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BUILDING. INSPECTOR RECORD
<br />SITE.WORK.DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATIoN
<br />I hd.tD rrrn und( F!ll! ,,1Fiu4 thd I m.rdrpt frcm lh. Conlra.i{u' l.i.ds. tis L! rh. nnh*in8 r.avr.ls( r01l t
<br />Bu.in6s a Prof6{n c.d.) ny (-ir! or Co!,nr trt(t r.qutr6 t Fmr r..!dM. tllg. iqio\e &nslih or qu$}
<br />srndu.. D.hr to n! N6c.. rleo r.qutrB rhc q,pli..d for 3u.h t flrn kr fik a !'sn.d $dmd rh, h. or nt ir licla.n derr
<br />r. rh. rm\uFd olilE (..LdM r Li.6cl l.r (Chqrq 9. ( nmftm8 trnfi Sdlx). TlnO of oirision r of rht B*indq and !
<br />Pnn6sionr (i'd.) or rhal lE or.hc ir.lrmpl lh.r.n.m ed rh. tsn for rh. d1.1.{.rdBhn An! rhLri{'rnfs<d.nr0ll l b-( r..
<br />!T'r'lica.r ftr r FDn $t ct' rh. rtfli.dnr tr r cn il p..!hy of nor dor. rhd fir. hundrrd dollss i lt00)
<br />LB $n6 of rh. FiFny. or my dplolG *nh tr.*6 s rh.ir sn. (otnFMon, sill& rh.qoll ard rh. ndc. ir fr{
<br />inldxldl or oft .d lor sh (sd 7or,r, Buind Dd PNfei,ni Cod. Tn. (-o r*oi3 I {G lr{ Lh6.d rt'trlv ro d.sffi of
<br />rh. rioltny n no hilds or trrymvB rhm)n, a $h.docsfi$i*h'n3.lforhmlforlhrcusfihtorhdo*nairlq.6.
<br />F.\ klal rhri rurh mF.\.!d! e mr iddrl.d ( ofrqld ftr qk Il hos6t. tlE tlildin8 d nlro\ffi it $ld unhin on.ld
<br />of compld Nn, rh. O*rs Uuik d will ha. fi. hr.&n ofFolins thd iE or sh. dxi mr toild or insro\ c thc FFF) for tlE FrIFx ot
<br />l. so*6oirh. Fqdt, mc\.lusrcly c.dn 1'n! r h l(o*.n .ontradon lo $nslrud lhc F!.d (Sc. 7L\4'1. lt6tds
<br />Md ftDftimtr ( od. lh.(o reror r L ic.n* l-a$ d.6 Nr !I,t'll n, u o* f,d aarf,oFn! s iF blild. or inPrc\ d rh6on.
<br />ud \ho llinrdi aM iu.n l,oldi $nh 6 (i.ne1o(3) hcda.d NuuMr to rhc (nmracttri lj.N t-d\e)
<br />I m .rmpr unrkr S<rFr ("
<br />lt[(r &!-t!]t!
<br />I hd.l,! .mm und6 p.naht of pqjuq olt ,\\
<br />Ihry.Etrillmi.i.m!(Gn'ftdcorcon5r6s.lftcurcfdtr0116'comrdeton,BFtld.dforb)S<tnn1700ofrh.
<br />I lbor codc, fo, rh. pdfomdc. oalfic work ror *hich rh. Frnn ir isu.d
<br />I hav. lnd ulll m.inrrin *0116' romp.Ml bn i6ur!mc. s r.qu .n h\ sd Fr u00 .f lh. l$.r (-o{. foi lh. ncfo.rr@. .l
<br />rt trrt ror*hrhrh.Fmn i3 sEl. Mt sor t6' compdsar hn fturtn.. c.ri6 dd Flq nunhd ftl
<br />l..nit rhd in rh. Frfomsnc€ o I rb. *ort for *h(h rhk Fmi n iisd I lhall mr mploy !nr. p.ren r uvnrE
<br />r, 6 r' b<Lom sbd ro llr urrl6 omFMion L{: ofc:lifonq ard +E rhd i, t lh.uld h6oft .ubj*r ro llE
<br />w.*6 mmp<rdion provr(B ofstrion lT00 of lh. llhr (tde l !rdl, fodh{nhomdys htho.Fnrsil6
<br />ltAiNlN(; Flilu. t1 w $orts' omp.nsnntr cov6.s. ii nnL$ful. sd shrll tubid .n mtloF lo mintl tn$nis md
<br />cie'l nna up 16 on. hun&.d lh's.d
<br />\rrnn 1076.rih. IrlFr (ixL hr6d
<br />i. aldirnn lo rhc c{n or.onFMrion, d,nus6 B Fo\d.n for rh.
<br />1.."^.r {
<br />I h6.b( a,Iun und6 FEtr) of Fjory lh, I D UEed u,'.Lr F.ri.i'n of (tuFd s (onn@'na rirh sdrcn 7000) orDn!rcn:r
<br />of th. ausinBs ed PrcfssniN Cod.. .nd nry lic.M is in flll forcc drl .fidt
<br />qalslalI:rjatrEriulqlq!!(I
<br />I hd$, lmm undq F hy .f FJu,r_ rhd !h6. i ! codrucrion lcnd'ir a86.y tu ihc psforo.. . f rh. $ ori tor which lhir F nir i!
<br />'s!u.d(sd 1097, (-i! ( )
<br />APPLICAIIT Df, CL iAIIOII
<br />| ,@a rrmnundd pcntrlly olrFrury o..orrh.lollosints &(lsdotrs
<br />Domhriin Pdnn$Ash.sror Norin.dh)n F.ddd! R.gul.rions (T[1. 10. tan6)
<br />Rdtuiral L!'q or fhifrdn.
<br />I cqrib rt6 rh. Ldr,l rcsuldoB r.a6drm 6b6lo! rdovtl.r. Rr ttPlictbl.lo lhn ,tilcr
<br />I (drb rhd lt|,11Ed lhtr tpel'(.,hn nrl {0r. rhd rh. itnrc rnlntu'on s !on.d l.srarosmpl}
<br />d k.]\3ld sl|(. I.B d, !E !o h{rlddB c.tuFtr .d hdd} tdlhM. r.F.5d tr 6 ol rhr Cn}
<br />.r$r. Mr tl<l6mFn, ffl rNp.d'on pupo6
<br />nrrn-,-h2-,*. l-.^ Lt lht.
<br />PmkFn.m.rpr,{): lI'I1'lL+!e)>{_
<br />Md ( ount! r. drE !F)nrh.
<br />Set Backs
<br />tto ilt,L
<br />Erection Pads t>/";J-
<br />[JFER Ground
<br />SLAB Floor "/Su bfloor/VenVlnsulation I lr
<br />Roof Sheathing q
<br />Shear Wall +I
<br />,l/rh I Mr
<br />Framing q I K u
<br />lnsulation/Energy t4 +\ll /\,1A -,+d"ii/4 *
<br />Drywall I )
<br />/lnt. Lath rl q r)li1{
<br />Brown Coat I t?l
<br />Masonry lt L I
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />FINAL lyrS\"tt t{,"\)?>
<br />Certificate of Occupancy t-1 U t
<br />.l 18.d5 .z .pJ 0 o NI.
<br />tIt C 1
<br />lr \ 't)
<br />I I
<br />I
<br />Forms/Steel/Holdowns v
<br />)
<br />II
<br />Notgs, Remarks, Etc.I
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