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BUILDING- INSPECTOR RECORD
<br />SITE.WORK COMMENTS OWN ER BIIII.DER DEI,('ARATION
<br />I h6.bv.mrn undd p.Mhy of Fju.r rhd I m doF fmm rh. Conkd.6 LicN lrs for th. folhrms r.en lS( Tlrlrl5
<br />Busin6i !ft1 Prolsrn (nd.): Any C y or Counry uhich rcqun6 a Fm( ro .odtu.l, ih<, mprov., (tlnolilh or Errn uy
<br />tud@Irsr6ns nrue.,.L. ra+n6 rh. rppli.er n s.hFni ro fik.si3n€d slddEl lhdlEorrt i! lico!.{ nu&lrn
<br />ro lh. FrsF6 otllE (i,nrrrtq 3 l-(d!.d lr* touFd 9. Colllll@'ns *i'h sdio. 7(xro ol Di\issn 1 of rh. ltur.N r.d
<br />Pr.f6bn! ('n&) or rhd lE.rih. n.rtr rE.nom d rh. bd. for rh. .,lqal .rdplhn An! ri.LlionorS.dnnT0ll5 hr M)
<br />!Fhc. aor . Fm[ suhJdr lh. appli(.nl lo s dvil ,6.hy o f nol mor. lhe fi\. hun&.d drlt&! (5500)
<br />L ii 0*6 of rh. F\'FrU. or nv @phrc *irh w.s6 a rh.n sk.omFoio.. $ill &' llr $int an llE rn(lE t arl
<br />idarddl o. ofi6.d for sL (s( 7oat. B6ilg sd Pr.fdhB (-od. Ih. ( odr-tc 5 t,rm l,w &!6 ln qtlv lo e.$G of
<br />ih. FDFrt uls hl dor urqo6tlEEd. !n rtF d,6q-i *tr hi@lr.r hd*laor rhmulh hn or kr o$n mphyc.
<br />rovli.d thd uch nrot.rd3 @ d ,{r'.Ld m ofir€d tu d. I[ tns6!.lrr tlitliry tr ltqoEEn . sld sab!. oft rd
<br />ofompkbr llEO*n6 a!,tllr wil h,w llE trrik ofFivinglllnlEorslEdilmlt tjor imlilwllE F$Fiy fr'r th. FnFc or
<br />l. N o*c.lrh. rrpd'!. m dcl6n b codtdirs ui'h lic.B.d conrt1m ro oErrud rrE pmF( {s( 70.1.1, &6 6
<br />rfi1 Alk Co& t h. ( onrd.ir Li(6n hr d€ mr ,{?ly ro e o$nd ofFrpqlt ufi. tdil& or imrn.\6 thsFn.
<br />ud sh. FftBclr for ru(h E!j.rr! qirh r Conl,n:ro(r) licdsd F5uln k, rh. Cofrr<r.i! l.k!e Las)
<br />lerc\.my nnds S ion
<br />D.r. ()..d
<br />Mlil;a!_(Aufftralloxal:giaaua!
<br />I hcrchy!mmundd p.nohr.f Fj'rr' on.ollhr lollo$ll'3 d(10r.lio6
<br />I hA. !n
<br />"
<br />nl mrnr.i. ! (-difr.r. of ('oMt ro S.lf-|tr$r. for sr.t4 mnpssslioo, B rFyid.d tor hr s..li.n l?m ol rlt
<br />llhdr co<t. lor rh. Fr(tu. of rh. tr d nn trhih rh. Fnd a ie.d
<br />I hav. .nd * ill nrinr.in *ork6 connnrd ion iBu..R.. B Equn.d b! s(l ion 1'700 of rh. l.5b.r Cod., lor rh. Faomft. of
<br />th. wo ntrwhichlhi! p.mil i! issu.d MyworkGi compdn ion iBurdc..ri6 Mdplrcy.umb6d.
<br />I ccn,Irrhar inrh.t6r.nn!nc.oIrh.sorl f.r whi.htln p6mit is issu.d.l rh.ll nor mlll.v.ntpdson in.nvmen6
<br />s 6ti tErom. h.r' n'rh.$m{d (omtEn$rion l.$.of( ililomi& ud.8rrhd iflsh,uld t(om.rut 6r iorhr
<br />r 0*61 ..mFNr i.n r.ri.hB oasd i.n !?m .f lh. l,lF ( oda I sl[ll. rMhs nh Fmd\ \ h rho< lrorilkr6
<br />\l RlII\(: li.'l(r b 6ur. \ort6 dnnFlsnsn (\Gq. s u.h\tuI. rnd 3ubrd e aphtq '.
<br />(m'M! FEia rnd
<br />comD.n-tion. &m.*6 .s r,orid.d nr ln.cnil nnd up io oE hundd rhoN.d dollB (llm,UDl, 'i iddirion r. rh.
<br />sdrb..1016 orrh.llhn (odc imdd ddronrr-s16x
<br />I hdchr rfin'n und6 n f,rlt\ o{ p6luD rhd I rn l'.o\.ri trnlr ol( tiirtd 9 (.ommd(inB $rh Sdhn 7($0) ofl)nRk,n 1
<br />.l rh. lr'Rines Md fm lBrions (odc. . mt licGc ir rn nnlforc. a.d.fl(l
<br />(
<br />I lErt] llrm !.dcr Ful) .f Fjur, lhd llE. i3 ! N,rnrucrior
<br />is.d (sc l$7. cn c )
<br />4ftr for fi. Ffoll1m. o I rh. { o' I a.r \ nah r hir Fri B
<br />AItu(rlfDl;EIABS.lla!
<br />I horb irm un,jq f6![, .f F]!, ,- .n. . f rh. folkn! 'nt ddlrlr ionl
<br />D.molitnr Pdmiis-Ash€knNolilicalion l:d6rl Rc3ulati('N(ril.!0. ran6l
<br />Ralutr.n tnrr ol Mniakdi)n
<br />I .dt'6 rhd rh. fdLr,l Gruldirtu r+rdlnr
<br />I cd iD thil I halc rdrl lhit rmlic.tn'n i.! n d. r h\c innrndri,)n N.ond I l!.L,e rr, NDnl! \urh tr I ( i\ ind (inn v
<br />oidinanc6 i.d slr'. t:$! rckin{ ro tuildrn*.o ,n hE.b .uh.n,. .crr.gn, ivB ofth's Ciry dd (irunryro drd l'rrrn rh.
<br />ali\. trhrk,n.J rro[l.ir ntr 'nsltmn
<br />,\pplic.nr or.1*.{i Si* ure Lkz ,2 rh,.
<br />/--zo€{_1
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathing qt 'a lt > )r.r' i;-.i7, kZ
<br />Shear Wall
<br />Framing
<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 Iil.tt tl 1 *tu.,.;nt '"\
<br />Certificate of Occupancy '
<br />Notes , Remarks, Etc.
<br />I DATE I ID/SIG.
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