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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDEN DEL('ARATION
<br />I nd.b amrm o..ld Frlt) of pdjury rhd I m ddnF liom (h. (onrr.croE L'(oe l in ror rh. folhuus rBrn (s< 70.1 I 5
<br />lli6in* a l Pro,crior Cod.)r Any ( rr! or Coud! rhi.h ,.qutr6 ! Fnn ro conrrucr. ah6. irqnov( d.rml6h or EFn st
<br />ntu(m, rior r) . Bud... als. rdFtr6 rhc alJpladr aor ech tEnir ro 61. r silndl i.rffir rh6l lE or nE B l!(G.d pwet
<br />ro lhc pn'visn,B ol rh. Conira.ror. Lic.ns.d lj* (Chapt6 9. ('on'n.ncinB slh s(rn,n 7([0 olDivision I oflh. Busins d
<br />PNfcirB ( od.) .r rhd lr or sh. ir .rd rhg.from dd rh. bdrir (r rh. .llecd .rdnt, hn AnyliolalhnofSdioi70ll.tbytn,
<br />sprl'col ror , Fnil tuhr.ns lh. lpplicur ro r cry il rsull) of nol mor. lhs fi\ . hun&.d dollei ( t50o)
<br />L a o$E.f
<br />'h. FFn). or mr trphlc $ nh Nr86 a
<br />'h.o
<br />xrk.omFMon. trrlld' rlE trqli *l llE r&ru.6 r,l
<br />inrdxLd oroiT6.J f.r sL{Sa'704r. tlllilB &d Proa6ioB ao& llEcod6dor'! I icN ljr &6er ,Fplyr,rndnndof
<br />rh. pr.Fny qh) h&.t\ or iqftr6 rhdnl( rnl {h) &E qch rsd hm!.lf or h.*lf or rhrnulh hB or hd osn drl,)!6.
<br />,,ro!idd thl3u(n ilFo\EMEenn inrErdorofisol for sL ltbtr66.rh.h ltruo, mlrovffir$!lN h$onc!a
<br />ofconpkrion.lh. (xr6 auikd will hrv.th.lu&n ofpro$d thd n. rsh.did nol ttrild or imrov. tt. p.lDoly lLtr rh. FurrDeol
<br />-1.
<br />6 oqE of ilE ,roF.y. m .r.bn.ly mdrxring wnh li.da.d co rr]roE ro .oBrn(l rlr Fn .tr (Sd 7(x l, &nr6
<br />!d Piltsis (td. Ih. ( ortMoat Li.le t * d.6 ol rprlr- t\ M 0*.6 or FoFn) N ho hrilds or inpro\ 6 'h6of,.tnd *ho co'nr*! fo, sh Foj.fr *nh. (tndo(, ltd*d F6utn lo dE('o r.dM'rIa6ett*)
<br />I m.xan u.dsS.cl0n_
<br />D.t. Orn.r
<br />WORKFTI-Y COMPENSATTOiI
<br />!EqA8AIj9E
<br />I ha.b) rlTm undd FMlty of F)ury ok of rh. follo$ inr d.<h.di'B
<br />I h,E,xj *ill minrain. cdifEd. of(irtrmr ro s.lt-lBur. fd knlde @mp.n!lon. s F.\i(l.d for tySdnn 17i)oorrh.
<br />l$.r Code ao. rhc Ffolrr@c oalh. *o.l tu sti.h lh. Fni n nlu<d
<br />I ho\ . rnd q ill msim.ir *odcrr conDdB.r inn i$uahc., s r.qur.J bv S(tion lr To(r ol !n. I ihor Cod€. for lhc Ffi,nns.. of
<br />!h. trort l& trhr[ rh! pdfrir is isd M,'worl6 .omr..s'.. 'BurMc. cei6 ed F)lKr_ nunb.r 6.
<br />l..nifylhd inrl,. pdaormaft. o I rhc $orl lor shichrhispdnrir is iesucd.lshallnoroploy lny r.rs.n r tuy 'nMh6s,6rotB!.lubjsrrorh.ro,rd'cdhFrelionlassol(.liaoB$,dda{rdrhatifl ,'ld Ii{om. suu<t t' lhc
<br />\0116 6,nFMronDn,vnioa olsdirn lT0Onlrh. L.br (ixlt.l shrll, fodh\irh $npl,'qirh th.r pNlitbN
<br />wALNlNC ljrilur. r. sm *srl6' .rmrqB, ion s\6.s. $ unhuful. r.d shtll sbj(l d @pr6!s !o (mrMl txMti6 ard
<br />ctrrl lio6 up lo orc nund.d lln'uul dollrs ltloo,u)O). 'n !dd(x,n lo rlE cD{ ol.ompdsi'on. &n46 a ltord.d fo. rhc
<br />1idi,n 1076 0l rh. lrh, cdla imdd &d .nrmt'. t6
<br />D.ls- apprdnlr
<br />-
<br />| (rFNSEn aO^fm,^i-OR -
<br />DICIJBAIA!
<br />I h6.ht armn rndd rruxy o apdjurt rh, I M li(a€l un ld lh\iiioi or(tup16 e ((omnffiins $ilh S.dirn 70(xr) of Di!6ion l
<br />of lh. Bsi.d.trd ltofsEE Cork. rn my lcN ir in tull for(,n.lkr
<br />grNrBlclll8L[dDaclc
<br />I hqlb-v llIm un& Fuhy ol Fjui, rhd rhoc ! ! edtuction lodinB rxtrr for rn. Fn'f,M.G of lh. $orl tu \ hkh llln F6i ir
<br />'s.d {Sc luJ?.(i\ ( )
<br />AIIIICANLD}:CLIaAIIA!
<br />I ho!b, 8trm ondd Fnrh y .f Fjur) on. of
<br />'h.
<br />follo$ i4 .LcldrttrrN
<br />Ddtuln6. Pmns.A$6rd Norilrc.rion ldla.l R+uldioa(rnl. r0. Pd6l
<br />Rqn,.n tm6of Ndiff,dion
<br />I c.nifyrhd rh. i.ndd !.Bulalions e*rdin8 abGtosrdrovlld. nollppli.ahl. lo thlr In)jd
<br />-l
<br />coli ly rhd I h$ c red r hL lpplicar i(!n {ri rl!t. rhflr thc atne. oi,mlalntn ir (r.r I r8, d n, .omply *ith .ll ( rl) an'i QlunlJ"
<br />ordhrm6 Md \rd. ljr! El&'ry ro_lq'gr..nrudnn. dn ha.lrr aurhorEc rcFendiv6 orrhis cny..d (nunrr_ ro o16 !p.n dEil::::,;::ro21./ ^,2/t/t l
<br />P.mlrer.n.rprlnr,:
<br />"
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<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framrn s
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />FINAL t -L-(?-J)eJaiz 6fr
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />Pool Fence
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