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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS o\YNlill auIt,Di:t{ Dt:t,(:ltaA'rft )N
<br />I h.rhy nfri.n' und.r lEnlhy or Fr)trry rh.r I m .r.Dpr tunr rh. (i' tur@ li.n! Lr* ru rh. tulld*n,s E en ( lid 7011 5
<br />t usiftt\ In lhl.asnn C.d.r Any Civ .. Ctudv qhih rqur.! , Fmi h c.n!Mr. ,tr6. rqxoe, &dn6n EF, $t
<br />rrudft, Frtr h ns trsre. !, Equftr rtE lrplrrni tbr su.h Fml, r' 65 ! qEd nr.m.r rhr h. o. dr u liEtrqt t@sd
<br />h rrt omv'rionr .l rh. Cntu*ror's l-iccnfd liw 1( hapr.r rr, C.mm.tuin3 $irh Srcrirn nrl] oI l)ivnion ] orth. Buiirc$..d
<br />PmrisIB C(xL) d rh.i lrnltE n.r.nri rMrmul rlE b.s rur rlr h.d.r.qrir AnrrblrlinofsdD.rolt J hytny
<br />rl,rlKr ror i rxmn lobFr h. .onlr r rorciv'Ip<Hhy.tmrmErhnn fiv. hundEn dolh6 (ttnr
<br />_1. r .r*r ol rlE rnFny, M my .trploF! yirh *.r.3 I rlEi 6L Nnp.Mioi. si[ d. ilE *rt -l E rM6 t d
<br />ddrlaj d ollir.J rtr !E lsq nx,{. gurBr ..d Prnrdih (ii}: T|I Cd,rrr.l Li..e tl* dq .ot F9ty r! x olu of
<br />rlE I'n'tEny wt h(ild!.r nrfmB rtBb( u, *h &E sh *' hihr.ll or ttrkl( or ikourh hir or h.r oq.qio,*1
<br />Frvij.d rh, rkh in+rmtlr r d id.'i.d (.ILr.d r6qL I tF*G, rlEhllllrE m itrpieE i!hlj*arli!.EF.
<br />oa.drl,lrm rlE Ow BritE nU hE E h,r,.n ol lr|in8 ih lE n aE JiJ d hi! n in+.oEl,E F)pd,lr rlE FrF. oa
<br />-1.
<br />i\.srrr.f rlttnl)n ny. rh.r.lu!q[ro rerlll3-nhlkdqt )d.&r6 k, onlur rlt FDF1 lsd ?O'l,r. Bu!F\!
<br />in l|rikr.r(ixl. Thr (i,nrh(lor't Lr.try trB dii\ nn .fi,Iy h d osxr ol lroFnr r h' hu'lJr o nilrtrfl rh.r6D.
<br />and *lr.onracGrrrnrhnn)FhwirhrO,tutrL'(ntic.nstpuhumrr,rhc(inrrkr.\ljccn\cljw)
<br />-l
<br />rm .k'r{i sa.L' S€
<br />rY0aff&I:sallrD&IArlo!pf,ct aSalu!
<br />I h.rchy aljilnund( FnlkyorOcqury.n. ol rh.l,,ll.*mE d.rlflrk,nr
<br />_l hlE !:l rrll tuu r cdf.{. olcrred ro s.ll-IIBu rrx hxl6'oqtura !t tlD}ilal i, by s.{bi l?m ot dE
<br />t tlr On , ft rh. IErldltm oI rh. rdl hr ptih rh. psm B i$kd
<br />I hrk .Jrl *,ll Eidrin hlt6' .oq.^r.rbn mrurE., r! Equiln by !E rrn 17m of rts L.hor Co&, lor rlE FfoI*-. ot
<br />ih. \rxl ls vhlh rhi. Frd trrd My qrtdi oqi:dEn lNrc? Ms nt Ft.y hlrr r.
<br />Pol{, Nr'ntEr _Hrp'Er:
<br />_l dif, rh,6 E Fform otrtE ydt r(, wnEh |tr Fr, it isEt.I.h.tl d.iplry dy p.en r d, ffi
<br />, ! r. tE$m rut j* ro tl! urtd'onF.Mbn L*r olctfiroh!. dri ic ilIl it I slnuld b...r altd b rtE
<br />wo .h $ p.NltionIsviliJNofsd,on l?(Dotrh. Llborcuti., Lull aonhwirh Nnply *ir[ rho* pruvisFE.
<br />WARNINC Fri[E tu x{u *rtir on+.dbn d,Ehi. i ud.]tu!, ud fi.ll sbiq u.npbFr ro miEt p.rt6 rd
<br />c l litui uI b oE |lilnd rLr-rd thlh6 (tlrrr,urD. r .dr.ix ro rtt cd .l (o.qrMm, deSd ! F.vitod tu Lt!
<br />Sdr$n 1076 olrh. Lh, Cod., inrdi 'Bj r lmy I f$
<br />{pD[.ur'_
<br />Lt(-EtsE) coNTn ('Ton
<br />I]EIIJEdIIOB
<br />I h.rlly .ftm uia.r ,EMIy of,.riry rhl I .m lt sn ui&r rmvbbn or (tund I rcmmrinr *nh S.dsn 7(It) of Dn khn 1
<br />or th. AB,ES !d Pn,t6 a Cod.. &d ny tf,.ne n h tu fi)d!n.tld.
<br />lrrr._ Conrr.ror
<br />ooNsTtalrcTtoN t.r:NDtN(i AGENcY
<br />I lErby sllirn uaLr FDlty of lErju.y rhd rlft i\ r conntu-iitr' !,inB rt.Ey titr rh. IErfimur. oI rtr ut l tur qhi.h rhii rEmn i
<br />rlkn rsfr hD7, Ctr C.)
<br />APPI ICANI DFCLAN.ATION
<br />I h.!r,Jamud.r FMlyofF.j!ry or of rlE tul5ro8 &.L. rh
<br />O.nnliFi PmG-A$.jor !.ld,arcrtrn l'.d.r.l R.Blld.hr (Tnl. .tO, P.n6l
<br />n.qlirBl trn.r of
<br />^ldifrrin
<br />I !.nJyrl'n rlELJ.r r.gulMD r r.3snn3 h.io\ tunr{:'t rE ,r{ rfrt'uhk r)rhn n^rr.i
<br />_l .df, rhd I h.w crd $1s .r,l..l e rn ixc tn.r r& rbor. 'itontrrtrr n rwr I .gE ro .-nply r.h .ll ci, rd ctud,
<br />u i'u'*r urt Sr . tr*! rrr! ru hlllha &Nhlrirq rn trEby.dbnE EF*ridiB ofrhtr Ciy r,ld Counr, ir' dd !!.n rtE
<br />rh.ve nEnriatud F,p.ny lir iBFdi.n pu4xkr.
<br />^Dpn..,r
<br />o. Arol SiEl!E:- D.r.:_
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />SubrloorivenUl nsulation I
<br />Roof Sheathing -----P 1 lo D $^ h.$m#)
<br />Shear Wall ' ''>,ri-J c AetN
<br />Framing l I
<br />lnsulation/Enerqy
<br />Drywall
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />rl
<br />FINAL qtrym t)/<#
<br />Certilicate ol Occupancy
<br />Notes Remarks Etc.
<br />Rev. OB'07-2015
<br />Ext./lnt. Lath
<br />Flood Zone Certif .
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