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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNER AUILDEi DF,LCARATION
<br />I hd.b, arm undd F .lly oa psjlry th.l I m .(art tum th. Conrr*oc l.i6g lr$ fo, ih. follo*,rs r.en ( st 70l l s
<br />B$'n6 an Prof6mn CdL) Any C'ly or Counly st'ch rqurc i p6nrl ro Nn rru<r, .116, nnprov., &trolish or r.IEn try
<br />$ru(lu.. Fd
<br />'o 't! su4.. d!. r.qun6 th. rppl(er f.r $.h Fnn ro nk d r!8ftd sr.m! rhr lE o. slE 6 I'c!*d poM!
<br />ro rh. FllEioE ot E Conrdoir Licoscd lir'(Chapr6 9, (osm.ncins wirh s(rirr 70LU of l)ivirion I oflh. trsin.s ud
<br />PbrdioB Cod.) or tha lE or !E b .\mP rhd.6om .d th. h.si! for rlE rlks.d .rq.Fion. Any r rol'lnn ol Sd.n 701 I 1 bj" my
<br />.p?li.d lor a Fmh $bjd! lh. lpplicml lo r cirr I pcnoll y o f Rn mor. lhs fiv. hundrcd dolle! (1t00)
<br />l. s ow orrh. ForEry. tr my frplor€ wirh r,!s6 a rh.ir $1. .onFEnioo. sdl & llE m d.d dE rrulu. i ml
<br />i arbl or oltiql fo, sL (sft 7o4,a. &!ilB md Pn'f*ioB ccL: Th. Codrd( t Lto& l.q'dB br +ly ro M orM of
<br />rlE IFFry who hril..h u mF!r6 rtEE( exl vho dE $ch Mrn hmt.la or h6.laot ttDqh hi or hn o*n anploy6.
<br />prcvii.d th.l 3u.h imF!!!E{! e Dl iioi.d u otu ao $l. lt ho6s, th. btd,r o. in!.!\ffi 6,ld *'thh orc }t
<br />6f6nprrin! UE ()lrG eildc *dl IEE rlE hd, of Foing d( lE n J'. dd ml boju or itrprovE lh. Fipory ftir 0. ,!rpo* of
<br />L s o*ffi ofthc F,Fry. m.rclNiv.lyco rdins wnh [c.ed contrdoRlo co'Erucr rrE Fo).d {Sd 7orl. ttaall6
<br />!d ltotsr Co& It. Conleroir Lic@ li* d.E Nr .9ply lo h 0$T6 of FDpd, *h. nuild! or imFrorB lhdNn.
<br />,nd who .odrel' for rch l,ojcl! wilh r conm.(s) li.d8 n puR@ k,rlE ('o rrlor!l.a6et trl
<br />lm.r.mq und6 Sdion
<br />laf,trE!5:(autlBlallq!
<br />DICIAIAIIO!
<br />I h@by rmrm un.ld D..!Iy of Dqtu] orc oath. follotr ox .kr!q, bN
<br />I h!v. d will Ei in. C6rifEa. of CoMn lo S.lf-l6m for srl6 strpddion. 6 F.ri.Ld lor bt S<ioi l ToO orllE
<br />t,bor Cod., fM rh. Ffolll,ft. of th. *orl for whth !h. Fnn ir Utu.d
<br />, trrc .nj *1ll n!inl!i. *ork6 cospqadr. iEurmc, I r.qur.d by Sd ion .1700 df lh. l,bo. ( od., for lh. pafontrucc ot
<br />ltu wor! for shich thb p€Eil a is,.d My uorl6 snFldirr i6l!d..ei, &n pok! nlmba r.i
<br />I cfiiry th.r 'r rh. pdtom&. otrh. $orl lor shah On Fmn is iro.4 I .lDIl mt dtb! &y Fsn i u! dee
<br />s B r. bdom eqd ro tlE "!*6'oBFsrbn Ls of (ilifom4 id lsr lhd itl 3luld b6odc lutid ro th.
<br />m*6' .oftpdslrion provGhN oI Sdlion 1700 orrh. tdu Cod., I irEll. fonhwnh cotrply wnh rr FlvirhB
<br />WARNING rot . ro s@ r.rta .ompddion orq+. ir lnLwtul. ud CEll rubj.d e dptotq b oinr.l Frhi6 Md
<br />.Nil lin6uproon hun.i.d thousrl d.lls (t100,000). in addirioi ro th.con of coEp.eriotr d,nBs6 a lrorilal fo. ih.
<br />sariod 10?6 oflh.l:tor Code i s.n.,n donEy rt6.
<br />_ _ Appliorl:_,- - _.
<br />U(IMED.CQNISAI;ISA
<br />OISJAAIIA!
<br />I h6!t r tllnt unda pquhy or rEjury rhd I m n.6!.J undd Fovtion olCntfls 9lcomsi.c wilh s.clirn 70(]()).aDivisn,n:l
<br />!a rh. tls,lE !d Prcrdiod Co&. tri ny lE.G i! m tull roc. in dT(r
<br />CANIiIAUqUOXIENDIICAGEICI
<br />I halty lrm ldla Frty of Fjuty rh, r,EG ir . @ldrucrb. lai4s rS4y for th. Ffoffi. of llE Nrt tor rtlch lhs panit u
<br />is!.d(sc 1097, civ c ).Ifio'r Na.
<br />AIIII(AIIDE(I.Aa^IIA!
<br />I hdrq drm u6dd pdrhy of Fdjury orc o f rn. nnbe int d..lsrt ioo3
<br />D.molirxrn Psdit' Asb.n* Nohficdtrr. Fdrd.l RclulrrioBl Intn0. P6n6)
<br />R.qu@d tard ofr*ri6dni
<br />I.61itrhr E ftdsn E8rl,lioE Egrtr!8 Bb<or rmr rl e ml .ppli.bL lo lhn FDjtl.
<br />I cdiry ltr I l&. 6d rlE Qplt rio. ed 31a. rhi 0E .bovc infoEuio. a .mai. I .gr* lo @mply wnh .ll ('n, ,.d Counry
<br />,{11tr n.6.'nd \L c l ass rcl,iiry I ,ftnru(1 iotr ar, lr.by rurho&c r.F.ddi$6 o f rhB ( ny dj Counry lo 016 utFn rh.
<br />ah . n6rnn.n FoFn! fo.
<br />.\ppli.r r or \Rdr sknrt
<br />tl ,t.o tr ^x-7- tt
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framinq
<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 />Engineer Final Report
<br />Flood Zone Certif
<br />FINAL 8-'?- t'7 .J)cl;1"oh
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc.
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<br />Erection Pads I
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