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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNEII BtJILDIiR DEtI'ARATION
<br />I na*D iffm und.r Ftlry oaFjury rhd I m qq,cr fnD rhc (\drrlod' l-i.G lrs lor rll f.lloshs la. llid ?Oll 5
<br />Bsb63 rd Proadion ( cjc) Any Cn) or ( tudy shth r.quic . FdDit to odrud. .hq. impio\ c .ktmli6 or rcrff m)
<br />{tud@, rd b 'rr sud... rbo r.run6 Ih. ,{iplicdl for ruch r6n( $ lil. a risn.d 3uidndr lhd h. or sh. ir l( .d fl;uu0.r
<br />to rh. rmvisnrN ofllE Co.lrrlor'3 l-ic6!.d hq (Chl]nd 9. Connftirs silh S.clon 7000 otlhis,on I orrh. B6'n* mti
<br />PmfaaN Co{i.) or rhd lEd 3r. iiq@F rhiefrod rnd rh. h6a for rrE alLXcj adFid. Ant rirLlion of Sdion 70!l Jb&)
<br />appli(. for r p6nn 3ubj<r! rh. rmlir.nt io ! .iv il pork, o f nor frrc rhd li\. hundr.d rnllles (1500)
<br />l.ao\Eoalh.FDFiy.dmrcnptlBEnha.36EdEnsbcoavddbn.*ill&tlE*qt.ntlE*Elcitr{
<br />inarral orolr6.d fm eL {S..7Or4. Bu!6 dd PDrdioB Cod. IIE Codrroas l,a.e l, {bc nor +pl, k' e o"a Dl
<br />'h.
<br />prnrdy wh builds or nnFold thd@l\ rnd slh dc sh Nlt hin!.lf or h@lf or lhmu8h nh or hd om .mploy6.
<br />trovi.lql th,l sucfi iEFalqErl e ml irod.d.. olH t r sL r( hs6s. rh. hrildiq o, inprcl€lrd it $ld sihin.E )u
<br />otompkrF( tlE (nE &rBa *iU l*r lh. hda ofForr{ tlu ,E n rlE dil d hild or irFor. dE FDFry to. dE ptqpo* of
<br />l. a t*E ofllE p.!pslt, B crcbn cly cod,.cr'ry q nh li.as.d (odr!.loE
<br />'o
<br />mlgrud rlE roj.ti (S(. ?Ora, ti6llB.d Artsin co+: Thr ( odrdo l-(.@ tr* d.c tur rp?|, r. d ornd df FoFU *lr bdildr or mpmr6 rh6sn,
<br />.nd wio codet for ruch FD].dr *nh . Coddorls) li.akd plud b rh. Conrdoir Lic.E ljw).
<br />I dn.ropi uaLrSd!(,n .lr & PC fo.rh6r@n
<br />D.r. onner
<br />ILlatrr&I:(auftrtargrDig:laAIlQI
<br />lhd.l\ amrn und6 Fnalr) ofFt6 rk ofrh. nnL\\mr &!l ari,6
<br />I h!!c srj s ill Einrnn ! CdrtEal. olcotrsr nr S.lf-l6urc In qorl6 comrdNd ion. 6 FovtrLd lor by sd ion 17(x) ofrh.
<br />L.tor ( ode ror th. Ffollffi. orth sori tm rhrh dr Fmn a isu.n
<br />I havcandq,ill r.aimartr rvoriG .omn Natrcn nsrranc.. s r.qutal brScd()n 1?0oorlnc l,at{r ( {,dc. for rh. tsfon s r.ol
<br />rh. (!'I f.n rhkl, rlJ! ln tr x Lasdl
<br />._," . th.+{*"t
<br />porrc'r,nrhr t ? f a'
<br />\h i.n ile,m..r'd dontr\ ndmh6 r.e"***,E4 fi(o ,.,.,,". .3 '/ -/*
<br />.-l.d$ryrh.l r rhc p6folr1rd.of rhc worl lor which lh8 p6nn s sru.d. I ihallnor dtloy dy pds. i. st m@d
<br />s B ro h<od. rut d lo rh! wlt6 NnFsdio( b*! ol ( rlifomi!. .nd ,s6 rhi if I 3h.uld bdom. srbjd lo rlE
<br />sbrt6 mmFdi,n FD\ uac ol sdiotr l7m or rh. ttl$ C.<le l J!ll. adh$ dh 6mdy f,nn rhE Fo\ tioB
<br />\'IARNING: Fnlur.lo sw *o.t6 comFFdFn m\s.sc is unL*lul. &d +.U suti.al & oploF ro @nsl FEiB,ld(N,l lnr\ up n, .nr htrnJ'd thousrntl ,lollnrs (tr100.001)1. idJirtrtr'o rhc.o{ ofc. rltBdnnr, d!n,,E.s rs ,n)ridcd br rhc
<br />Sa1iln 1076 ofrh.lrboi ( odc inrdd dd rnora' \ fd
<br />n,. , t.3o- t7 noo,*,
<br />I h.rcr,r rffm uojs Fahy of Frurr_ lhd I m ltr.$d unls ofchsltslrtcominr udh lEciion 7fi,) df Dririrn.t
<br />ol rhc ltusins Md Pht6sn'B Cod.. Md ny licd6. is rn tulllor(.0d.fl(t
<br />EN,,
<br />I h6$y lltm und- padi, .f prjury thn $-. i r .66ru.1nn bdin8 .gfty for ttc Ffoll1rMc of lh. mrl for s hich lhn Fnir ir
<br />is.d (s( 109r, civ c )
<br />AIfIICANI.aECIASAUq!
<br />I b.rht .trm !.dq Frny of Fj!ry oE of th. follo*hs d<L, ioN
<br />Dotul'rb. PmnrA3lcror trorifi. ioi F.ddll R.ruhlFN (TnE.10, P0d6,
<br />-
<br />R.quircd h16 oINorific&rion
<br />I I lcdrryrhd rh. f.d.[] E3uldiod Erdirr 6b6r ratutrle.hrrpplr.bkr.rhsFnFd
<br />\ffIL,t rru r r,",.,-a rr,! lprr*.r.r !n id.,hd ,h..h{c u.tunn 6cond r lsE,o@mnr)
<br />lrdlld6 !d $d. t^s EL!f, ro h,'ld'q s4ulh( rn h6.b) dlnriu E!..!dutrG otrh6 c('
<br />Jbow m6r.n d prnFnr ao, mp.n." p.F:/ , - ,:;,;;:;;;;-'w D..
<br />P.m,,(..n. (prrno: 7.. ,i }*cn llar*lt
<br />ad Cou.r) lo olq qx'o ttE
<br />- (-, o .t 9
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Roof Sheathing
<br />Shear Wall
<br />Framing 4tt /i? ) lv a 6 ?
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Depuly Final Report
<br />Engineer Final Report
<br />FIood Zone Certif
<br />FINAL q/Tq 17 J .11n21;1 8*
<br />Certificate of Occu anc
<br />Notes Remarks, Etc
<br />/ooqqgY
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<br />Subfloor/VenUlnsulation I
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