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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNER ETIILDER DETCARATION
<br />I lF.t't.lfm !.dd Fll|' of F)ury inr Iea@F &oo rtE Codrar@ La.@ ti* forrn f.lb*in8 ,E,. {ac l0ll5
<br />Buin6 .d Profdior CorL) Ary Cily or Cou y whkh r.qun6. Fni ro @nrrud, .nq. i!,prcve d.mlnh or rF.n ey
<br />!ttu.ru.. FDi ro il3 suftq .Iro ..qun6 fi. arpltur to, qch p6on ro 6t . ri8.d xdaEl Oi h. or .lE b licsB.d pro.d
<br />lo llE F\irio6 af 0E ConEIld! Li.a*d t * (Ctplq 9. Coffiing *'nh Sdion 70o) ot Divnbn I of rh. E{siB od
<br />Ptuf6ioB Cod.)or rnd lr or{E ! crapr 6cnom.d rh. b6u for rlE.lk*.d ddprio.. Ar} vrLrirn ofs&rDn ?011.5 hy &y
<br />.pllcul tor r pqnil $bj<r! $c lpplicet lo . civil pdulry of nor ftoa rhu 6!. h.n&.d dollar (1500)
<br />-.- l. a l)\rc oi lh. FFrr. or ny dplo,6 wilh s.g6 B lh.r eL onrEuiio( *rU & rL wl di llE nnd4 i Dr
<br />m6kt d or olIacd for !.1. (Sc 7u4, BuD4 dd Prbf6io6 Co& TIF Coifi.cd t Lr6E ttr &6 nor 4p1, b a olG of
<br />rlt FrFiy *lb hnld.or inpovitrEE( rnu,ho &Esh w.t hiBltor hEIf orlimuathn lEoE qnghys.
<br />provilcd lha wt ilwsqrd! e d irdrdGl n ofird 6r rL l[ to*w. t,E hlildiB d npsvoEr i] -ld einii m ]t
<br />of.onpl6!.. rlt OrG Ecikk *dl h.r tlE hda ofFovi4 th. lE o. slE dd Dl hlld d irylE $. g!Ft, Sr dE Frpo* ot
<br />L a osE of rlE FrFlr, D d.lGiv.ly .oddnU qnh lt d.d .otud6 ro otu . FnJd (se 7o4,t. &6iE
<br />&l Pblsii Cod.: Th. Codreroi. Licffi l,*- do6 mr $9ly to d owna o f FoFl, who build! or iipm6lh66n,
<br />ed wno cdn &1! for.uch Fojd! wnh . conra.lo(3) l(aB.d pn6@i ro rh.Co.b..1or'r tic@ lrw)
<br />I o.raF undd Sdio.,B &PC forfii! ra,n
<br />D.l.: _._-- OrErl lO8lcsrtaur[diliriq!Df,,Cti{A-nON
<br />I hd.by .II'm u.dd porlry of palIry orc ofrh. tollowins dcluari.N
<br />-l
<br />htE rn will uin.ir . Carifd. oacoE ro SdfiM fn wr6' @qd.io( B ForiLd tu by Sd
<br />t bor Codc fd rh. Ffollrec of lE hrl fd *hich lf. FDr ! isod
<br />N$ "* - *r, -.- *dtd corpquEn lEllfue s 'tquir.d by sdri,n l7{ro orrhc L.!or codc n)r rh. Ffollfu or'li. wI fd *iih rh! md . eid Mv 6rld o':rEdba'@ffidolrvMbd E,* Mlytcan ?ltn dn
<br />^-,,**2lqoovos ..*--tt /t lzd
<br />I.diqthll mllrFf.lrl4.of $.*olt lo, whth rhi! pdn ir i$u.n I rrsu mt @ploysyF$f,rayME
<br />s sloh4om$tidtorlr* 16 omFqior t!s.otcdlifomi{ rd.iEltn,f I ihould bEom $qd b l!.'
<br />Nrtd oBFsrion pmvtioB of Scriof,!?mof Et.hnCod.,I JEIL fodh*nn onply vnh lho* Frviriod.
<br />WARNINC lnturc to kuc wrk6' cohFsarion svdrs€ ir unhwtul. !d !h.ll lubjd e dploF lo simi l FrIb ad.nil finG up ro or hcnd,ld rhousd &rU!E (t100.m01, u .ddihn ro rlE o. ol coh9c6dio.. daD{d 6 FoviLd tu rlE
<br />s(hon :t07b olrh. trbr (iit..
<br />",,,,10[q lzo
<br />DECIJAAII(I!
<br />I hs.by irm un.ld p.nlhy o t psjury lh.l I er licdsdl und.. F!roion of Ch.pt6 9 (.onmdcins wnh S6lio. ?000) of Divbion l
<br />of rh. Buils dd PmfdbB Cod.. rd mr lice ir in tull fo.e tn.ftd
<br />,.,. b
<br />0 qlv15l"
<br />ZO v_ly_\4t@
<br />cattrBr(rolL[IiDlrc-&cEr(}
<br />I hd.by.rlrh undf tadq of FJur)-lha lfiscsaco[(ruclion lc, Dga8ft) ft)r rh. pqfolllle-*..f lh.trvt fur}hxhrh6Fnr !
<br />6su.!(s( lt0i)7. civ a.).
<br />AITUCANID}:CIJAAIIO!
<br />I tctryarrn undd pqthy otFJury onc oflh. follouln*.,.(ls ioNl
<br />D.mlnion Pdmils-Arb6los Norinciion Fd6rl R.r.ulat io8 ( l ill. 40. P.n6l
<br />R.qurdl ldrs of ldr'ff,dFn
<br />I cdiry rhd rh. aol6d r.gul{it,N r.g,din8 ab6b! lmvd a. nor @rli.bk ro rh6 pbjd
<br />tN(ha,ry rru r u,c r*.r rts upr
<br />)lrdi.!nc6 Md srorc L+! Eldmx ro
<br />nd.lhd$. ovc infom.dion Dcor.cr l l3rdro.oaply wnh !l I Cny rnrl Coutrry
<br />ah.!c ,mrional rr.pdry for
<br />,ulhr.n?tEla {tr6ofrhB('Io dd ( ounl} ro drE upo.rE'\ /-'-,.k \q I rr,
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUl nsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framing
<br />lnsulalion/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />lt
<br />FINAL I ql-zD \-.)tl+-6'l
<br />Certificate of Occupancy I
<br />Notes, Remarks, Etc
<br />appd(.nt or at ! sirn.run
<br />*-r--..,rntr, N wfi
<br />Flood Zone Certif .
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