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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNER BUILDER DETTARATIoN
<br />I hq.t,) .llm un& Fslry oaFrjury rhd I m 6@F t o rh. (hMalo6 l-a@t u for th. fouopin8 lwn tS€?011J
<br />BBin63 drd lYoldtun Co&) Ary Cily or Cou'n, whi.h ..quir6 ! Fnil |o sn!ruci. tts. i69rov.. &,mlirh or .qu D,
<br />rrudE rir ro iE Nue.. ilo ,.qurd rh. Spli.dr tor {ch paiiir lo ih a s{i.d ddmr rnl lE or nE i,s liccn$d Duo,
<br />to fi. ptuvilioN of tlE Conrr.doa! Lta!.d t v (Chrpld 9, Conmftr8 wnh Scdirn 7000 ofDivBio, I ofrhc &!i.6.rd
<br />Pn'f6hN Co&) or rhd h c JE i' smF rhs.from ud th. h.ris for rlE dksaj .ronfl ion. Any viohion o f Sal hn 701I tbyM,
<br />aprlicant for o Dcmil Jubjd! lh. .r,Dlici lo ocivilpmtyof rcl mr.$d lir. h!.dcd &llar (t5c0)
<br />I, s o*n6 of rh. F)Fry, or my mployc wnh r+d s tlEn $k rcmpdsrpn. *il &' llE *st tn {E i^E!( it t{
<br />doxLd ororqcd fo, elc(sa.?01]1. Bcina ed PmrBbB Cod.: Th. ( onkrdor'! Li.dg t wdo6mlrpplyloso$n6of
<br />th. FDtdt wlb bu'llt or inq..\€ dEb( in wh dc ffn Nli hinklr o. &rd r or llreush hn e lE o*n 6rrh) c,
<br />Fovid.d rhal $ct inFo\EMrs e mr i.toidl ot otrsql tor sh. lC hosdr. tlE ttrildans or iFFDtdE n sld *irhi. o.. ,6
<br />ofcotrphntr rlE G{E ao'tla *ill ,EE tlE hid6 of Fo\ra rL lE n rlE dil B1 hild .r lrqn\r dE rrcFry tr th. FrF* dr
<br />l.do$n6ofrh.Fnpdy. crclusilcl, cortrdmS *nh hcd.d conlr&1o6ro rctgrucr rlE FnFr {Sr 7(x,1. t}a!6
<br />!d Pr.ki{Co& IlE C."r,*lof ! Li.cn* l,w do6 mr r$ry ro e ownd ol FroFny who build! or imp06 lh6(n.
<br />lnd $nr cldfrl! for iurh rr$F! wnh. (otudqr ltdE d p!6d b rlE (t,'rrxroi! l.i!e lr*1
<br />I .n.rmd un& lidn).
<br />D.t. O'rE
<br />ltoRr(ERS', COrlPli\Srtf t(rfi
<br />DDS.ASAIq!
<br />I hd.br rmrnr und6 rcmk, o f paroD om olrh. lLnbtr t.l3 .ktled kE:
<br />I h.\. id tr 'll mimsi. r cdifkdc of coler ro s.laJNE fttr $vt6 .otrqEsdion. s Fovd.d fo, by S<rFn 17(x) o f rh.
<br />llh^, CLd., f.r lh. pdrol:1@. .f rh. $oi. lor lt(h rh. Ffr n i\u.r!
<br />I hav. and sill mihhin r o.k6 conpssrnn iBurR.. s Equt.d b Sar m 3700 of rh. Iihor Cod.. for th. Ffo,fuc. of
<br />rlE vorl for whi.h thn Fmn ie is.d My work6 conFnr.lion iBumc. cmq &id ,olicy .udbd @:
<br />I ccnifyrhd in rhc p<fo.tuDc. ot rhc qorl tuq,hrhrhlrFBi E nsw( I lrullmr mpbrot Fe. ine' haF
<br />e 6 t' h<oft sut*i' t rh. $sltd omp.Mion bsr of crlif.mi,, s'l rer thd if I $ould bdomc sbjd lo lh.
<br />*o.td snFuno. For6ioc oasdrn l?0o ot
<br />'h.
<br />Llhr co{,., I CEll. lonh*nh compl} * 'lt tlo. F irnr6
<br />WARNINC ljlilur ro sur wo.L6' comp..snnn covs6s. il unlrwful, ed d'all3uhjel d dploF ro ominll FEhF i.d
<br />c'v,l n.6 uI ro oE tun&<l r&'u$d dolld (tllr.000). m rddnx,n ro rh. oc of ..hFMion. d.in *6 d Fovid.d for lh!
<br />S(ton 07(r..t th. llhor (tdc. nt66! ed
<br />,,.," Jl7ll8
<br />^
<br />.'T ilxl-l---tl---
<br />r itiFsr oi'iirr n,v'rol
<br />Dfln&llta]
<br />I h.dty rrtrd uhdo FEh, uf Fju) rhd I m lr6r.ri unln Fovtio. olch.pra
<br />ot rh. Buds ed Prcra$d Co&. i,n my h.e 6 h tull aorft in dTrr
<br />3l'11 tB
<br />coxirailglall.lElDrlqaaEr(r
<br />I @ rnm u.dd Ful', of Fruw rh! th6. ir. o'dulion lddins lstry for lh. FfomM. olrlB w.rt fitr whi.h lhit tEmil ir
<br />'*ucd (sd t097. ( ir c)
<br />ATIIIIAULDI;CI.AaAITO!
<br />I l*!'*.trm undn Fnrh) olFrury oE or rh. folL*in!.l6h. i<'a
<br />D.m'l irn Pdmit!-Asb6ros Nor'll.rrhn Fcdgrl Rlsulaln'nr (1 ill!,10, Pin6)
<br />R€qurd lnlrof Nolifi cax,n
<br />I cdiryrhat rh. la16dl i+uhi io6 rcledh8 ah-rosrdhoslr. R apPl(rbl. h rhis ptur.d
<br />I (di6 rhd I h,!. r@.1 rhis .pplEari)n ed srdrc rhd $. dl c rnlomrk,n rs c.tr< Itrcto(tmrlrrdhall(-i't.n!(-oun!!
<br />ordiMm6 ani sbr. l.rs Ekr iry ro hlldirg hach! aurhonz. r.Fc$rariv6 ofrhi3 (irytud cou.tyro ord utFn $.
<br />dh\.morx,n.! ptuFl, tu GFdhn
<br />appoo* o..r1-, sg'."- fy *" 3lt lr ?,
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />U FER Ground
<br />SLAB Floor
<br />Subfloor/VenVl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing 1-L'('tg JJ.J&,fvq)
<br />lnsu lation/Energ y
<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 />Flood Zone Certif.
<br />FINAL B 'x7 -/8 JJe{s}{vA
<br />Certificate of Occupancy
<br />Notes, Remarks, Elc.
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<br />I4{,.=
<br />Set Backs I
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<br />Engineer Final Report I I
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