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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />UFER Ground
<br />SLAB Floor
<br />Subfloor/VenUl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing N\7-\\r9
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar l/1
<br />Handicap Req. tr(\ \(/ \ \\r/r^ \!J
<br />Deputy Final Report ' '
<br />Engineer Final Report
<br />I
<br />/)to )F|NAL r #t,\\?r\ \a ,()q/
<br />C e rt if i cate-.-of O ccu pa n cy \:./
<br />o
<br />2-
<br />I I
<br />tu/,rflr, /1
<br />Remarks Etc.
<br />OWNEA BI]II.DER DEL('ARATiON
<br />I hd.6t .iTm u.dd Fn ty of Fjury rhi I 6 adF tDn rlE (o".cl6 L(.@ ls lor llt folk $ing lran ISc.7011.5
<br />B6ins $'d Prctdion Co&) A.t Ciry or Coud, whrh EquiE ! Fnn lo cotsru.t, tnd. imP,ott. .lamlBh o, lcin -y
<br />3rrudu., prxr lo n! i!.@c.. d!. r.qun6 ltE .p?li(d for such p6nil lo iL i 3i8n d $naMl lh.l lE or JE i! licd!.d p6uau
<br />ro rh. FDriiirB ol tlE Corn&ra t Li.cnrd Lrr l(a.prd 9, ( omi.B wih S6rhn 7000 ol Dnilio. t of rlE B$itB ed
<br />PDf6bf,! ( o<Ll or lnll ,E or JE b doilr rwrom &d rh. tsis for th. .lLs.d eroqi(n 4., lrLtion olsaltu 701 I 5 b) &y
<br />appl,.lnr tU a pdsir ubjal! th. +plic&l lo a civil pdlly of .ol mE thm fi!. hundrcd dollB (1500).
<br />-1.
<br />s osN olrh. Fstlty. d n, anpht€ snh e.s6 s rlEir sL Norourht $rll O rlE f,ui td 0E r.rr@ i! d
<br />inr6xLd o. oro.d for i.L (Sc.?(xa. tlNinB ed ProfeioN Codc Tt. Conl[clor', Li.tu lnw do6 ,ol @dt 'o
<br />d o*E oa
<br />rh. rrDFry u'ho hd& d iq..!6 d.ta .d sh. dc sh $ll niGGIr or hd*lf or dmwh hi! ot lE ow cmplort6.
<br />For iLd rhd st imForqErt e 'd -iod dofidd 5r sL lf.lsEs. rlE hrildls ( ir+.sqd ir ild ritb w )@
<br />otc6npk.I! rlEOrc Boilda sill hlrr E hdar olFourB tLi L or Ja dit m! hlld m in+.oE ln.In'Fy t!. ttt F,po*of
<br />-1,
<br />so*E of rlE FsFty, s dclNr.ly $nrrsi'na *nh hcdBal.oddN !o odBl tli FtrF (sd 7(x,1. BGin6
<br />!d A!kn. Cod. 'I'n. Conlr.cloa r l- i..ns. Lsw do6 nol q,ply lo e o*ni o aPmFn y Pho build! or iEProv6 th6on,
<br />.nd $h. corrE.lr lor 3ucn Fj€rl wnh ! comr.lo(s) li.as.d puBurl tollt(o.k.doit Li.e k$)
<br />'**flI'
<br />",. =t I ,1 o
<br />I ha.t'y r0im und.r p6ult' of Fju,r.' om ofrh. lnlltu in8 dftL{dioB
<br />-l
<br />h.!. nrl will m'nt.in . CdlifE{c of Co.$r ro sclf-lsur. for *urkn omp.nsrntn. 6 Fo!'.!.d for by S6lion :l'7ur o f rh.
<br />tiu,r Co&. lo. th. psfollr]tr. o[lh. worl ld *hich lh. psmil i isu.n.
<br />-l
<br />hrv..nd $illMi ri. e,td' .odFetion 6uteq 6 r.qun.d b Sdx'n 1?00 of rhc L6.r ('od., for llE Fflfu. of
<br />r*s ror uhkn ihi! D.nni n iscd My wmkd' .onpasar io. iBurmc. cMi6 &d F licy .@bd ml
<br />Policy Nunbd:-ErPn6r
<br />-
<br />--l cdrt lh.t 'r lhc F fol:m of lh. *!rl for stuch lhu Fnnn i! isc( I $.ll ml d'9loy o, FMr ir uy ooF
<br />$ I to b.\T,n. subjcr ro rhc vorl6 .omp..sion hwr oa( lliaomi& snd 4xE lhn ia l should b6om. subj*t to ttE
<br />u..t6' 6n cdion FDvitio6 oasdion l?m nf rh. L.tot Cod., Ltll. f.ntsnh onltly * nh lhi Foririoc.
<br />$ARfiI\c rlilft to w. \qt6 conpdih, t\64r. b lnL(tu1 rn trdl $brGi o alplolq io slsod Ftrtis !n
<br />.trn fin6 u, ro on. hufldrcd llarusd f .omFMiion, ddr.sd a piov'd.n for lh.
<br />s(ridn 1076 otlh.l,tu
<br />1o l1'{6
<br />DICIIAAIIIIN
<br />I hd.bt rfim unda Fdy or Fjury lhi I @ l'.68 d utdn Fortion o, clEFE I (6n.fting * h S.dio.'7uo0) orDilinn I
<br />of rh. Buins dd PmfsioB aod.. an dy kdE a i! full foic. ral.fiEl
<br />CAIIIAIJCIIAUIENIIICrI0EBCI
<br />I holby dTm ulds Frby of Fiury rh. tlE. ir . odruliD ladins rcc, tor rlE Ff(xrfur of rlr * t 6r *tthlh6 Fni a
<br />ile.dtse l0o7.cit c).
<br />AIIIJ(AILIIESIAAIIA!
<br />I h.d, 6trm u nd6 F.x, ot Fj!ry oR ol
<br />'h.
<br />folhtr in8 d.cl,rl n$:
<br />D.nolirion P6nit!-Aststos Nolilicarion l.cddal R.lllalionr (1ilL 40. l'dl6)
<br />-R.q0tGj
<br />Ldl6.tl'loliftrion
<br />-l
<br />csr,ry $d rh. rcLral rcglLlioN r.ssdins stdos ronor dl &. nor +dk bk lo th6 Imj.<l
<br />I .dilr rh,t I h.\. r6d thir !ppl*!ri,. ai 3t'r.. iDfotuon i! coel I !*G ro oftdy wnh t[ ('n, tnd ( ounl!
<br />.rdina.c6 and srarc li$3 Ghtin8 n' boild .uthrt. rqrd.'xaiv6 olthh ( ily Md Counrtro o16 upon thc
<br />abrc aErNEd preFny fdr i(ralion
<br />o,Or.."r* n" t"r"".r"* ,/l
<br />PmhRrra.(pn.t):
<br />""'
<br />-. tgrllu
<br />zZwn
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />Flood Zone Certif.
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