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BUILDING. INSPECTOR RECORD
<br />SITE-WORK ID/SIG.COMMENTS OWNDR BTJILDITR DEUCARATION
<br />I hdct, alI'm un& poidry ot FJury rhd ! m dmpr nor th. ContEcroE Lic@ l,w ror lh. follo*rr rN.]k 70 1 t
<br />Buin6r ard Proadion (.uL) An, ciry or aouniy whkh r.qub€ a Fn'r to @rEtuci. .lrd. in9rov., danolirh or EFn mr
<br />rlruct!.. rnr to ils isud.. .!o n+n6lh. tpplis! aor ruch Fmt ro nk. siSn d rd6E th, tr or dE ir lic6u.d p{Nor
<br />to lh. Fo\irh6 of rh. Conr*roi! l-icd!.d lr* lch.Ilrs I, Comdftins *ith S.nioi 7000 ol Divnion 1 ofrh. Suind dd
<br />ProldioB Cod.) or rhd lE o lE n adF 'hqdion..d th. t6is fo, 0E .lLs.d adFio. An) viohr@noISGr$n 70ll 5 by.ny
<br />.rrliunl for . Fmn rubdr rlE .prli(al lo . civn F tr of mr mr. rha 6r. hui&.d &'lbr ( 15fri)
<br />l. a osG of rlE poFit,.r mr mph)6 ${h qrs6 a rh.r $L @mFltiotr $ l&' UE *qt !n $. dd@. mr
<br />idci.d s or6.d f.r 5lc (S6 7Ol,{, B6'B ud ftlrairB Co& TIE Co ardstt#t rrL6Rx4pl}loaorcof
<br />th.F$Frt wt h,tl n nrF.6 rtE@ trl rh6 do6 sh trlt hi@lf or lE$lf or thtuugh h6 d hd o*n dpl$q
<br />rroriLd lh.r uh nlFoEEi! c d nd!.Ldoro&.d 6rsl.I[ lbesq.rlEhlildiB rEortu i! $ld rih6G ta
<br />of conpkioo lh. (xc Dunra r{l h.E rtr h,rld! ol Forit* d'i tE c JE dn d hrild 6 lrsDrr UE FDFq fi, tlr F,FE of
<br />L c o$ffi olrlr FEriv, m d.l6ir.ly co'nixlnu viri li.d!.d cotu cro6 ro w*trcr rtE F!j.n (sG 7o{{, 86t6
<br />.i P,oki{ Co<l: 'It. ( o' dor'r l,ic.e t * &,6 mr {,?ly ro m oq.s of pr.pqry who boildJ or impnrdIhsan.
<br />rf,d uho 6dk3 tu !!.h FtFrr wnh r (bnldo(!) lisEd pul:ld ro rh. CodMd 3 Licd& Ir$ )
<br />I &n.tmpr unJ6 s(r0n
<br />ulBr};f,ir0rttDtsarto!
<br />IECIJAAI!g!
<br />I hd.by amm uhdd p.nahy.l Fjrry on..lrh. tull,)$uU d*ldalioos:
<br />I hav. !*l s ill na'nta'n ! ('.nifi.r!. ol (irr6r ro sclf-lnsuc lor {0116 .ompdsatDn, N previd.n for by s(l n,n :r 7(x) or rh.
<br />l,abor Cod..lor th. p6romn(. oflh. sod ntr qhiuhihcpcmn is i,su.d
<br />I hav. and will nsinls8 $0116 .otrrt 6, n,n iBursNc. Es rquir.d by S<r ion .l7tlo or ih. I r}x,r ( i'd., nt rh. ld lnmMr. ol
<br />rh. qcrl n{ *t(hrhF Fpir( q|U6] V) \ql6'r.mFMnn '6r (cdo ril p!l'L) nun't{ !./4"#r'/ Co$ 1.$
<br />,'o,(yNumhq 46UAA/s$"/{ r\pr6 al./--.
<br />I cd,ft rhar mrhrfE(r.mcof rh.trorl fM *hihrht Fni ir B dI I ddl nor dpbr sv IEv,n m.n).rarE
<br />{ alo tE om. $bat ro rh. trnt6 $nlxMtn l&s of(rlifom6. ard afr rhi ia! shouE bc.om at d! lo ltE
<br />r6*c comFM Kn rnn upN ot sd on r Too of th. L.tu Cod.. I JEll. fonhtr'ith onpb n nfi lhs Iifl irnB
<br />wAR\INC faluE ro suc r$rld'on{Edri s\6rS. n ak$tul ixr $dl
<br />ctil tu6 ul ro om huolr.al rh.s.d &tlhs (tlm,tm), in ad,nsn ro rh. se of &m*6 a F.ritl.{ lot llE
<br />ii'Nurrft
<br />LllLNsf,DMr&tcfoa
<br />DI(LIBI\IIAI
<br />I ho+y tnm urds Fully orpqJuy thd l o l,cdE d !rd6 rrrrEion ofo[lrE 9(omrffi'u tr ilh S.dr'tr 7fi)) or l)'v,q,n .r
<br />oa thc tlusinG &d PrcfdFE (-o&. lrl ny li@ Lr in tuU fore &'d.fid
<br />r.i.d.cr&$: G '
<br />-'t1*W018
<br />Oc 9'x
<br />catliiau(.tlaNrrlDllclcttcr
<br />I hE.by rm.in ondd Frhy oI Fdl' , rhd rhd. Lt r oo rtu.r on Lndina r!6cy for rhc pdionM.. ol rh. *orl li,r *h(h rhrs tHnir s
<br />issu.d(Sa .10q7, ( iv ( )
<br />At8rlgtrLl)lOAAATO!
<br />I ha*yrnmundq Fnrk, olFJury oE oafi. follo*ins ddl,r io6:
<br />D.mlt6n PdnlA3lBror MI'fi.dirn [qjsd R.suhioB('l lc.10. Pur6]
<br />R.quir.d Inrd of N{'ft!Fn
<br />I cdiry rhr ilE r.d6.l rcsulai)E E8rdins Bttnm @rrl !. @r +pl&bh ro fib F!i<td-
<br />El cdr8 lh, I ha. rad rh! rl,lrd.i !d rd. rh! lh..toE infotuion i cord I BE ro of,ply $hh.ll ( !y.nl Codt
<br />otdina6 Ed srd. t B EllA ro build,B colEtu<rF& in ffit.rhoria iq.6.dniv6 of rhn Cny !d Cou.r' to anq Wo. iE
<br />aborr '6hEn proFn, ,G BIrdFi
<br />APpli.rni u.,rsor sisnriurr
<br />/2 -o, //4.r"d
<br />,^ffAtt o "l 2u l(l
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />UFER Ground
<br />SLAB Floor
<br />Subf loorNenUl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Eraming 20 lB 2-\ya \etxiX
<br />ln s u lation/Ene rgy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lr4asonry
<br />Pool Fence
<br />T-Bar
<br />H andicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />FINAL lBst 4 5 iYttllEal?'l
<br />Certificate of Occu pancy
<br />DATE
<br />I
<br />Erection Pads
<br />I
<br />Notes, Remarks, Etc.
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