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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE rD/srG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Enerqy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />lZ/lU,ct <"\*q
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />OWNER BUILDAR DEII'ANATION
<br />, n6.b! rlrm u.&1 Flny ol Frury lhr I m dmp{ tlo rlE Conind6' Lic.nr t $ for th. folLrin3 ,En (Sd 7)l I 5
<br />Uuins .d Prolcior Cod.I Ary Cny o. Coudy shi.h ..qui6 . Fd to oddd. ntc. inFow. &Dl!h ot qti' ay
<br />ntuduc. ,nn lo n. Nue.q d!. rcqoir6lh. rgplrd ao! ru.h Fmi! k, 61. ! lisnsl sltiddt $!r h. or dE ir licdsd puelltl
<br />ro rhc FovnioE of rlE Conb&ld r Lie.r.J t * ((tuIro 9, (bffii.8 {nh Salion 7000 ol Dn d'on I of rlE &EiB dd
<br />Prefdioo Co&) or thd lt d rlE u 6s,4r $d.6o6 di tlE b..! for tlE rlLs.d dolprpn An) d rio. of Sdion 7011 t by ey
<br />rprlicad fu. . p6ni rubjdi! th. lpplicel lo ! civil FEn, of not moE lnd fiv. hu&t .d dollrr (1500).
<br />-1.
<br />s osF or$. FFry. d ny d4lor6 *nn s.s6 s lh.r $L omFdion. r'ill <h dE trqt !n dE tuR ir d
<br />irioid.d or o,rd.d f nL (Sd 7044. BuiB &d Prla6hE CGI TE ( o 6.ld r LaN l,w dc ft, eply lo 6 o*c of
<br />rh. FqEry s-ho hiildi or nnFov6 tlsol\ ..d who &E Mh *oll hiNclf or ncrlf or lhDush hi or hd om dPloyc.
<br />FoviLd lhn uch mF!\EId! c &r -ndn d d ofibld fin.lC ll ho$c, dE hlildia c,s.orqEr n $B wrhn m !-
<br />or@qld@ rh. O{G Buil& wi! lEtr ,E hd6 of FD\i,s dlr h. @ ,h. dil IDr br d or itr+.o€ dE FoFy br ,t FlFe 6l
<br />I.so$Eoarh.F.F!).oqclundyo,ri$sunhlrsu.dotu&roEroFdM'lEFojd(Sa.7Or-{.ltar6
<br />.nd hDrsrh Cod.: TL conlr&1or s Licd* hr &B mr .rply to x.*ns ot FoFly sho build! or i6pro!6
<br />'h6@n..n'l eho ont6r tor luch I'oiilsunh ! Cod6ckr(s) Iicd.d pu6mr ro rh. Conln.lor'r Lk.M lru)
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<br />d dftF un& sdio.-
<br />l&!}8f,E84:(!rtll!lAl]O!
<br />DIqdAAIIO!
<br />I hd.by amm undd FuhyoftEjuryon. ofrfi. followin8 d6la{ioN
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<br />h.v. rd *ill tuor.i! r Ca't sc.lcoeu ro s.lf-l@ ld *qtfl @nr.erioq a Forij.d fo, by Sdhn l7m orrlE
<br />l:!or Code tu th. Ffl)ffi ot rhc *dl lq *ti.h rlE Fdir a is.d
<br />I h.v. lnd *ill minr.in sortdr .omp.Mion iMnft.. s r.qun.d hy sElion 17(J0 of th. Lbot CotL. for llE Flolr@.. of
<br />rnir FEh ir isrd. My rutEr e'mFsln ilgd. cm; in poky n!nb6 .(
<br />-lcqlitthd
<br />in rhc pqlo']]@. or rhc sork lor *hrh rhi. Fmh i! is.{.1JEll ml oploy.nyF$n in D} mxE
<br />$ B ro bdm abj.d b dE unl6' omFEiion l,u! orcdiromn .id .gR dr 'l I slsuld h6oB $t 6l lo rr.
<br />Nrt6' onFu.r hn Ftr\iioE of Sdion l?00 ot rh. ldor code I dtrll. fdhwhh ondy *nh lho- F!v6ird.
<br />WARNINC t-olu. r. suc sork6 {mp.Mlion sr@B. ir unhwful, sd lhrll ltbjcr a dploF lo si6in.l poBhnt od
<br />b oF hdd,.d lhou$d &lbE ltl({.uDr. in allj ion. d.0.s6 a Foril.d lor rh.
<br />mdd ri rtll'6- r fG
<br />t0 3t J
<br />IICIJSAITQN
<br />I hnby rmrm lnds FEIIy qf pGjury thrl I 6 licdb.d und6 Fovilioi of (tuPrq 9 GonrlM.ing silh S.dDn 70ur, of Dirlti.n 1
<br />ol rlE B6hs d Pmft*ioB (_o&, !n ny kou i! in 6rll lorc rd cfi.<r
<br />c//l Zzstfi,4q13 T4;-
<br />colsla!(flo!.lllDlllilcEdcr
<br />I hcb, .lTm un& rE n] or Frur] rhi rh4 i! . <odtudioi ld'din8 .str] fo, lh. psfo.rr@. of rlE $irt for tr hth lh! Fnn .
<br />AttulAAlllqlaalrQ!
<br />I hd*y dEn unds poihy of Ftjur, ok ol rh. hllowins d<Lr{EN:
<br />Dafrririon PmirvAsbdros Nolilic&on Fql6.l R.suhrions (Ink 40. P$6)
<br />-R.qun.d
<br />tdrd of ]'{orificdnn
<br />I .dirt rhd $. laldal rcSul,liore Esddins 6tBtG mrvtl r. nur q'dkabl. ro rhis pmjal
<br />b complt sdh.llC(y rnJ Coua')
<br />lrhi(-irvatui(ounryr0 rdu'nrh._t cdr$ rhd llErc @d rhE,ppl(d(n,n r4. rhd rh. rh,\. '.fotui,n 6cotrd Irsd
<br />orduuc6 Md Srarc LauEhuulo huildins (946ud i.n. e{h@b\.dhyuc rcp.6dlltr6 n
<br />.ho\. rmrFn d pmp.n) rm Bndhr pu.pdl -// -/ ^/
<br />^ppr rorA.6,srM,un X h44 C-{//r-
<br />P.oft(un.rp.,.rr L 'kn{l futrK-I
<br />-,", to/sy'rt
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<br />Pool Fence
<br />Flood Zone Certif.
<br />FINAL
<br />-,**: lJl"ftp-n,,,,' ",,,o -LL{L531b01j02-
<br />cn,.d (Sd :1097, (-r\ (.)
<br />l..nd{ s N.nr.
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