@ of
<br />tlE FoFry st hlilld u i,rFoG d!6tr rn *h &6 rdr s ti@lrot hdrlaor rlrou3h hn u lE ort dlphte
<br />F.vi.d rhd Mh i,sorqEi. c d irod.d d offt..d 6r rl ll bM, dE hj rrlE d in!.offi i! sU *tns .k t-
<br />of oipliiE $cO*E hiEs wil i6t rlt hrrk oaFolie di rE o,lE dd ml hdd d ut !E d. FoFrv 6.lt!. FrFeof
<br />-1.
<br />so\rE oldE FrFry. m qch8ir.ly co'rr-liis snn U.q!.d.on-oB ro o'sDct llt FF (sft 701'{ &!rB
<br />En PtDk ir Cod.: Tt. co.rdor't Li.e hr d6 mr sly lo - o$G .f FoFt, s lF t{ild! or inFo\€ lhaotr
<br />rhd *ho 6ffi fd 3kh Foixr! wnh r Co'tb-rd(., laaa.d Fl6lar 'o
<br />lh. ('odr..ld'r Ltd r^)
<br />I m.rdd un& sd.n .B ltPC tutlrd.n
<br />D.t. Oind
<br />]!!8liE!Lgru$MAl19!TISJSAIIA!
<br />I ha.br amrm ond6 Fshy of lqury on.6trh.lollos4 J(lt.rn'B
<br />I h6!. dn willMi lin . C6lifqr. ol CoMr b S.lal6ut. fo. sor kdr' .onlFnrxon, c F.vidoj for br Sario. r7o0 of rlE
<br />kbor Codc. for th. Ffollwc of th. mtt fM whkh rh. pchn b is!.d
<br />\ h . ind r rll maoEr wo . coBp.Ndrn rMumc, N r.quir.{ h, s<l ion 1700 ol lh. llbor Co&. fot lh. Ffol:rl&c ol
<br />rh. {ork fo, qhi.h rhi! pdnit i! is.d. My wotkda Nnpdldion aNure.. .ri6 .d policy oudbd d.:
<br />evefuEf\ }.,h-ll.r,qL I r,!,(tAr.r,c co
<br />Tboooo 7 q z*rAl
<br />-l
<br />cdi& rh, in thc pdaolM. of llE sort lor $hich rhB Fron n isu.d. I rlllll ml oploy uy pqsn ir Dv n.llE
<br />$ d b t4oft sbjar ro rh. wna' @mpauion h$ of Cdiaomn. &d .sE lhd if I rlhuld bcom. tubidl lo th.
<br />rort6 ohFrd'on pl$6bs of sdion l?m of rlE libor Co<L. I adl. lonhs nh omdy \ nh lhor Fnvitio6
<br />W RNING: F il@ lo c@ *ortd' @hp.sri,n s!@C. i unl&ful !d rndl Nhj.ti e dnploF lo oinind FEli6 t d
<br />.icn 6.d up ro oft fiundrcd lhousd do,ri6 (.o0o), in rldirirn ro rh. .on of.omFG.lion. dlEsB ! Folid.d aor llE
<br />sdi.n 10?6 .a rh. lll.r cod. inr.d d
<br />t1/tl/761 \orerrYn- \ t'tfF
<br />ul](L\&\lra]
<br />Fuly of FJuD rhd I m Fori.ir. ofchlFc e (onljffiirs s (t sarnn 7000) or Dirirhr l
<br />of rh. BBiB ud P,o63liod cod.. i.l o, lk@ i i. flll tnE,n.lYRl
<br />c6l ozq 5c+07<
<br />\^v1 t17o1$71-17-ep yfitf,{1, rvL.
<br />I hs.tD' aflm und6 Fslt, or Fr0ry thd Lndiig {rdr for rtE rEfotu. of rlE wrk ftr rlfth $a F{! .
<br />isucd (S< 109r, Civ C )
<br />AIIII(AILDIIIJAAIII]B
<br />I hatb, aIIm u.dd FEky ot Frjury o( ol lh. aollo$i.! d.clad ionr.
<br />D.molirion Pnotu-Arh.$os Notificilio. Falgll R.suliion! ( rnL 40, Fdn6)
<br />_R.qun rj laG oaNoli6c.lion
<br />r.gul,ioN Eading 6b6xr rano\ ol s. nol tf4ni.abl. to lhie prejd
<br />ran rhi, applicarnrn ltd nrr. rhrl th. !b(,!c rtunlulnrn 6 (oFEl I tsrch.on lywilhaI CnyddCo@ry
<br />. lrNs Ekiry ro buildrn!.utsrirc r.prBq!.riv6 ol rhii ( n, md Couily to dld ,Fn tlE
<br />tu r Ff-
<br />,",. la /'7-01
<br />b/ I /rotq
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