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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.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 />Framinq
<br />lnsulation/Energy
<br />Drywall
<br />Exl./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 />Flood Zone Certif .
<br />I
<br />FINAL ,r//aq,
<br />Certif icate ol Occupancy /t-J {-/
<br />Note Remarks, Elc
<br />OWNEI BUILDEN DELCARATION
<br />I lErct, lfltm unlcr Fnlhv (,1p.r]tlfl rhd I d c(n{, aFm rlx O'drrhn' I.r.n< liw t rh. foll,vrt Eron (Se7OlIt
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<br />P.n.({tr. (irl) { lh.r lE q.& n.rcq'r lh.r.fmn.hl rlI b:n. iitr rlE .lk3.n .ic,{r nn An!r$Lrirolsa rTOll llhrrn,
<br />amhr{rru !pcm slhFkr,{ 'prhanrx' IcrlrlFnrlryofno' tu,r rlutr n!. hundrcd rlollar(!5flr)
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<br />rh. F,IE.ty wh) hilJror qEB rtrNo.orn who dcr rkh q'rt h!r\.ll'or h.r*Uor rhnrugh hn or hcr om.rnhycc.,
<br />pn'vrLJ rh.r ruch mFUmnB e ftn -rorldl ir ofi.fti lM sL ll, lFM. rh. t! lrU tr lqnrftd i! { l *irhu o* Jt{
<br />ot(,lpkrin rlr ()*E BUllLi $dl lIE tlr h, kn oa Frbs rhr h. d rrr Jri n tu!d nF EtrFiFrynrllEFIFEol
<br />_1. orEr ot rlr F$Fny, u.r.tunwly .oda-^r 68 *nh lf,frGl odrann b NncBr dE rmFr tse. tu4.{. BBrar
<br />.[, hDEanncnt:Th.CirrDroirLr.Nlj*&Erft rfi'|, h uo*d oar*oFny wtn l['Ui or in'lmEr rlEr.r,
<br />.tuj who o.rmds tur $ch prnrLk virh r ci)nrn r,,(o l.o..d tdlsnr ro rlE Corrr&rn.s Lacnc Iw).
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<br />DECIAEA TT
<br />I h.,ll,y a,iirmrnJc' Ixnrlry of FI'rynmolrlr k,lloe'nt JdL'rr$nt:
<br />_l hrR Dl , rll murrtr r C.ndirr. of Co.<nr ro Srlr-lnor li, h,t 1$n{rndrn,.i Flvrrdl ror hy Sersn lfir orlrE
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<br />rh. *,xl ,,r rnrh rl$ Iimn s Nihl iiv *.rk6 $frFnrrrr m\!ru( (dir In Fnr y rumh.r &:
<br />.,v,1 rtrr\ trp n) om huftlr.J rhou\rnJ J.llxr r1l anktrr k' rh. !,\r r, (nnll'.n\rrR)n,u8.r rs pnrvklcd i, rlr
<br />S..rrm v)76 o1 rh. lih' (irL, nr.r.{ rli r D s19 p'oV \i
<br />DICIIf,AI]QN
<br />!frr.r F,vni'n ol (1irl,q 9 tr)nrnrErn3 * h Selin 7tx[) or trv(x,n .lI lrrhy.ltunldd Fn.lry olrErlury rhal
<br />I rl!.Iiu!n($ r l,'Dn\!on\(,r1,.
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<br />I h.Ety lIftrh !h!.r FElry of ,xrrry rh.r n. dft rturDn hhl!3 4.n y lor rlE F.ftm. ot rlE Hrl lu shih rhtr Fni !
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<br />APPLICANT DrCI.ATAATON
<br />I h..rlry .flrm unLr tEmty ol tr rury oft ol rlE nnbsnr d.(Lr.r rr
<br />D.tu'l rrn P.rn r^rh.no, Notnrtibn F.tLtl R.gulir[nrtT l. rl0, Pd6)
<br />_R.quiftl k(.r ol t&r 'r{ni
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<br />n(,frr I rFc rd sn{ y qnh.ll C(y.r,l (iiunr,
<br />. r.Fc{ni tr.rDlrh^C y..J(nu yn).niduFrrlr
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<br />I(.nifyrhrrrrh.ll.rntrNnc.dlrhcq rl l'tr whk h rhr\ ncrmn c Bru.rl,I $rll n.r cnl'Ioy any I.Gon lnym,nmr
<br />s, n, hcroE lubFr b ih. *ytsi .o,rirnqrnn l'*t ol Cal omu.,i ?3R rh:r ift lt,,utrl lrnm $hi\r trrh.
<br />s,*dr' $nttn\.rd nnrv66nr nrsNrD. rTttl dt rh.ljh, GiL.I \hrlL r(fhlnh(-n!ry * h rh'( If.rsi'n3
<br />WARNING: l,, ur l. $rr. k .^' .onf..t2rk,n N\ri3. rr lnl.wtul. r.J \tull q'l'Fl an .hnl"ytr k, omnrl Ftulrs.nl
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