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BUILDING. INSPECTOR RECORD
<br />SITE.WOHK 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 Sheathino
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<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 />Enqineer Final Report
<br />Flood Zone Certif
<br />FINAL /./'- /t .AH/o )
<br />Certif icate ol Occupancy. /
<br />Notes Remarks
<br />OWNEA BUILDEX DEL(ANATION
<br />I hcEb! .tlto ulLr FMxr .l tEriury rh{ I o .t.nt{ 6rm lrE cl'nlra16 Lr.nE u* au 0r r,rk wi.! Fr$n (Sa ?oll.J
<br />Burms ,rl Pbfc(rr CcLl Any C , or Cady vhrh EguB r F hd ro LrD{M1, .X6, nqroE. &ml or !tF!. uy
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<br />!, rrE F)vlt$nr or rh. Conrrw r Lr.n<n L.* (Ch., d e. C.ntrBrr l h S&ri6n 7m) or Diwf. I ol rlr Busidl &d
<br />Pnn (ir CeL) { rh.l lE rr nr ! .r.rylr rtE troo .nl rlr k.6 fo. rrE dLtal .kqr,. Ary vELrr. or Sdb. 7ol1.5 byry
<br />.prlKad n, rlim $6l.ak rh. $plran! ro..,vrlp.nlhy ffrn E rh$ nv. hutlc.i.lolL8 (!5m).
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<br />ptvrldlrhrrruh lrFiEr rs i,rml.ndoltGj tq qL llh.kE,tlrh l!+dlqt&ed !. r ls.hooE,t-
<br />ol d,rpllrn r'I O*Mr Bulli.r * lEE lh. tu,hn ol F)vrU rhd ,r { ilE drl rd ru! or !rF)E ilE FId} for rh. FrFr ol
<br />l. .r o*mr ol rh. |t)rEn!. u .tLtulr.lt .odrarri *ih lkrn{.1 codfuim n' ('nrer rh. Fnj.lr ( S\.. ?lx,l. Bus6r
<br />,rl PluklrnCut Tlx Codhktr r L(.re bw d,f,( mr .ptly nr { o*K of fr,)Fdy elx' l,u,Lli o. 'm[orci rhaoD,
<br />rntl wh' ntmcr! ld sulhIn*cis *rrh ! ConiE(ion, lrchcJ tl6u'nr (,rh.(i'nr.ctoir l-$ns.l,w).
<br />I rmcr.n unlc. S&ix
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<br />EAIA!8S:C0TIIENSATIA!
<br />DECI.A IATION
<br />I h.r.hy rlltrn, onJ.r Fnlliy ol Fquryok nl rh.l(nL,wo8 &al{o(r'ns
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<br />4.",.,
<br />Itn rh. Frlo'rrm. ol rlf urt ftr vh.h rlI Fmi . triu.tl
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<br />*orle*' .omFnsar i,n FUvnxrnr of S(i $h 1700 o, rh. trh* ( !iL, I .h.ll. tnhsnh drmply r ih rh,< t'n,vsbnr
<br />\lARNlN(; I lllr. r, \'err $!rl\T\ (,ln|*nsrrnr ul. and drll nrhj(r !h.m![)y{ tr' dmnrlFuXr\ lni .
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<br />lEljldSarl(a
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<br />r Nnmnon8 * h S.(rn 70(,) ofDrvr!'n l
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<br />6 3a7O z7
<br />CqESIETqT,Ei.LENPIIIiICENJ
<br />I h.Ehy ,nh unLr p.M,!y or lE.i'ry lhr rlEE s t oBlulDr ldr! llmy ror rlt Frrm oi 'tr
<br />q,l for *lEh rhr r.ini .
<br />nrkLl(S.. .1097. c'v C ).
<br />APPLIC'AIr DSCLANAT!ON
<br />I Hry .nim uBLr !.n.ll y ol l.rltl.y oE ol rlr folb*h! *tLr.r nns
<br />l).nnnil)n l-rm,tr^rtE(os N(rr,i..in,n lcdcBl R.3ul.rpnrl'r k 41, Prd6)
<br />-R.nuuql
<br />L.(.t ot fidlrds
<br />_l ccn,lyrhi rhr tul.BlE3uLrons E8ddin3 .\lr{o( rcnlvrl rrc nor+nLit]hk k' rhtr fi*(r
<br />I ucnrlyrhr I haE c.l rhtrmll{M :r.rhdrhcrh)k,nto@ri,n6(dd.I.Sr6.rn{,*trhrUCr,rnlCoud,
<br />r('n. s'rl h:rchy ,urhru. Elrcstrlrtrvcs ol rhr C y rnJ County
<br />.tr,E mnrr,ftd nDrEny ttr irl
<br />Z_L
<br />I
<br />I:Lkir Addrcs:
<br />-
<br />Etc.
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