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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNER BUII,DIR DEL('AR tTl()N
<br />I lEEhy .ll'm u'n r rEuly t,l p..nry rh, I 4 cr.npr rn,n trr (.dturm Lxo* L.e fin rn nnb*r! rc&rn (Se,o! I I
<br />Btr\incs .,rl Pnlac(i,n C*lrrr Any Cdy or cr,'unly whah ..quiB r F.rn h otrdBr. 1116. n{roE. !.Bnsh or EIqn My
<br />nMU6, Frtrb r r$uB!, dq, rcquErrh. {,t'lEd for su(h tEm n,lik r rtmJ ddcmnt rhil h.ot nE n [ccn*! px^ud
<br />k' rlE rn'yr.rB ol ltI Conrrrtr l L(nhl t:w (Cn td 9. cotimNr! *'lh Sdin. 7fiD ol D'v(bn I ol
<br />'rE
<br />BurE3. ..!
<br />Pnrf.sklir CoJ.)orrh4 h.orrh. $.r.nv'r rh.rc,n,m! lh. b.nt nn rh. tlLS.d.r.r{ri'n An, vx,Llrr.l Serirn 70l l 5 hr y
<br />.mn.. ntr.Ffln{l'Fkrhc rmlxtnr ro r.'vnp.mxyornoi m,Ertun iiv. huBtr.d dollur (l5tro)
<br />-1.
<br />.s own.r.r lhc Jn,Fny.,tr my.nrlolt.r, h wrrcs ar rh.r {'L comt'.nqtrn, w,ll&) rlr *,{t !n r& {tur@ tr d
<br />d.rLl (.lf.rJ nr et (5d 701,1. B!re< oJ Ptul.$x!..G{cr Th. Codrntx'r Lr6F L.* {td{'Plyhuohrol
<br />rh.pn'|Eny wh burus or utn,vcs ilrE,( a eh! &8 sh u'* hmtll or h.rell or rhholh hn or k. ow..q'lort.!.
<br />F(liLJ rhi rurh 'rts\mdr e d hrdiai r offcGd nr e! I( h)kE rtr hr ot d qhEnd n tlj *[hm on. y.e
<br />or cor{llxr4 rtr (rBr Bu'tLr w l h.r rlE t!,J.n or th,vu* rhd tr r{ {r dn D{ hr!! i, u!n'e rlr FrFry rd rrE F IDc of
<br />-1.
<br />15 nwncr ol rh. 0oJl.n y, rm c\.lurv.ly co"ln.linS wirh l(cn*J ront.(r6 lr' oNld.l rlE F,F{ ( S.t ?(x4, Burtr$
<br />drr Prftr.uC,il. It ( onrr(rtr't l-rcort t:* tkFr nn rrpl,
<br />'o
<br />m o*ncr ol FoFl y *h, t urltr rm0orcr lh.t.on,
<br />2.J *ho udturt id rDh F$F.r w[h, conrfrrdo l..nqi n! urti brh. conr,rtr-r lr.n€ L.*1.
<br />_l rf,.rhF unLr Srtr
<br />la8a&Ss:laMfENl rrgx
<br />DETI.ASAIIQ!
<br />I h.ahy illud unJ.r ltultyot Fifiy or orrrE rdhwo3 &(hrniE:
<br />-l
<br />h:y. !n 'rll BdrD r Cdfrrt..l (lflr t' S.lf-lnrur fitr k{t.^' Ll'n+.nd nn, ar noqlol fttr lry S<1rM l7([ or rh
<br />Utxr (ii.. nn th. p.rtnM-"-c of tlE k)ft htr wh(h th. p.rmr ! L$ucJ
<br />-l
<br />h.v. rnl wrll dihtrD srt.n cohlEtrldr.n o$rBc. rt a{uiEJ h, S-r$n !?(x) df rE bru Cni.. f F F.l(rrrEIt of
<br />rrF s,* ror whrh lhf pcmn r! !!rBl. My 8o*.6' q,nF,t{o, ...!re. .a.r !n Frl., nlnh.r e
<br />$' -nry ,t, .,* ,*n,,*L. rl rh. rnrl l,{ *hrh rhr trrnr r Frxr. l \hrll r .npliry rny IEBI h my nfuF
<br />+\.t, h..,,nE.uh,c.r r"rh" *,ltc ..ryrn.rrr,nlxw! I(rl'Irtu, rtullrEc rhar I rh,uU h...m \uhFt rorrr
<br />*rtdi crn(Enei$n fflvl\In\ ol Sdr r)n .l7tD ol rh. trhn Grt , I rh.ll, lt'nhDnh (ltr{ y *nh rli,r lnrnins.
<br />\lARNlN(: IJ'1, '. n' {rtr'c *ork.rr \!rrtrtr{rr({ (o\.rN. | trnli*nil.\hill iuhF.-.r r. drI ,!r r,r rul Fel.r .i,
<br />hunJ,\:l t,n'u\. d"llar\ (Sllxr.rxrr), n dI (xr ol dn{En5.tor. d!ro8 d! ,nrut.d irtr rh.
<br />d.. urcrc{ lrl rbmy r l&r
<br />a-
<br />Ih.Eby.ltunu.rnBliyofFriuryrh,IrnLdnQtlrkrF)vs.n.f(lEP(9r..htu n8 w.h s.d nn ',0q)) ol D,!ni'n !
<br />oI rh. Burocs. dtr! Pnrlc{tDtrt C{xL, ul ny l(n{ tr h fxll li)(. drl cfl41.
<br />-70 02 tb 221
<br />t
<br />I hcr.hy rlft un(l.rFn.hy I .^ rjury ihlr ih... N 1 .on(dcr nn Ln'1o3 .8.tuy i,tr ih! pcrl.rNrc ol ihc work htr uhNh rlis F-mi n
<br />*\!.J tsd .lll97, Civ. C )
<br />l.ftlcr! Naft:
<br />-
<br />ttukar ALIt.\.
<br />-
<br />APPI I(ANT DFCI {XATION
<br />I H'y rfim utnd FMry .l Frtrry oE ol rh. lolloru! tk ljrrr$!:
<br />D.drr[n P.rnir+A!h.(o. Ndili..lrr I'cJ.r.l RcluLl.n! (Iirh !{). Pd6)
<br />_RquntJ lriicr oI tlrrlirnn
<br />I c.nfyrll, r,t rd!..inruLrbNE8.rd'n! 8t$txEfr'v.lE r .orrlt$kb rha pmjd
<br />{}(d ythi I hr( rr,l ,htr lrrlr.rr,n hl d,r.rh
<br />olLur( nrl Sr{c l.*! Ehry rn t ,rlu{6n{tu1
<br />rr rh. rtir. n,lor ritr,n 6.o'r.d l +r(. n)(o lnv w lr ill ('rvtrd (i'unrv
<br />Hry .urh'riz rcFcrr iftr of rh6 Cdt .rn Cou , b .dd uFr ih.
<br />ah,v. nrnr(,nrd F{'.ny n, ortrc.rrn
<br />Applic{nl rr lr.nl Si(ntrrun
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulalion
<br />Roof Sheathing
<br />Shear Wall lA
<br />Framino Ff t [flw r.\r{\r}
<br />lnsulation/Eneroy U L-/
<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 />FINAL afurB-rt w)
<br />Certiticate ol Occupancy / '' I 'U 0
<br />Notes, Remarks, Etc
<br />-+
<br />e"r*y rrunr,*r, :
<br />Flood Zone Certif .
<br />4tcr.lta n
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