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BUILDING. INSPECTOR RECORD
<br />SITE-WORK rD/srG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsu lation
<br />Boof Sheathin s tolk/:r 5N*6
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Itrlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />FINAL llto/$7\4
<br />Certificate ot Occupancy
<br />Notes, Remarks, Etc
<br />Or{NEN BUILDCT DELILARATION
<br />I h.rcny trllum undcr pcruhy oa Frrlry rhnr I d cr.mpr ,hn rh. ('odrebu Ltcn* b* ror th. lolher8 r.r{,. ls* I).11.:l
<br />Busirr( .nl Profc(i,. Cd.r: Ant Ciry o. counr, qhth r.rtliEr . Fmt ro cnn(nx!. rlrs, i,r'omvc, &nEl,rh or EFr M,
<br />{u'8. Fir l0 s rsre..lm rcauiG rlE .p0li.r for {sh Fmir ro nt r rirftd <d.m! rhd lt or rlE i litntn |lur@
<br />r. thc F,virtff or rhc Contdd s Li.c.*d l,w (6,pt.r 9. Co.rmrcitrr wiin Sccrhn Tlxr(, or Division I or rh. Busift* lnd
<br />PDr.$i)rs c.rlo or lh.l lt m tlE k .r.flfl ilrr.iirm.rn rlE hrn ror tl.t dLa.n .r.'iori,n Any vi,ld*,n ol scrbn ?0.11 3 hy.ny
<br />lpplf,rnr ror . Fdi {bj*rr 'h. !p0lK.nr '. r .ivil p.ehy or mr m,rc
<br />'tEn
<br />fiv. hu.!r.d dollst ( 35u}l
<br />_1. ri osrr ol rlE FFny, d mr.q,loFr snh *!S.i * rlEtr rlk crrfE.dbn. \i[ rh rh. *qt .!ri dE nnrlft a t,
<br />mr. h or of.rcd ror {L (Sa 7{X4, B$iEsl .nd Pror.$ins Cod. Tnc G}nr,!d.i( t,ten{ L.* diEt nor .ptly io rn owmr r
<br />rlr F,Fdt slnt illr 6 infhB rlrlrn dd s lF ds *h knl hjmrlf or h.rclf o. rhmuSh hk or ls oln cri{lloFcs-
<br />|trovkLrl th.r lEh inq'ffidr c B{ dcr*i r .tu ltr sh lL h,rN. rlE trillE r nlFtrrEn i! $U wftf, ir F{
<br />.f mqrkrion, rh. Ouft. Bxit d wil h!rc th. t{r&n of F,vin8 rhsr tE or $c dn d buill nr irqnE lh. ,ln)pqry fB rht Nqr,c or
<br />_1,ulown.rofrh.llnrFny.r.ncrcluiivclyconrrcrin8wirhli.cnsdcn rcd,,u k, uotr\rtucllt poFcrls( 70{4. Busn.s
<br />.d h'l!a\in ('odc: Th. Conrrrroir l-tcn< li* &s fln TI'ly k, Do$kr.tph,Fnt $rr, huiur or inpmE! thsotr.
<br />r.d pho drntrh trs iEh proFh qirh r c.nrkr,,! (, lk..*n punuld n) rh. Co' r61oi! Lttne l!*)
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<br />DECIABIIITIN
<br />I ns.hy rmfln ur&, FMlry ol pcrrury orc oal& folhsin8 &{lsdi,nr
<br />-l
<br />h!rc sn r ill roi.hin r Ccnifiqrc ol Conscnr lo S.lt ln{!ru lor wollc^ omp.n{rn,n, 8 rovid.d ror hy Satt'. ]100 or rlE
<br />tlk (irk. nr rh Flo..Enr of rlE *ut lu *hah rlE F nir i{ nlucrj
<br />Ihovcandwillm.,nfuinwnrl.R comp.nsarn,n insurEc, !r rcquncl by S..tion.U(xlotrhc lib.r (td.. fot rlt rEf.rmr. of
<br />rlE url fr *hi.h rhn Ftur i. n$.d My edt6 .rnpcndrr in.Urc qri.r !n Fli, nun$.r ft
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<br />Nx'fy rh{r in rrE Frlor.rN.lrlr sort lr r
<br />w, a\t, hd,m r!bj..r b rlE *oAn\ ()mpcn$rion
<br />*0116r snfxnqrrrntmviri'morSd6n.U(x)of
<br />wAIiNINC rrhr. t, sE krtst, otrFnern
<br />/hih rni\ Ftui n ated. I $.ll n .,pt', ry Fmn ir.nt MM
<br />L*r orcllilomi. !d rxr rhd if I !ho!k tr.oE .ubjd ro rrE
<br />rlE uh(r cuL. I .ldl. frlh*nh orpl, wirh rtb. Ibvnii6.r dr6*r i unb*rut arn shdl sbFr x .rploF tn aimind Forlr rid
<br />!n'r rfi.\ trf ro or hutrrl'.,] rlN\,utr| ,loll r"tn - dlry,Q,) rh..o{ .r .o lrtr\ r.0. ,hrr'S.1r\ |no!tr|.J |,tr rhc
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<br />ugJa.ulln
<br />I h.ruhy uifin!.dcr p.Mltyor Frjury rha! I un liccnyiuBirrnmfi\i, ofCh trd9lernnxkireqirhScdiu7(XD)ol l)ivni,n,.l
<br />or rlE aurirs .,n Plr,fsrir( Cod.. .d nl la.M ir b ful tuN .nd clI(r
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<br />I h.a.hy rfiirn unLr II ulil o I Fgur) I hd I cr{Mrb. Edrr! r!.Ny lor rlE Frf(ImBr of rt *olt ft, Ehah rhE Fnir ir
<br />ksud ( Scc. 1097. Civ C ).l.ftlci. N.m'-
<br />a8tl.tl6ltl)EcLa8lllll!
<br />I hdtr, lrmru Lr FmIy or |rriurt om oirrE lollouxrf d.(lu{k ni
<br />l)rd'lnion Pcrmir\.A3h.rror N{nifi.'ti,n Fcd.ial R4obtions tT k.l). Pfi6l
<br />R.qun d Irlrdnf t*riirdrrr
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<br />6 dlllk r,..EE
<br />rrBULr!io\ r!!udtr,g r\II!r\rrnr\rlrrc n rptrl.rhlc rrrhtr l)n'l!r
<br />rlE!h)vr ri nuri,nrn$'rc.i I n!r(r).unUysnhrll( ilyitr'1(i)utrry
<br />,r ,,n lrEby.urlrtrt! rcrrcE rdihs orlhir Ciry.rn o)unry ro cnr6 uF,r rlE
<br />,\ppliosnl .r ,\r.trt SisMlur V':.
<br /><rl,o A. iLa u o:*1 4tz
<br />,,",.,2A 4'/6
<br />DATE
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