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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNER BUII.T'F.X DF-LCARANON
<br />I herchy ,fiirm unl(r Ftulry ()r lxrFry rhi, I m .r.nfl rmm rrE Cnntalrn l.r.n€ ljr lor ilE nnl)*in8 M$n (s- 70.11 5
<br />Bo'ms sil ftof.Ixn C,iJ.l A., Ciry or Coudy shrh r.quiEc . Fmur k, !'n{tur- drq. irvrux, d.hhlh or qEn ry
<br />ntum. I'rnn) n|sl!m.. ds rcauir! th .I|pl{inr ror \En tEmr k, fiLr rsKj {d.mnr rhd lEor {E n 1ft.*d PUN! ,
<br />rn rhc lrovinn\ na rll Conrrlq r Lk.n*d Ij* (('hrflcr 9, comtrin8 wrlh Sc.'r'n 7000 ol Dilni,n.r nrrrh Borincs a.d,
<br />li,tc*n,n\ (ixk) or rhai hc or \h. ir.r.htr rh.kln)m.d rh. hasn lor rh..lbtcd ctrnlPr{,n An, rnhrrn of SRriin 70.1I t by rny
<br />lprli.0tu tur r |](r.rir{rb,..h rh. {!plicanl t' ucivilpcMltyornot mncihrn lle. huiildldoll \(551 ).
<br />_1. a\ o*K ol rtf, fl'Irny. or ny cq,lnle\ * h *rrc\ !\ rhci, slr dml,.tr.rri'nr. will &,
<br />'tE
<br />*ort ard l,E rlnd@ n rn
<br />inrcnlLrt ornncrcd n* {h rsd 7(X1. Burimslnd l\nlc$ioN Cod.' TIE (-ontrKttr r l.icn{ trs&rir rPtil} !, in dwk..f
<br />rlE Folmy *lr't lli or n\m6 ilrn,n, rirlr,&6uh*rthirelf o,hd{lf nrrhn,uShhi{{,hro*n.r{'bv.6.
<br />povrr.d rh.t \sh mFrsrd<@mr nr.nLd,x oll..tr] ftrsL l(hrN.rlrh manlqhtlm.r6s'UrirhmorFt
<br />of oit*irntll()lE Au brEiInarrrlEhon,.norFnrnStlstrEtrdEdnn{h'Uornrym\trtiFtH}ldtltJ!'FEof
<br />l. .r oqw dlrh. t'r'Ilcny. omcxclusivcly (onrrfrnl *( rh. lll.F (src ?(!,r.,nhm\\
<br />.rxi rtrltsrtr(i',1. Ih. r\nirr.rtr'\ Lk.n.. Ltrr,1,(ysh. huil'l\ or trnlrr.t rh.r$tr
<br />,trJ rl'!) (ni',,r\ntr!(l'tn,'lr.^\[l'i(itrtrrr,
<br />-,",:':;l'i;lJ ?AA
<br />t]Irr-\B.r.rr]:
<br />I turo ,r1 r
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<br />ll ntr'nrrin r Ccnif(rrc ol Con\ctrr !, Srll l.{E lir sorlur' (.tr,trtrsri,,n. ii pmvidd tu h:_ Sc(ir t rlx) ol rhe
<br />l,rhorCflh. nn rh. FrfornBncc ofthu *ort itr shRh rhc l(nnd s n\u.tl
<br />I haR sM will nr rnra in wdrlcrr conr( n\(r i,nr i'r{ur *c. 0\ rcquftd hy S.rr ii,n lTlX) uf rhc bhot C dc. ,,tr rh D.rlnnrunrc of
<br />rh. *ork tu shrh rh^ Irrmil is hqd. My rork(r .i,nEn{el i{,n in\unm..anr r Fntynunrbeim
<br />_l..nilt rh,r'n rlt p$rofluft c orrh. rorl nr *hrh rhr lC.nrr N s{jql I \hrll nor .n
<br />v) r! n) h..o k. nrhF\ r r, rlr (orkcri r.n,Bn\trkr 1.ttr. ol (.]
<br />*orlcr\ .onIrlAxr(n1t)n,vaion\olS..li,nr.r?(xrolrltrlnh
<br />wAllNlN(; I Jlrr n, !ruc \ror[c^ conl,).nerk,, (o\.rr
<br />.r,l rtrr!.'.rL ,{a I' ihnl'h. F.trnlJiill.r.'1lr*iriri'.
<br />:;:'eiiE;,5"-:;;
<br />I h(rrhr" Jrlntr,r'rna Fr lr) olttrlur) rh,( I J.r I1(cf\
<br />\(i)Jc xl nN lr( \.
<br />,vNxrol(lL', r (r(.o nrrk..rnB qirh Sdrntr Trxrr)oIl)'\si,n :l
<br />(l]riuf,tglI,x.LEtrlBli.A1ililqr
<br />I h.rby nmudc. JEtuhtof pcrJur' rhd ih.r ir. Lnneurirn tndinS !8.try ntr rlE F.imE o,rlt fiik r.r rhEh ihn Fmn il
<br />i\*.J (sd ll(,97, ( ir c )
<br />AIIIICANTI]DSAAAII!]d
<br />I h.atry rfnn u,xlcr Fnrlrt olFrpry ox oI rlr n'll)*nt dchrari,ns:
<br />l).mliri,n P.rnnri Alh.rktr Nooli.rri,n li.,.nl Rctulnifi lT,lt {r. f!n6,
<br />Rcqun.tl lrri.rof t* ilrdin
<br />l..n'l) rhJr rh( i(11(rrlrctuhrr,n. mg{
<br />I ccniiyrhrr I hrv.rc rhnrprli.irioi
<br />unhn,n $ 0ft1Srri.ljrr ruUrin! l{) huiLli
<br />rh,r mnriift{ !r)p.nt nn |rcr0nnu
<br />rBrr r).oi!ny sirI rll ( iry in(l (nunry
<br />^i,',"")'l,zl,
<br />,tppliEnl or ,lg.nl SItNluR ?)
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Sublloor/VenVl nsu lation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framino
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />lVlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enoineer Final Report
<br />Flood Zone Certif .
<br />A
<br />FINAL 2-214U y.\zfiL\
<br />Certiticate of Occupancy UL7
<br />Notes, Remarks, Etc
<br />I hrEbv afltrmufrL' JhEh!.,rp"pa "*.'r tlr r$Brown Coat
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