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BUILDING. INSPECTOR HECORD
<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/VenVlnsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framino
<br />lnsulationi Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coal
<br />IVlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Reporl
<br />Flood Zone Certif
<br />I
<br />FINAL ?D/z*c il414i .\
<br />Cerlilicate of O nc
<br />Notes, Remarks, Etc
<br />.)rvtt.R lrt truRt,tt.
<br />I lmby rtrm utxl.i Ful, of FrJury th{ I D .krqr ton th. co'd16 t4r lrr fd rll folbvD! E.s (Se.roll.5
<br />Buin.'s ,nd Profaidn C.d.lr Any Ciiy o. Ctun! *hth r.qun.r r Fd r. c.dM, .lls, i'r$r.w, &mlhh or Ep.n Dy
<br />idE.Firbits i!M.rt Eqlc rlE 4?lId for '&nFdb nl.. trrEd {daEtr thrlrdr!.-lrttEl Flrur
<br />r. rh. povirhnr.llh. Co r&rolr l.ie.rd llv (cllprs 9, Comftrcin3 wjrt sdtih ?clD ofDirhhi I of th. BBms md
<br />Pltrf..rnN Cdt.l e rha Ir or rll n.Eng rlElfom.d rh. h.rb tu rlr ritrd.Eqrin Any vi)hi.n of Sdir 7011 5 by rny
<br />!prla.! aor i p.mn tubJei! iE .pplE! ro . cir it p.ul y ol mr mt rhs fiv. tuidftrl dolla (tt{D).
<br />$.*ft. l.h. F{Eny. 6y.rpt'F.r **h w.!6 o rrE, bl. onFdn., *:I d, rlr 6t rd rlr 1fu B d
<br />inr.dal orolf.ral fd.h (S- 7ol,a, B6iBr.nd Plrr*ioD CcL: Th. G)dh_-!r'r Li...€ t *dBd.ppltroeowtor
<br />th. FoFny *n' ho nq inlmBnEe.n vllo dc sn wtt hire, s tE slfor ib.e8h bir d tE om.npbl4]
<br />Fnrir.n rh.r rsh inp.nEcd. e d i..flr.d (.f.Ed kr.l. l. LrrE tE llildiq ( lr+ioErn ir -b Mh.G Fr
<br />orcont,lri4 rlE OqE Buil]d will h.E
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<br />h,!.n o, Fsvin3 rhd h. or {E Llid d hJi! odlpl$r l,l pbpqty lor lll peo€ oI
<br />'<O./ll. r nN k, ol rrr prop.dJ. h .(lunv.l) Ndra ro8 *rh lr.E J . odrr bn ro Lon{M' rlE Fiq! (56 70.1, ButiEs
<br />- lrl Pn*rs cd.: Th. Coirdd r k.nr llw &B d .9?ly ro u ovE ol FoFny *to hitl. d r+mE! rhda(
<br />.id whn mdftB lor sch Fojerr wnh . Cod*!,(, rErdt nurud ro tlE Od6d'r tieM b*)
<br />,,,,^/ tt I toa'"1 l]I!t !-Bll!l!
<br />I h...hy rnim un&r Fmny ol Frrn .r ot rk tnll)r iry J..Lrdr)N
<br />_I hrw rn v l mid.i. r Cdirht. olcoMd.o S.r-llw t i urla $np. iio( .! Fovid.d rDr htsdi.n 17@ of rlE
<br />t.ls Ccnq tu (lr psrorllrd 6f 0E di IG rttn it FEil i isr,rl
<br />_l hrF rr'd *ill Ein.i, srtd .or4.Mn. iNm., B Equftd b, s<!ih troo of E Lrbq Co{L, fd rlE pdttuE df
<br />l,r xrt lr errrh rt! Ftu ! i*d. M, sdl6 tunpcdbn mlrr mid ,rd plr, rurIEr E:
<br />Poli.y Numbd:JrriB
<br />_l rd ify rh4 in rlr Frfomrc. of rlE wo for whi.h rhi! tErhir tu nsu.d,I shrllmr.nploy ey IERon i.&yll]rftt
<br />s d ro h.sr rubj.{r r. ilr srrdt otrpcMin Lst., C.lrtom, .rn.tE dd rr l {rrld b..ofr dtJ.cr r. ilE
<br />sor(6i {nqHsrEn p,DvnlB of SBrrn l?@ ot rlE trru Odlc, I dlll rdhsnh (!r91, r{h !. FDBEB.
<br />WARNINC: FrluE ro EN krt E otrp.d-i, @wnr. it unLwtul, lrl slEll3uhFr 4 .trploFl ro Gimilrl Fuli!.dl
<br />.Ml fiEr op ro oE h{ndEd rh.B.,, dollr'! (llmll[), D rddrir r. rlE d of .orp.Mri6.. d.ma.. ! F.yiLd ar ,.
<br />DAIIJIAITQU
<br />I t*by frrm ud.r lxMlry .t Fj!.y rtd I rm lienrd u.dn F)virm .r atr.Fq 9 (6mftrir8 *th sdim IxD) .f Divns. 3
<br />o, rlE Duirr! ud Pbfr.rirb CaL, lrn ny Ij..M ir in tuU ioG !n.ftd.
<br />qQNIISUCUAUIII)INA.AGIICI
<br />Itftby fm udLr Frly ofFrtty rh. E i!. (:dNb ldnu rsdy fDr itl Fdf.rm orrlE rdt 6r qhi.h rhr Fd ir
<br />&El rsft. 1117. Ci C.).
<br />AITIICSNI.DEII.aIAIIAff
<br />I hd6y rlftu lnLr D.Mhy al p..ju.y oE of rlE lolbrim d..Lr.rbB:
<br />t).Dl[on P.mir]Att rd NdinotDn Fal.rrl R.t!hbh' lTirk .lO. Pd6l
<br />Rauirs, Ldrd of |ldl6ru
<br />_l rnify rh! rL ralanl r.8!hrim r8lrdBr alBros Enr,vd e t rptlubL b rhi! pn,Ft
<br />_l.d'fy,!rIhxv.s.trtu\rppltrlio..ili .rhrrh.!bov.inromDrionn(omurIryrroomdy*irhlllCilyrdCoumy
<br />ddmNr .tn Srrr. Lj*! EhlU ro tI Jna .oNEdDa !d h.rh, rdlbrE Ep.*rrliE ol rhr Cuy .ri Courry ro dd uFh rlE
<br />rtrtr. ft.rrto{ Iln)psn, Il' np.dni r{nlb$ ,_
<br />A ppli...l or A36l SirMiuE
<br />I
<br />Rev. 08-07-20I5
<br />Sdnr-,
<br />) tuileY
<br />Irn&r! Ad'lE r-
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