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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNER BU! LDER D EL('A RATION
<br />I hdrb lrm undd F..ht oa Fjq lhd I m dmF from rh. (onrdo6 lnceli* for rh.lollorx8.aFn (s<1rr! 5
<br />llusinds &d Prufsn'n Co,i.) Ary Cily or Coumy s'hich ,.{und , Fmir r. .odrlrud, tts. imtrov.. dindlirh or Ea,tr dy
<br />{ru.tu.. Frr ro i3 i<um., dri ,.qut6 !n rylier ao.3u.h Fmn ro 6L. nsxd sln@r rhd rE or nr E licded pued
<br />ro th. FovLrFE olrh. Co.r,rc!.r'r Li..n*.t rru (Chsfld t). ( omlrtrinB trith S.clion 1000 of Dnntu. 1 of rh. llNin6s 8nd
<br />Poasr.. ( od.) or rh{ lE o. JE ! .ropl rhd.fiom od rh. tE6 nn th< !lLs.{ crotxio. Anv vioLh. olSdi,n 7l)r1.5 tD !n)
<br />{pli..d lor . Fnnil sltlelr lhc lpplicm! to i ci\ rl Dcuhy o f nol {. rhrn lirc hon&.d &rlln (t5(xr}
<br />I. 8 o\n oi rh. FoFnt, or ny mnloy6 {irh s.X6 6 !h.ir rrk smp6enro.. trilld, rlr sGI md rlr rrElE i! d{
<br />rd6ri.l orofi6.d for rL(Sa 7Od{. BulEt Md Prea(rnE ( od. Ih. (irdr&1o.. l.ic.e L.*.,06ml q'tDrrooos6of
<br />rh. rft,rdy *b rxinr Dr i,r{F\6 dEon. ,n r b &E uh tr!* hi,MI, or h(rlf dr rhtuust hi! or h6 o$n dpl('vc.
<br />rrornlcd rh!! $.h imForffir c mi dqd.d oi o,Ysd rd et lt ts*66, rlt tnrtdnE or nr{m\ffi i! $ld *nh'n.t }w
<br />olcolg'kion. ih. ( )qE B{il& sill ho\! llE hrno dr Fo\ !ts lhr rE or .tf, did n{ tlill or in{rori 0E FtFr! for th. BnF r.r
<br />L s o$ K ot th. Fordy. m .rclciEly codrlcl iry urlh hc<s.d .ofu,.r.n ro .oihd llE p.ol.d llic 70.14- ItBm*
<br />.nd lttrkir Co&: 'I hc conrsro.s t-i..M h$ do6 mr .pply ro x oq E .f p.oFn]. r',F build! .' inrdf-
<br />'n6on.!.d $ho mddsf.r (h pr.).rt trnh. CodGlo4tl licdu.d pu6@n rorh! Codrdoas Lkre ks)
<br />I mcrmF u.d.i sdr'on tl &P( f.r rhK r.f,son
<br />D.t. Orrd \tonxrts. ( ontPFNsaitoN
<br />DlgJadlta!
<br />I nd.hy amro undd p.ul'y of Fju') on. of rh. folkr$ ins d.(l[.lirN
<br />I hlr. !d *rll @inrlin r ( cn ifrar. ofc.lMr tu s.ll-IBur. ld unisr' comr..!n ioo- s Fovid.d l.r tiy sdrion 1?(xr o f 'h.
<br />I !bo. Cod.. for rh. Ffoffi. ol I h. * orl lor *n(t llt Fnn . su.d
<br />I h.v. !ft1 urll hridr'n $ 0*6 ..mlEBdhn i6!raft.. f,r r.qui..d h! S6lx,n ]7m ofrh.lrt{r (i1.!., ntr rh. Ffon.m. ot
<br />rh. $ork aor shichrhL pantr is 6u.d. Mr uo 6 conFMion iNu,uc. cdir drl rblicv ndnrhd r.
<br />, ., -CouauTs,c T^Jrsh),, \,,.,.wolqn\tt,'{u, rc ce
<br />? -/ r- 2o/A
<br />I c€nify lh,l in rh. rqfor,ucc of rh. *o rs *hi.h rhi. Fnir ir isu.n. l rh.ll nor orloy any IEr$r r iny ntn6
<br />$ a l. b.cotr lutir! ro ih. *!rrd comFMion U$ oaciiaohr ud .sr lht
<br />'r
<br />I slhtrld b..om rut d o llE
<br />*.rla'.omFulionpmvnioNofSEiionlTO0oflh.l.bo,(od..lt$ll,rodh*irnsnglr'*nhrtb*ImrilioB
<br />lraRNtNC F.itu.. ro su. m.L6 comtEeirn 6\d,8. 6 u.hqful. r sh6ll lubj.ri tu dpbE 16 ainrn.l FMli.s n d
<br />ciril fin6 up to od hund(n thous.d dollm (tlfil,o()o), in ..Bilion to rh. cor of comFqr'otr drmald $ I'iovid.d lor thc
<br />s.nn'n !0?6 otrh. Lrtnr ftrk, inrid Md dbrE s ac
<br />2-t1-u/7
<br />DlclJAAIlqN
<br />I heby lmrm und6 FnrhyofFjury lhn I o li.nt.d undd nm\i!h. of(n G 9 (comnftins r nh Sclion 7000) of Dirisnr. l
<br />of rh! Buind md Pmadoc ( od., d my lic@ i in tull torc. !d clT.d
<br />,,.cn.(.,.r' C7?
<br />",," ' tZ-/?- Zol F
<br />(o!i l&Ia!-LElDlliGAcEx(}
<br />I hd.by aflird u E Fndry of pojuiy rhll rhd. i.. codsltudhn knding $fty ror th. Ffo.r@.. ol lh. trorl 6t "tich rhis lEr.il !r
<br />su.d Isd 1097. ( n c)
<br />I.nJ6.r N.m.
<br />arru(Adr.!&gaaarla!
<br />Ihall'Yafimu sljoih)of FJuryo..olrh. roll.win* d<lmr ion!
<br />D.mlrio. PmneAlh.slo! fJolifi.drn Ecdq.lr.8uUlDE (rnh t0, Pd6)
<br />R.qur.d ln16 of fi,r'rirEdin
<br />I .d'f\ rn! rh. f.d.r.l rcsuldrB Eardm8 .{do! rn\ ,. mr mlktl'k ro rhb [toJ.(l
<br />(Jr.-,6,r,trr-.,ol,r'6.r'pl'(drcnd(!r.thdrh.rfo\Gi.lotux,n6..r..rl,scroonpbtnfi.llC'l\rnd(.unrr
<br />'o,U'n (6 Md sld.l,w! Ehr'ns rn hurlJrna codtud'.tr dvl h6.by.!lhort. rqr.9ldl,!6.f rhii Cn, Md (-ounry nr dl6 !F.nlh.
<br />!tFr.,Elnn d FoFn! for iNFinn
<br />,lppli..rl or.\E6l Sittr.tur.
<br />rcnireumrtpano: )L
<br />.,'"'/Z-/?-PE
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lns u lation/Energ y
<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 Reporl
<br />Flood Zone Certif
<br />FINAL
<br />Certificate of Occu NC
<br />-..1
<br />I I
<br />I III
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<br />I I
<br />t,
<br />Notes, Remarks, Etc.
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