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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS (xc.B{ild( Ir..l[rlbn
<br />I hd.l'r.mrn und.r !.Mhy otp.rury rt i l.m.i.mpl forE rh. (onr.do,r' l-i..nr lr* aor rh.follor'ns ra&n (G Toll J Bcit$
<br />!*l Prcl6ib. Co<t ) Any Cnr 6r Courty r,fiich r.quiB . p.rmir ro .oB!rud, .hd. improtr, rk@lnh or rcFir dy itMtEc. Fn. [o ir.Bur.. .l!o cqui6 $. rp?lE.nl for tkh p.rmn ro [k . .isn d lrt.l6l lh.t h. or !h. u lic.tu.d tu@l ro lh. pornioB ol lh.
<br />Conl..cloir LE6.d uw (chrFd c, cohh.EDs *,fi Sdbn 70m6f Orv'tE.I oarlE 8$16r..d P.646.6m Corl.t or rllr n or
<br />sh. i3 .r.npr rhEcfrom Md rh. br.n tor lh. .llq.n .(npr irn Any rbLrion ol Scriln ?0! I 5b,m,f?li.. Lr r Fon tubj..tr tl!
<br />lprlict.l lo.cirilFunyolmr mE th.n i!. hu.dr.d doll.r(1500)
<br />l. ! oqM or rh. Drcp.ny. or my .mpldyd {iih r.3n 8 rh.r hL cor$.Nr.tr *1ll do rlE ro* .nd rh. .trudu. u mr mtod.d
<br />or olI.r.d for nl. { S6 70,14, Bun.6r &d Pror6.Dn! Cod. Th. Conrtdoar L(.e Ir* drB Nr .ppl, ro .. oEk ol rh. pbFn,
<br />rls boiklt or inprov6llE mn..rd rho d6 r*h *o* hinelfo, h6.lf or thtuusn his or h., owi cnploy6. provid.d lhll !u.h
<br />i(pror.n.fi e ml int..dcd or olt r.d lor nk I ( lb*.\ 6. rn buitdi.s or nForhc oloEr tin on. )* of.of,pldion. rhc
<br />O*E.auildn *ill h.v.lh. burd.. ofFovinJ lhr lE or rh. d b(i6 or imp.olr for rh. purFr orrk)
<br />I. - o*E orth. F.Fry, .m crcluir.ly .onlnddt snh Icc6.d 6ir,.cror ro oorru<l rh. rojd ( S-. 7044. Brind .nd
<br />Pba.sion Cod. Th. Co.r.d6r'r L alu uw d6 d tpply to u o*G of proFry who b{ dr d m0ror6 rhd6. , .nd *no
<br />@mndr f6r ru.h Fordr wilfi ! co.r&lo(t lrc.n*n purunr ro rh.aonrndoar L..M l^ )
<br />I 6.rdpr uld.r Srrib
<br />taaf,E&i.(autt$rrl)n-plqiaArl(lN
<br />I h(rby.mm undd p.n!lry ofp.llury on..irh.Iolhwinx d6LnrhB
<br />Ihrv.!nwilldi rin.Cdirdl.orC.B.rIroldr.lBur.lorsrldt.omp.ro.rbn.I provd.dforbySer6n1700olrh.
<br />lrb.. (.d.. r.r r& r.rtudr.of rlE *o.t fo. vni.h rll Fhn i3 i$u.d
<br />Ih.!...4w'lrmnr.'n6rl.13'ohp.mrpn,n.ulN.,.t Gqur.d by s.ctDn ,?flr oa rh. l.ho, (-ode for th. p.rao.mne ol tlE
<br />*ork fo, qh.h rhtr Fmd n 's!.d My srkst 6mp.ner b. ,cutB.. .eir .,n F[<y nunb? !E
<br />Poli., Numb.r Erniol
<br />(Tni! Kr ion rc.d .or b.compl.r.d if lh.p.mit t for oE hundEn.roll,B lllml or h$)
<br />l.cni! lhrl n $. F.fo@rc of llk *ort fnrhi(h thn p6nit t isu.d.l rhrrlmr mrhy rny p6on in my h.nn.r r. s t6
<br />b..!m. rubr*l ro rlE *od.n omFnrtEn L!.olc.l'lor.!. r.d .3E rlI| 'll rhouH b..om iubrd rorh.so 6
<br />/
<br />WARNINC r.'U.ro r(ur. *o .B comp.nr.toncovi
<br />fi.6 up lo oE t!.dr.! lh.rnd .lorbB ( t 100,0m,,i^ ddh6n to rh. con o, conr.ntarnrn. dlosB a rrovid.d aorrt. 56rim 1076 oa
<br />rh. l,bor coi., da.n .nd.ndEyi f6
<br />UIEIiED.(AIIBASIABIDICIAEAIIO!
<br />I rE.by.flirn unds Fuhr of p.rjury rh.t I h licd-d u.dd pr.v,ion orchrprd 9lNnm...'ng *nh s.dion 7000) ofDivision I of
<br />lh. B6ind .nd Prof6rh6 ( od.. !i nr li..e i!
<br />'n rull r6rc..n<1.fi..1
<br />, ,.,"\*0,t1, lew\rwt
<br />(a!flatrqlo LilDltc_acE!(r
<br />I h.r.hyrllim u.d6 ,.Mrly oft'fju.r rhd rho.i..o6ruti.n l.nd'ns+.r' fu rh< p.tfomnc. of ih.son( foirni.h rhr pdnr is
<br />issucdlS( 1097.(,! C )
<br />o.drMr6ma S!.!. t,wr r.l.ury rohuildin3 .dhorr. r.rrMdiir.r ofrhit Cny rhd('oudv ro.nt6 ul[n lhr
<br />t
<br />.boe. d. ioBd proFn
<br />Applic..r.. laor !i3 :
<br />Pmilla m(prinl):
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subfloor/VenUlnsul
<br />Roof Sheathing
<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 tt>hYhs vP^grvJh/
<br />Certificate of Occupancy
<br />Notes, Remarks, Elc.
<br />MlWP51\P6.mil-h3p6no.ms\Burldrno'lBp.cnonR.cord.doc 03.3106
<br />ATIIICAtsIILDES.AAAIIAX
<br />D.mlnh. Pmnr-Albcdo! Nolirsrio. F.nol R.Suhtbo (TitL,(), Pfi 6)
<br />R.qutcd lrlld orNolifrc.rbn
<br />I (6rily rh.t rh. f.nol EBuhhE r.3udirB Bh.ior r.er.l E ror rppli.rblc lo tnn phj..t
<br />_ I .dily rh!' I h.r. ud lnL rpplic.rion .nd .rc rh.t rlE .to\t hfot ran n cor.d. I r3rc io conply snh .I Cny In coury
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