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BUILDING- INSPECTOB RECORD
<br />SITE-WORK DATE ID/SIG.OWNEI AUILDgI DEI-CARATION
<br />I h.Ehy rllnm uBLr Fully oa lEr,lry rld I d .!.t!x fn,m rtE C..rrriF liu{ L* for rh n,ltu[! rc.sn tsd 7011 I
<br />Bnqnc( .d Pn,rcson Cin ): Ao, Cdy or (i,unly whf,h r.qurcr ! rEml r' .l'n{tucr, .lr.r, !ry'hv., &frnilh or Epr& u,
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<br />I' rh. F)yBont ol rlE Co.taroar LE.ed Lzw (Clq .r 9. (.lffi^-'r! *dh S&kD ,ffi) of Divirrn I ot rll B$m( lrl
<br />Pn .lronr Cdlc) or rh{ lr or rt | .i.nDr rhefrro ud rh. hsrr r.r rh. !lb8..l cr.mdn'n. Any vx,hrin or Sal$n ?0:l L5 by .ry
<br />uni lir . Fmrr ruhFk rtE rorlf,..r ii! . .'vrl p.M!r, ot n, frrE rhD fr!. hunlral JnlLr. (tJfl))
<br />-1.
<br />n o**r ol thc F$Fny.,r ny crgloFr * h *{.\ !i rt*tr $LumFar.lx'n, *dl.t' rtr *& a* rrr <n1rm s ftn
<br />urcn dl ,f, olilFl nn eL (Sr 704a. Blrmrl lrl PDl.(bnr (irk TIE (tnrE_-ktr'r lr.n. liv &x! .d +t'lv b a drrr .l
<br />!h. ![rFny *h, horLl! or uqnrs rlrRrn, snl pln &B s(fi*'dhrnncll orh.r.laorrhnnrahhr..h.rownchpbv..r.
<br />pnltLJ rhrr rhh ,r{n,Emdr e [, ,rc di,rdli...J lir e! Ii hrw. tlr ti{ irE or rqFEcd 6 $U wfin m Fr
<br />ol..n{l€rr'.. rlr O* rBud.rwillh!v.rlrtu^i.n.rF,vuErh,Irorrh.,jddt or uqns llr totEl! rfftu,uFEul
<br />-1.
<br />osRr ol rh. Fliny, .m cr(lurv.ly or rar h3 B h h.ttrrJ rodfidtrn n, .orqdd tlE PnrF.r ( S$ '7(X.r, Suqxs
<br />d! PDlcrlr. (ixL th.ConrEt,'rt-f,cn(Ir*dd\fr rtPlyn).norrrol lroFny *b hlrLlr u mnhv.{ thcrd,n.
<br />anJ eho conrturr ktr.uchIn,r.h*(h! (i'nrrudonr) lrcn\cJ plnuMr k, rhc Ci)nhchn s l.tcnlc Lwl.
<br />Irm.t.'n unr.rs.rk'n B &PC l,{rhnEr{r
<br />!voi(FRs' c(lf,lP6isATloN
<br />oEll4EAuax
<br />I hci.hy.lltrmundcr pcn.hy ol p.rlury om otrlt (,ll*,n3 &tldrnns:
<br />Ihrv.elwrllm{nrrh!C.nii.srcolCon\.nrn,S(ll-ln{trci tq rkcr' .onrPrn ron. !r FDv'd.dntr6yScrxon.l7(trolrh.
<br />t2ll, (-,ri.. ti, th. Ftumle( ol llr *ort tu *hrh rtx Fn ! r\kJ
<br />I h.E rd *nl mI u ,orlkB' ..mF^r.rin 'n5!r.Ec. ri rquirql t'y S(r pn .171,0 ol rh. I $or Co!c, tu rh. p.dn@ or
<br />rtr *o nr*hrhin! Fmii t L$!al Myworl.6 .onVEnlrbn usurs..eir lrl lblry numtEre
<br />Pi'l(y Numhcr:-_Erp@!
<br />I (.n,ly ihd
<br />'n
<br />rh. IlcrlormBe .l r h. *ork l,tr shf,h rhtr Frn, r nruc,l.l shillndr cnPlt,rrny lt6oh tnlnyB ncr
<br />qr r h tN$r ruhr(l ro ihc *tt r (,ftlEnqrrn L$\ ofcrlf.h!. mJ UR rhr n I rh{It h.ronr sunr<r nr rlr
<br />*dc ron,Fn\rrn,n tn,vsonr.! S(to,l?l(,dfrhc Lihtr (i c.l\hf,ll. n)nhw(h Nmlly w(h I ln'k In,ernrnl
<br />$ARirtt(; Ii,nh(. r, kaur. *olk.n s)mlinsri,n !,n.rr$
<br />(rrl lN! trt, n, on. htrn,lkrl ih!'u\r l J!'llr'\ rllrrr.lxxr) 1
<br />.rn rhil utlAr r .rr?tiiy.r t. lrol FrIr\ rnl
<br />i.N8.s r! tn)vrlcJ ntr rh.
<br />olrlr lf,htr('(iL. mrcr.n rBlitL4-l.t
<br />I linhv ,l1"f, u l.r FEIy ot ,.rrur! tld (hFr.9 (..omR-'m! *nh S.din ?(x[lorlrink)n I
<br />nl r)n.ltunm\ ixl It.lr\rDrr (itrl.. ut n,r lf,.n\. i1n lulll,rr nl.l,.(r
<br />q1a511.L r1
<br />I hcrbyrllirnu' cr Frulry ol P.rJUry rhlr rh.tc t r onrlocl !n L 13 r!.tuy fd rh. P.dn.nu c ol rh. *olk n{ uh(h lhrs IErn !
<br />rtu.n rse. $97. civ c )
<br />l-nh! Allrss
<br />ATS.IiAII.DES.ASAIAN
<br />I hftr'y diD od.r FMhy .l F,pry oF ol ilE foltrvhs n .L.i n.r:
<br />t\Bll i,n PcrhdlArli{or Ndlttr.t$. F.&r.l R.ru hr,,ns lT'rt .r0, Ird6,
<br />RcquiEJ li(.ror Mr irir
<br />-l
<br />(dJr rh.r rh. t tLEl ElulrEn{ E!r&n! xh(tx rm)!.Im *'l .fi'lr!'L r. ih! I,nFl
<br />Etl rhs .g'lrtt$n .n! (!l. lh.l tlE rbv. unrmri,n tr otul I rlE ro Ntr{,|, wnh rU Cr, r ci'unl,
<br />ron(ru.rk'n [l h.r.hv ru ,u. rcIi*d.ns oflhlCiry rd Grunrylo.trs ulnnill
<br />ul
<br />.€\o
<br />LLI- 11
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulation l
<br />Rool Sheathing ?lt/t4 n
<br />Shear Wall
<br />Framing
<br />lnsulationi Enerqy
<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 />Flood Zone Certif
<br />t
<br />FINAL
<br />Certiricate of Occupancy I ' I
<br />Notes, Remarks, Etc.
<br />COMMENTS
<br />,q*7/
<br />Jb1/rl4/t l/4
<br />I
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