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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE tD/stG.
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Roof Sheathinq
<br />Shear Wall
<br />Framino
<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 />Enqineer Final Report
<br />Flood Zone Certif .
<br />FINAL )//y 5 \e ?lp*+47
<br />Certilicate of Occupancy
<br />Notes, Remarks, Etc
<br />OIVNI]R BUILDER OEI,CARAIION
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<br />I dmcrrnrr und.r S.din'
<br />Illxf,l;Sri.IlrllEENsarl0N
<br />]JECLAA6IAN
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<br />-l
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<br />t'olicy Numh.r
<br />-
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<br />D.l.: Appll t:
<br />t tcrtsElr t-tnrttcltn
<br />DEII.ABAITAN
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<br />* h Sel [n TllrD of Divnln ]
<br />ur rhc Bunft\\ r.d P,ori\i'n. C,ik. .d nry lrc.r i( in full Ioc a,n .ff(r
<br />l.'.cnsc (-Lr$
<br />qtNsrxJJcuaNl.[ DlxlililN(I
<br />I hcnh, amnn undcr trtrilry rf lirrtrry thrr rluc n n con(rucr0n Lftlins lActuy n{ rh. BndnMNt ulrhL rorl |,tr whrh rhi\ Frnn .
<br />isucd rSN 1097.C't ( )
<br />bndci\ N,m
<br />-
<br />Irndci\ Addrcs
<br /> PPI ICANT DECT-AR TION
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<br />-Rcqund
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<br />.r-!cm rrc{)"(n.F!
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<br />xlron rri {rr. !tur rh. ,lntr infomr$n r cm&] I d3re t' orqriy triih rll cirtanl coonry
<br />r )_ lll ( oun!! k, ..rd upon rh.xr url h.r.b! aurlr,rnc tc,r.€ndnB ol
<br />AppliEor or,lrenl sirElum
<br />"-"*\y D Le t4 V.i tda4uo)t h)oe/2_,11y
<br />COMMENTS
<br />I
<br />Subf loor/VenUl nsulation
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