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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS O\[NER BtJII,DER D'II'ARATION
<br />I hdqr! arm unds Fnilty ol Fjury iiat I d crofl fbn rh. codr.doB' Lk.N k* ao. th. aollosi.s r.Mn (ss Tlrll 5
<br />Burin6. ind Prcrdion ( od.): Any (-ilt o. counry \hi.h r.qun6 a p6mn to conslrucl. 6116. impror., .t nolBh .r rqrn ant
<br />srruciu., Fior ro irs (umc. !ls. r.run6 th. ipgltut for ru.h pcrhir ro flc ! tr{rd srdmo' rhd h. or !h. t licG.d poB!n!'
<br />ro rh. ForiiirG ol$. (iintdor s l-i..m.d U\r ((l!t'rd s, (-ommtr'ns trnfi Sccltlo 7(tn oa Dirn6n r or rh. Bxsind and
<br />PmfNi'N (-od.l or rhli tE or stE is.rofl lfiG.from od rt t6ir fo. rlE llhr.d.(<n!rM n) r(hrinofsdi.n70ll J b,.n\
<br />4,r,lic!nl for ! p.mn shjarr rh. qrli.lnl lo ! civil l).ult) or mr m,. thd fiv. hundr.d (t)l!tur i tt0o)
<br />L s osnaofrn Forlny, or my.mplrrc wilh war6 s rlEir $1. conFsud i.n, *illdo lh. srrt dd$crMm i! mt
<br />rln6d.d or o,Id.d f.r d. {SE.7O4{, B{riB dd Ptuls'oB C.de T]i ( odrdoir Lic.* l,$ d.6 mt epl! lo e onnd ot
<br />th.Fydr r ho hiild ( nlror€ llsun !n q ln &E sh $.rt hiElf or lErxllor rtmuth h. .i hd o$n mrlhlc.
<br />ForiLi rhi 3*h lilmr€dr e d d.i.d offqd i, sL ltt n6s. Etlildi'r or lrirmsEr i! r'H $rhn @ ta
<br />of srtpliff. rlE OsG 8lildd uill l*. rlE h,rl.. of FvrE $a & d JE dil d toild G i,p.otr th. prrFry for lrt Ftrpoi .l
<br />I. ao*ndoaihc pr.tqry. m.du!ir.l! cddrdinS snh Ii.o!.d conr.doBto conrrud llE Fmr..l (56. ?(x,1, IIB'.d
<br />In E!ftsi. Cod. l1l. ( o.krror'r I ic6k L.* d.6 mr rF 'l! ro u otrnq of ropdrr s hr bu 'ld! or mpk\ 6 rhd6.,
<br />md tr ho olnrtt lor o.h Fsids q h . codd.(, lr6n d p{tsd ro irE co rdo.! t.Ere lflJ
<br />I o.rdpr unn6 sethn
<br />vaa5[8l:caufEslarla!Df{IJAAIIA!
<br />I krdr rmmu.d6 Frhrof Frurt oNofrlrfollo ng 4(Ldi,G
<br />I h!v. d vill f,,ihrain . Cdia..r. or (i).knt ro s.lalmtrE f {.rt6r' (om!ftation. d provid.d for bysd'o. 700ofrh.
<br />hrDr ( od.. tor rhc p6li,M.. oflh. *orr lor whi.h rh. rsni n isu.d
<br />I h!e...d qill mrim.in qort6 .omFub. iEunE.. s r.qun.d h! s6!nn !?m 6f rh. Llrtr Co&, ror rl' tEfollffi. ol
<br />lh. {oll fnr \nth thi. Fnn 6 isld M) *o.t6 mnFdFn !B@..dir tn Flay.umrE ft: :
<br />l.sr,E rhar in rh.Ffonre. olrh. rorl fd *t!ah th8 Fmi i3 6.u.J. I nEll m! opb! rn! Fen in dr nuF
<br />s 6 to tEor *btd ro rh. $mld mnFsnnn bu! of (-!hfome !d *,r lh, if I ltFuld b<.om 3nt*r r. rlE
<br />u'o 6' .ohp.dliotr provlioc ol s.dnrr 1700 olrh. I rtry Co<L. I Jall. lonhwnh .oqrly lvtrh !l$r prolbiod
<br />WARNING: Failur. ro surc mrl6! .onpsslion ..vm*. t u.b*'tu|. Md rholl subjd u dplors ILJ ainn,l pdDhid tnd
<br />civil 1i..3 up io on. hunlr.d rhou d.ll6 (1100.00(), in .{tdnior to rh. cosr .r.onp.e!ion. rl,mr*d N ,rorid.n for lh.
<br />1076 ofrh.lltrn(oda hrcd el1-7o-11
<br />^
<br />r Prz,o\o
<br />I nfth,,mrm u.d6 Fn lry oa pdjuh- lhll I m licnkl und.r tror Bion ol Clupts 9 (..m.ihs vnh sdhn 7ul0 ) ol Divisio.
<br />ol rh. llBi6.rld Pi.ldioE co{.. ftl m, lk.M ir in lull lor.. d.fid
<br />,.'"."...r*, C-\O
<br />D.'e j -ao \-1,"",,."'".ruffi&rm-
<br />(o!$f,u(IralrfdD.lllilclltr
<br />I hddry .llm urd.r Fuly ol Frllry lhr rha. s . @dtudioi ladE3 {ft, 6r th. Ffollrltr. of th. srt air *iah
<br />'h6 Fmn i!
<br />niu.d (sc 1097. civ. ( )
<br />aPPLI( ANt DtCLtX flOl
<br />I Eurd amm und6 Fnslr, of pajury on. of thc folloNin[ d( ld ions:
<br />t}mohFn Pmns-Aststos Norificarion lcddal R.Suhrions (rirl.40. P!n6l
<br />R.{utrnl kr6 ol l,Jd6.ri.n
<br />I (6lrty thd rh. r.&ralr.ruhnrd r*edinr 6h<i)r rmolnlr. nor r0tll'(rhl. ro rnis rrol.d
<br />I carify rhd I h,v. rcnd rht lpplicarnrn &rl srar. rhlt rh. rt{vc inlomdi{'n B ..nd I alre h .onpr rnh 0ll ( il y .nd Counr,
<br />ordirorcB !d Sld. Iiu El!li,{ lo ln'ldrs codru.rirr lri h6.t^ aurlnrt. rqtlddn6 oI rhi. Cn} ud ('ounD lo d s uF.n rtr
<br />rbo\ . mr$n.d F.lEnr" aor lq,alir
<br />o ((,o rn g\ttz
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />Roof Sheathino
<br />Shear Wall
<br />Framing
<br />ln s u la tio n/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 />Engineer Final Report
<br />Flood Zone Certif /-\wuijH ldLxtl g-t6-17 v.tt{.ti1
<br />FINAL v-ti;47 Y,)4)U
<br />Certificate of Occu an
<br />Noles, Remarks, Etc.
<br />I ,"allDi1
<br />So\lr. )
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