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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNER BUITl)ER DI]LCANA'NON
<br />I h-.by rmm un&r Fnah, of pdjury thd I s .rmrl fmm rh. Codocro6' l.'.ft. kf, fo. th. folloqhd r6,n lsd ?011 5 .
<br />Bsin6r .nd Prof*ion (o&): Any C y o, Counlt. *hf,h r.qund t Fni b c.dru!1. .lrd. Inprole dt noltsh or rgtrn at
<br />strudm. Irnr to e nruMe lho r.q 6 rh. qDlkot for such ,.m ro fr|. . r'rtd 3rd.ffi! rnd ,E or slE it hcd.d pu&u' ,r
<br />r. !h. Frnnio6 oa E Co.krtoir l-Gn<d lir' (Chtprd e. (.mnfting $irh S{xon 70m oa Dtrs6. I ofrlE Busi.d !n.l
<br />Pmt sKf,!Co&)orlh.l lEor!h. n crnq, rhr.from dd rh. baiC tor lh..lh.d ddFrn Any rioldio.of Sdi.n'7(r!l 5 b!.n)
<br />aprl'ca ror 4fn( sulr<rt ih. .prlicrnr u . ci\ il F..hy o, nol moE th$ fiv. hundr.rl rt,U6 (t500)
<br />L N o$c of rlE EoD.ny, o. hy ophlG * (h $'36 e rh.r $h comF\dio., $ill &i dr $ltl t'd ltE idE 6 nor
<br />iddri.d q.Fqcd tu $l.lse 7044. auilrd ed Prefddd cdl. Th. ('odrxl il-tetrr66rctrpplvloeo$ffiof
<br />rh. rroFr! sh.lx[cr.r nFb6 E@ rd *ho dG $ch sld hiN.lf or h*lf or lhFush hi! d hd otrn drloyc.
<br />proriLd rh.t i!.h mproEE i! E rcl ,ld!t d orofiU.d 6r !]. ll h.$qq,llE biEit€ or in{frvaH n $t] *lhii R }s
<br />otodgLiF( dE O*G B!ld6 *ill lbn tlE hda otFDmS lhd lE or sl'c dd d hiLl m i,ttmrt fi. Frrry hr ih. pt Fr of
<br />l. 6o$ffi oath. I'lrdy. M crclusir.ly c.ntdin* r irh li..6.d odrxlos ro Nintud rrE Folal (Se 7O$t. aui6
<br />dd Aefsir. ( od.: Th. codrrlor'r Lk6k l,!q doB ml tp?ly ro otr.6 o f F.pdly sho b{ildt or ma*o!6 rhdmn.
<br />sd {lI. codracl! for ch F.j.ft *nh. (t'ddorl.) lksE { Frl:d to llt Coddo.r Lice l.wl
<br />I o.r.mpl undr S(h.n
<br />D.r. ()nn€r
<br />\l oRxtsiiri conrPrNs^ tloN
<br />DEqJAAIIAT
<br />I id.i^ o,lim und6 p<nrhvofp.rure...ofrlE folkN in* &rle.lionr
<br />I h.!r ad srll m'nrlu . Cd'frar. of ( llEdr to s.lf-lEur.f.r *olt4' comDftlarFn, s Foriddj Lr b S<lFn l7fil olrhr
<br />ktr, ( o&, f.. rh. Ffffi. orrn qo* rorrhi.hrh! pdmir a q.d
<br />I h.r G and q ill n.i.hin r 0116 comFtsdnrn inMM.., s r.qur.'l b\ Sal Fn 17(xl oi rh. t h.r ( o&. ror rhc lsfonrR. o I
<br />rh. s.it for which rhn rdm ts irn6l My $orta' smFnsio. rtrluu.!.ffi.id r.ltt nun$< at
<br />.-,-:./rP15? l.Z to
<br />P.'rc, Nun,bo . 5- ryq&q1tlfL ..; \-\-\g
<br />I cditrhdr irrh.FtulruMcof lh. $orl lr *habrhi! pdnn it i$!.d,1!h.ll d.l dployan! Fmn in u) m F
<br />F s ro b.$ft sbi.rl to lhl trttla smradnrn brt ofc.Ifons u<I r*r rhd if I shuk tFon. $bar !d rlE
<br />$trrtd comp<ner io. F6!iri.N.asdnn l T00 of lh. l,EE Cod.. l sltrll, fonhw t of,Fly q ilh ltF* pF\ iliJc
<br />WA|NINC f.ilur.lo sur norl6 codrdd(,n .o'6a8. 6 unb*aul. !.d suhj<r m mplo!( ro mminal rEBlrk anJ
<br />rnil fin6 up nr orc nud,.J rhous.d do
<br />sdtion 10?6 ofrh.l,hrrCd.. inrdd d
<br />(tl .hmd*B ri Fo\il.rl f( rh.
<br />0,r -\-.)
<br />ul]i,\ttDll2lllt1(IaB
<br />DU( l_llt I(t\
<br />I h<.r,y llrm undr p6rty o I Fjury rhn l o licglcl undd F.riii.n of (nqr6elc..M,.s trirh sdhn ?0(l()).tDnisNn I
<br />ol' rrE l16nB rnd PNIBioN cod.. d f,r li..e is nt tull lora id.fi.d )
<br />.*r*rOyf O
<br />o"..21.o-\q,-x1
<br />t
<br />o1 )r^ U'Uar"rv'1
<br />I hd.br" .mm u&r p.n ny oI pqury rlln rhdc 4 , .od
<br />Nu.d (sd :1097. ( iv c )
<br />ion lddh8 .sft! ,or lh. psfom.n . olrfi. sork for rtich rhG F,ni ir
<br />Set Backs 1\I n 'yl
<br />Forms/Steel/Holdowns t\I ,tl 91,
<br />Erection Pads t\I ))/\:YJ
<br />UFER Ground T\I |1 \YI
<br />SLAB Floor l {,vf
<br />Subf loor/VenVl nsulation tl
<br />Roof Sheathing
<br />Shear Wall -Ud /tt2
<br />Framing
<br />lnsulation/Energy a/,
<br />Dry\ivall
<br />fxt./lnt. Lath q/n/ry/
<br />Brown Coat
<br />Ivlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />4f;]1
<br />FINAL (/1,tsa /eL)>(4',/)
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />AIIUCAHI.DESAAA]IA!
<br />I,-e.J.rm ond6 pa.h y oa Firy oc of rh. hlheing dcldrioro
<br />D.tinnion Pmir3 &bdo! Noritrdhn F.dd.l Rquhirn, (l nL iro, Pd6)
<br />. R.qui'td L.(6 ol t{iiftnion
<br />I cdi& rhd rh. t dq.l r.sulrti.B rtsining sbdd rml rl u. mr +pltrbl. rn rhn Pmr<l
<br />I rd'6 rhr I h&. rc.d rhit ipglrdnn d {{rrkttE rth\. Ir{ff,i mn scotrd l.B'dro..n$bsilhrll('ny.rdcoun'\
<br />nrdmft6 rd srd.l ss Eh@{o hrrrdrfi ct6rdbll,&d hl6bv dlori,t r.D.snttr6 olrhn (' t dd cou ! ra dr6 up.. rlE
<br />!r,o". Nrn d r.pay ro, im*dbn pr!r66 ,/ / / -
<br />,rppro"r-ep,stn.r,./- \ffi n, [a'll'q
<br />;;-, ;^:,;:;- I - c h "]it' 0,. f aJ
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