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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.owNER EUll-DEn OAI-C R TI()N
<br />I hcrhy rllnn und.r |xn.lry ol ncnud rh:r I rm.(r{'r lNrn tlE O'r r!.t!^' l.r.ns tr* tn ilE loll'rn! fur'n I.EL Toll 5
<br />Burnc\\ .ntl Pro,.tin,n (',1Lr Any C y nr counly whkh r.quFr r Fm( k, ('ndrucr. rlr.r. 'mfn,vc rrcfrnBh o q'!u an,
<br />(nkhtrc,tfttrl.rr\ r\ur&t. i1o tctttrt.t rhc q'Pli.{trr l'tr {'rh Fr nnr k' llk i r ilncJ nftmnr rl*r hc o. sh. n li..nGr nuNMr
<br />h rh. F,rr$i. ol rlf (i,nrrr.!r r l.Nnql lr8 lc-tut{n tr, (innmE'nt w h S$$n 7Ux, ol l)'vnr'n ! ol lh. Uunn\r uil
<br />Pr,l.ni'n!(iiL),,ihrrk,*rh. K c\.q, rh.r.fr'o rd rh. t!:!! n! rlE.lklcJ.r.n{ir)n Anvrrllor!'nolS(rrn7(!11Jhvdnv
<br />rpplrinr(trrFm tlhFrl rlr a{'plErnr (, ! ( r 'l
<br />p.Mlr! or d)r mk rhan | '!. hunlNl Jtil.r I tl{lr,
<br />-1.
<br />J( n*mrol rlrlrsFny,,trmycmr*)yNs v h*i3$,r rh.r <,komFn!.ii'tr. w'll,h) rlE*,f,inl rh.{drh'N r{
<br />ni.trnrl or oltcrcJ i,tr qk lsc_ 70{4. FuriF* rtrJ Ptrnc$i, C'!,q Ihe (tntRkt'r l-(cnk l-rw r\ nor +Plv r) an o}er ol
<br />rhc nF'Fny *h' h J\or rqs'wrrh.Nn,. dl *h,&x!luhul* h'mrllor h.n.ll or thtuu3h h( r h.r {wn .hplov..l.
<br />llnrlrl.d rhrr ru.h m,F,wmdid dn dcrhtrt.ltiBl nrsk ll, hltrfrs. rh. titrLl4r tx ,rth*!md ! $Li wihn ok F.
<br />ol.onrtri'( rh. ( Nrr Bu Lr *!ll hrlr rlr tuLY ol F*rry rh, lr or {E Jii n{ tlrtl tr ntrnt ln. Fllxnv lnrh ltu4r'< ol
<br />--l. r\owrkr.lrlr F ,r y.rn,.nhtrrely(,tr[ntrrnftr[[ltr.nt.(l(otrrrr(rr\r,,iNnudrli_t'o,.(irS..7l!J l]Lrtr$\
<br />,,n,1 *l!' (r r!(r\t(tr \khIrrI.Gs hr(iDrr&n)n\)lt. \.JN,ru.[n)rlI(ntrtrr.ntrtl-k.tr\-lr]r
<br />Lnn.\-nrF lul s.!r[n .8 &l'('l(trrhsr.:!rr
<br />IIORKI]RS' C( II\I PFNSATION
<br />II}:ILASAIIIJN
<br />I hkherlltrmutr crIrnrlrroln rlu'f o,tolrlEnnL,* t3nr(lIrrn'n\
<br />-
<br />I h& lri !!ll md.u ! Ccrlfr:r. o, Con{d h S.ll- lhurc lir *ort6' (oqEnrrDn. '\ F*r}d lttr hv S<rx,n 7(Ilol rlx
<br />IikF (nrc.ltrrh. Fdo'M. olrlr k n, *hrhilr Fmn ! rrkl
<br />rlf,w.'kntrwh'(l,rln\ItnnLr1\i$ucnMvwork.^(orFtr\.rntrrrurukc.itr'.'nrllr'1(,trlolir r:
<br />-l.cnnyrha!
<br />h rhc lxrl,trtutu. ot rlf, uork 1,tr 'hrh rh
<br />*) i\n' l$om suhi{rh rhc w.lksi .onPcn\nrnrn hw\ nl
<br />tr{'r.i. t.mF'n\rrr( r.rhk.n..lt(rrin r-lll,tl tht lJ
<br />lvAfllllN(; l. ur( t, (ru. strk i\'.!iqEn!ri)n.'tr.
<br />. ,1 l,kr !p t, on hnnnd rh,oer &,|lfi r'lllx,.lrrr)
<br />I p.rh r rsuGl.l rh{ll nor.mtk,in, n non in.nym$Nr
<br />Crlli)rn!, .J ,IN! rh n l rh'uld tx.om rubirl lo th.
<br />rtr (irL. l {sL nr hrih omply * n rtl'( nt'vFi,n!.
<br />rr!. tr ubwrul. .nl rh.ll rbi.{t r dq rrr
<br />'o
<br />dtE l Fol.r rDl
<br />bn h rlE ({ ol .orr{r.trdiln. drm3.! . trofrl.d flE rE
<br />I lErhy tlfm unifl FMxt.l F.rry rlu I d ln n$i ud.r Frvlr'n olcrlrtid 9 (lrrllftBu! *rh Snl.n 70Nl ol D'vtr.. :l
<br />of rlr BurE.i rn Pin i 'nr Cdk. !r! mt llt^{ s o tu[ n,R. .uj cllNr
<br />4)\
<br />^!.Ll sn r!,i (i\ ( r
<br />al'Il,t( a\l l)1.( l,,1RAll(ll
<br />I lrr.l4.rrliru trrlr lr .' rv !n ltrtu,t !trr. ol rl'r l,nl,,$tr,! (l.i Lu. tr r
<br />l tarnrrn' ltr trr\ Anr{o\ N.|ltrrrrr I r.l.'rl R(!r.n0r I l il. lrr |r'6r
<br />It.qur-l lr(.r or Mrnirrr
<br />I dd'lyitui rh.l.d.r!l(sul.i(,nr rlmlo8 rllEdos k.rtvrlrl. n{.mlrit'k h, rhtr Pn,r1r
<br />l(ri'rythrr Il'r\.'(rirl'^,rplliIn,rtlrrr(r.d!!nHr$n'\(!ne. l.'3rNn)ro rlv*!hill('ryrnn(i{tr v
<br />l.r.l,t rdL-- (Fcsorrrs,,l ihr t''iy fi!(in'ntvr'rnr.r uFrrlritrIltr f,.\,nnl Sr. ., r!\ rrl {rt k) hu
<br />ih*. nnk,frd ln'Brit r'tr m\F.r
<br />'\rrli.{nl o..\scnl Sisn{h'ft G
<br />Set Backs
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />Roof Sheathino
<br />Shear Wall
<br />Framing
<br />ln s u lalion/ Enerqy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coal
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif .
<br />/r{
<br />FINAL 1-Y-lo1 X&l.5r,l
<br />Certilicate ot Occu nc
<br />Notes, Remarks, Etc
<br />COMMENTS
<br />Forms/Steel/Holdowns
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