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SITE-WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUlnsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq
<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 />cw)FINAL b/ 7//tz \/-K
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc.
<br />I
<br />II
<br />BUILDING. INSPECTOR RECORD
<br />()\\\t.R Bl t)t.R t)rr ( \R\rl0\
<br />I hd.rr'.lrm u,*. pa.tt of Frlry rhd I d.roF nom,! co rd6'tiru tlw fo.lh. rolklsin3 rd]n{sqmtl5
<br />BNh63 rt Pror6n. co&): Ary cty or Co!,ny f,nrn EqunB . Fiil to sl!rud, .116, inFov.. ddml6n ot ,q.r o,
<br />shdur., prior ro irr iesuMc, dro icquiB rh. appl'(or for 3uch Fnn l. fik r tisEj sldddl rhd h. or JE it li.ard p{Bul
<br />ro rhc rrovnNs of tlE Conlrlcloit l-iccncd ljw (( h!rn6 9. Com@ins wiln Salion 7000 ol Divi.ion I of$. alriEs ad
<br />ProfNbN Cod.) tr rhn lE or $. b dnnl,r tha.f.om Md rh. hdt for lh. .lks.d sflFion. A.y vioLriof, of Sclbn 701 I 5 by dy
<br />rppl'cs for.Fnn$bjix1rrh..r?lirerto!.irilFnrlrrofmtm,.rh&li!.huti,tndolh!{1500).
<br />-1,
<br />s.rcof rh. FoFry, or m, mploraG *nfi *.s6 6 th.u $L omFdiotr sill & EEUI !n !.1(r4 i! mr
<br />iddd.d n otr6d 6r xL (Sa.7Or4. BclB od Eor*$6 c6&: In Cododd . Lt.@ tr$ {bd d qrply lo o 0$6 ol
<br />rn F rEry wrn bud<h d i,S.o\€,E!a !d who.IEGt Nit hi6.lf or h*lf or rhmush hi3 ot hc oE @plor6,
<br />prcridol lt tuch i!,Fo\q6t! @ d n'di.d $ oll.d n sE. Il lDve. ihl tiildiB or inp.l1Effi i sB wnhin or. ,a
<br />ofmmpkioll th. ol,D6 BoiEd will taw lh. budar ol pftrvi.A rhi h. or thc did ftn hlild or inFow d. pmFly tor tlE Ix!F. oI
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<br />B osE otrh. FoF . m a.l6n.lr.odrdins wdh licoE d cod'*rdto sdtud rlE FoF (Sa 7Ol.. &alE
<br />,.d Pha3ir Co.k: Tn Conlndor! Lic.* Lre &6 Fr @ltbdowFoaFopaly*b btril&or mPoB lh6@ll
<br />od *ho colnrrrr ror such FoF! wnh. Co do(r) li(qEd Flrurr ro E co rr.ldi l-tag tre)
<br />I dn.rc pr undd S(to
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<br />I h..bJ smrnu.ds p.nah) of Flu^ otof$. tuk's ns d.(lod6B
<br />, h.r. ed $ ill roinrain r Cdlir(ir oacotEdr ro s.lf-lBurc lor sdld comrdrlio,', s r'uiloj for by s<tio. 1700 or rhc
<br />kbo. cod.. forrh. pdfonr c€ollhcwolt tor vhich llE pdnn ie isu.d.
<br />I lII1. lnd *ill mlinlanr *ortdt comp.Barirn iNrMC., s r.qundi by seliotr 3?m of llE lrb.r Co&. tor rlE Ff(nrllm. of
<br />dr mrt lm whkhlhis D6hn ! iEld Mymrl4 @mp.!dbn ilElllu. ffir nlpoliy.unbd..
<br />Poli.y N!mb.r:-Eipn6
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<br />cdrry rhar 'n
<br />lh. FfollMc of lh. wort lor wti.h lhir FEn b isu.d, I !l'!ll ml dplot.rt Fe. in y Iund
<br />$ 6 ro be.m. $ti6r lo lh. sodd omFurion Lq of Glifomi& !.d lsd thi if I dbuld lEom. $bidl lo lh.
<br />$o @ osFMbtr ForEioB ots<lbn l7moa0E tdr co&,I stEll. tnhsdh @f,dt $nh ftE Fovin c
<br />IiAENING: I{ituE lo sc rst6 odgdtion .o\-.s. is uh$tuL ud tldl $bj< 6 arprtF ro oimitd FEl- rd
<br />ciril find up ro oc hu,rik.i rho!!.d dollrs {tloo.oml. in rddnb. ro rlE cor ot conp.rE lnn. &r g6 a Fovid.d for llE
<br />S61on 1076 of rh. t h.r Co&. inl6.n sd ttdrE 't E6
<br />I rc.nsrn coNT{acroe
<br />OECIJEAUA!
<br />I horty .,Im u.& FDly of Fjury thr I m licE d u!d.r Frtb! of Or+a 9 (ol|lffius *nh Sdrion 70001 of Ditition l
<br />oa llE &!i6 ud PBf6n6 Co&, Dd my lioB ir n full foc tn.lI..1
<br />Lic.N. CIN:- l,ic.ruc Nunb.r:
<br />D.r. Co n.lor:
<br />cQB$auclltld.jrdDaqlcElcr
<br />I hdtby .,Im u.&r Fuh, o f Fju.y lhi llEr i r o'dn(rbi ladiig +4y lor llE psfo'lre. of tlE $od tu $nih lhi! ,ani a
<br />is!.d (Se. 1097, Civ. C ).
<br />AIIIIIAtrI.DECIA8AIIII!
<br />I hdltt.fimufrLr pa.ty ofFJUr) oE oflh. follo$ms &<Lt hB
<br />Eftnnion Pdneash6lG Nolifi.arion Fcddll R.*uLl'oN (Tnl.,r0, Pd6)
<br />R.nut.i Lc[d olNotifi oli)n
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<br />cd i6 lhd lh. t ddtl ..sukrioB EeEdins Bti6k'r .dn d rc nor +ii..6k b this Foj.<
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<br />ordmec6 Md Sr.t. tr$3 E!nu{iv6 ofrhis ( nr !d Coolylo cnd uFn
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