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BUILDING- INSPECTOR RECORD
<br />SITE.WORK OATE ID/SIG.COMMENTS owNItll au[Df,'ta Dt!t-cataaTtoN
<br />I tftl'y rlt n uDLr Fuly of F rry thtl t D.r.trpr ton tlE aonr_]oR lite t * ld rlr tollorut E.eh (sc.701,.i
<br />Burih.rs Id Prdirhi C.d.r any Ciiy dr Ctudy ehth ,.+irs . Fd !! 6.{M, .Xd. trFDE, d.Dlilh r Epltr uy
<br />srrucft. t'.i,r ro irs irr!4r. rtb r.quh! rlE +di.d lo, luh t d r, fiL r nard nlftd rh, l' d {E ! l.rasl Frurr
<br />ro rh. Ilsv6k'a.rrh. C.nrdn,r l,k.nr.d lrw (Ch.pr.r 9. CoErEi.g *ilh S.crh. TuL of l)iviri..I .frh. ltoirs r.d
<br />Pnrr.sbn. C.r&) n that lt or .ll s .r.rpr rlE 6!n .ni rlE blar tbr tlE ull.d .r.6Fbn Any virhrbi ul Salnn 701l.t byey
<br />.pglannr,tr.,.n ro6Fd. r. {'9lt!n! ro ! crvr I p.Mky o, mr mE r&n alv. hund,Bl doll0rr (15(Xr).
<br />l. $ oqEr or r& Fotdy, or my.qihrr.s vnh $,$ a ilEn ob dnp.Mr4 Ull d' dE x* ri dr rMd ir d
<br />idqrlai or olTd.J td.h (Se.7i)a], BuriEs dd Pmlasiotu Cod. TtE CDilrrdt Lien. t * &6 d +rly ro s o*a ol
<br />rFlF, *lb hddr d ftftB ih.r@ !n wb .h.! sh uxt him.lf or tsrll or rt@uBh hn or b.r own.n'pb)8,
<br />pr.rid.n !h.r,(t urFo*de G d)l it.ddofiord ln et tl lFrlc, dE hildn! m !4rwBd ns! rihxd,qr
<br />ol.urvrri,\ Ur OwEr Bu k eill ht* r,l hrnb or FEr ilr lE d dE dil d hri! r inIi.E fi. roF y .d rlt pl,F. of
<br />_I. s o*Er of rtE Fr.ry. d.r.lBrElt .onho! *rn littrcl !rdd6 ro odMr thc FojBl (Sd. 7}14, ahir(
<br />dfil Pif.sirrco<1. Th.Com tqrLt trrL.*d&rd.p?1,tuuo*wofFDFdy*n boildt d ln?DE rhd$tr
<br />Md vlF <'nrdr lor ruch pn,r$ *xt. c. Eronr) lt.N.d pu\'a ro rh. Gdran r Lh.B f.*)
<br />-l
<br />m.uqi u.&r Sdbr- I rt PC fdrhsErh
<br />]vQEril;etlau$lllauaN
<br />DECLAAAIAI
<br />I h.rchyrrrtrmufr,(p.nrlrvolltrlunoxolrh.krl!)qin8 c.llr!ir({
<br />I h.r ud r I m.llnr r Cdltd. olc{led b S.rln$E f6 xr'rlm m,p.db4 rs FDvid.d ror by S.crDn ]TOO of tlr
<br />tlta Cd.. fd rll Fflfu. ol rlE *dt k *hi.b rlE Fnir r i$ed.
<br />_l tuE lnd sdl moth elt.n' uor{EB.rn. rnruhB.. r( fquEil by Saru l70o of rlE Lrbor CuL, for.ll Fn']rBt of
<br />rlx *vt Lr *hIh rhn p.d d id.d My *,rtd mrnEdri ntlrlm sEr !d polry numh.r {cl
<br />Pol.y umh.r _ErpEr
<br />_l Mifyihn in rlE p.rformr. olrlE rort for shihrhit p.rftir n irEl,I tlu! d.rpl,, uy Fm in yMd
<br />m shbcsmrut d rotlEm 6 ompcnuhn l.vi orcl fomn, d rtfr lhr irl Jbuh haom {bi.d h rh.
<br />hll6 6np.ndbn |,ovtpB ol Snr.r l?@ ol OE trbq Oql., I irll, fonhvirl rttrlcl, *irh rhor D6vitEB.
<br />WAiNOIG Fri|ln ro iM qf,td. @mFd!! oErt! ! lnLstot rd 'rrll 3ubF s arPkF ro m.l tEol-..r{
<br />.'vil fin.s up to oE h{.dEd rhou-rd dolkr, (l l00.(xx)), ri ddir ih t. rh. 6q of cdrFMrion, dtnE B 6 t,ovd.d ror E
<br />ltaion :1016 of rh. Lhr Cod., idfrr o.l !.omy s fei.
<br />ucBl[DsqtsIMlJ f,
<br />lEclJSAIIq!
<br />I tmby .frm uid.t D.mhy.r Fjo.y rh{ I .m lienrd und.r Fnvsion d Cn!fld 9 (..mmmi^8 urth Sdir 7{lx)) .r rriririn I
<br />ol rlE llut'Bs ral Pllioim Cixr.. rn my Ii.B B r tull foc tril.fid.
<br />COISIAIICIIAtrIEIIdGTGTACI
<br />I lEEhyrflmur&r IE iy ol F.jury rhd rtm ii | @dtudbn taiins.!tr, fo! rlE pdfclle orttl u* tur qLhrh! Fni i
<br />nirn (s6 1r7. civ c.r.
<br />AITU$NI.DISIdBAITOX
<br />I hdrby dtm lDLr p.n.lry of p.rrlry oe of th. follosns d.c,.nrioEl
<br />fr.mhtion P.mL-Arh.io, tldirf,ltrr F.i.nl R.guLrirh (T l. a0. Pd6)
<br />-RcqurEd
<br />lrtr.r of I'ldf!!rio.
<br />_l..nrtrrsr rr. i.J..rl kru[rn8 cs&J,ry a\h.ios Emr'ltrE r{ aml'dchk t, rlh ni,r.r
<br />_l !.nity $.r I n r E d lnir .p9la.ri.n in nn. Or dr rtoE i.lodid i. .mt. I .!@ io onply *ili it Ciy nr, Ctunt,
<br />rhirh-.! ud Srs!. Lrwr Ehring ro borldins coa{odi,^ !n lEcb, dl$dr ED.Ed{rB ol rhn C y an C@dy io ds npord.
<br />rlb$ dd,r{ FoFny fd ituFd.n PlnFE
<br />A p0licrnr .r A*cnr StDlsm
<br />P.mh( Ed rrrho:
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Rool Sheathinq 1.lo.2r]2 tyayt@o atn
<br />Shear Wall
<br />Framino
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lvlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enoineer Final Fleport
<br />Flood Zone Certil.
<br />c9/
<br />FINAL . r to-//(yu Wytf.\e6l
<br />Certilicate ol Occupancy
<br />Notes, Remarks, Etc.
<br />Rev.08-07-2015
<br />lhl.:-
<br />AD[6lr-
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