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BUILDING- INSPECTOR RECOBD
<br />SITE.WORK DATE orvN[R BUll,i]ER t]El,(AB T|ON
<br />I h.r.hy lmnn ufrlcr ncMlry oI pcrjury lh{ I @ ercq,r lftnn rh. Q, n'.hN l-iccn{ L!* ror lh. r'ollowin! r$5n (ticc 70.11 5
<br />Busim\ anl Eot sxrn (ixr.) Any ( iy or (i{d! shah hrtu!.r i Ff,r{ i(, crn(ru.r. rhd. infDrt, d.mrlrh or.qEn:ny
<br />{rucrurc. pritr b il( nqum.. !lw' rcquncs
<br />'hc
<br />lpplilnl fi, \u(h lrrnr r! ,lh , riEftd {sr.nE.r rhur lr or shc i! Iiccn\td pxrtutrd.
<br />r' rh. F)rtrx,nr of rh. (imrrt, r Ltrn$n li* (Ch.fld 9. C.nnrNin8 $ h S..rnn TlX of Dnnrrn 1 !a rh Bu(im$ rnd
<br />I'n,lts( is(if,i.)orthrr lLor shc ncrc'nrr rh.rdrnn and rh. hl\i\ ntr rh.dllclcd.rcDOi('n AnyvidrrionolScdi('nTUrl5hyrny
<br />ltrliod lor . Fihn uhl<{h lhc rmli.,l ro!lirrl,'.ul!J_olft{ nvcrhin,ivr hunJd nolhrlS5urr
<br />_1.,\osftrofth.pmImt.orhy.mnk,tt.irirh!!86:\ih(ty,kdo.rcnqrion.tr l&, rlt ernt !d rlt {turm ir n{
<br />dcdLal or ult rcd lrtr eL r Sa 7llra. ,iuw( md Pn'lcsinN Cdc Tt (i,nkrntr s l.*n* l i* (l.r not !t'!ly r' !n o*ftr or
<br />rh.Inlrny trhr hoill\ Dr itrF,vd rtrhn. rrn skl d(r\ su'h surt h n{.llor hcrf,llorrhmulhhnor ltr o$n cftUl,,yc.(,
<br />Inn\ rldl rtnr \k_h rq'mroEdr e Fr rn.d6l o. orf.rrn t, sb ll. h.r.\s. rl* lx'Illiry r dItu\Tft n th rrhn.a !d
<br />nl.otrtkrir,rtr(,*ncrarrl.lsuillhawrhch.nornmvinSrh{lrorrlDn!rnhuili]u.irl{rrtMrhctmFnyforrlEN.ti,{or
<br />_1.!ro*mrofrh.r.Iiiy,im.rlun\(lycod,rcrn3wirhI'eo{r,codralorbon{NrtLFli!lSft7{},aurft*
<br />rl th,rFBr Cod. Th€ (i'nt.&lois l-Ecrr. I !* dE{ nor npply b nn osncr or t,rntEny shr bu ink .r impnv.\ rt Eon.
<br />rnd eho mnr r\lnr\khpn,rrijvirhr(l {Bcr'n \, li..n*d purud ro rlE C.nrr.l[ \ Lt.n{ I ne r
<br />I rn'*( rti u dcr Sc(rtrnl
<br />ta8trrL5tg)lrfliltallg!
<br />ll[g.AaAllori
<br />Ihci('hyalltr uMrr lttrihyoiBrjrryo'r ol rl( hnLr$tr,9 (lc.tururi,n,\
<br />-l
<br />hrvc afll willnuinui'r sC.drliorc rLi)n*nr (, Sclf.lniut. nr sor[.r! $n\En\srr)n. r\ Fov'd.{ f.r hySc(rk'n.17(r]ol lh.
<br />Lrhr(inc.ltrrh. n€Itrnurc ofuh. w,,rt fin *hih rhc Frnnr i! tr\u.{
<br />I hrv. snd will tu'mrin r orkrr! conrr*n\ari(r in(urah..c, r\ rRtutr.J hy SNr i,,n .r?(x) or rh. I ititr Gdc. n, t& Frlonurcc oI
<br />rhc *ork for qhrh rht IE.md is Nrkn ily*qlcF ui{E.{tlbo rnrurn. cnK !d,r,lky numh.r c
<br />l.(dilyrh!r inrh.trlitr'utr..orrln.*urll,nshf,hrhi\n(rnritrn\!r,t.I$rllnol.n+loyan],|Ervnlnany unftr
<br />v, A n) tr.o r \rhFr r' rl* r ortd\ (on{rnur.n htr r ol ( rlifir.ri. rrl rgN rlui il ! .hruH tRrnr \uh]l.-r h ih.
<br />Borkrs rorti\rri(rpn)vrshn{nlScdi('nlru}olrh.ljtrtr(irh.l\tull.i)nhsnhcnn{lyairhrhu{p$vtrinr
<br />l. ril \hall {hFt u dtll'Fr t, mn,ul lrtulrs: l
<br />.'!rl lnr(\ ut, r).n. htrn(lr(l rhuu\rn,l ,lollJn (lllr,.lxx)r. tr, rJd "z);-"*"'*"""-S$fu4 ti)r6olrh.lr}rr(irlc.! .rr{,n.la{orrt \kr\t.22-b\z
<br />tlEgaSA.r[]!
<br />I lrahy rn,n un&r rEMlrt of Fr]llrr rhd I rm lcnrd u.dd Flrnbn o! (lEfls q knndd'n8 wnh Sdlr,. r(tr)lorDirth..l
<br />or rh. aurikis!trJ Pmfcr{ioo{ Codc. lrn nry ltcnq n tulltoftr dllcnN'b
<br />/ - 72- zq Zi
<br />c0lliral]cl&N.LlBDlNc-aaEt.cl
<br />I lrEhy rntrm uftLr rEmh y ot lEr]llrr rtur rhcr. r. $n{urin Lfttns rs.E, n, r,x FadEL{ or rh. *rf,k lor trhEh rhr Fmil i\
<br />i\\u.d rscc 1(,9? r'iv C I
<br />I .ndd \ NrnE _
<br />AIE!:AULDEII.ASAIIA!
<br />I lEr+ry ufiim und.r p.nally of pdFry uk ofrh. folk,*'nt d(ldnrtr$r:
<br />D.frriii,i P.rnir.Arhcikx N.'tili..riir kla..l R.tubrio.\ tTirL ll). Pd6)
<br />_R.nun.d l.n.r of M)tiliclir'.
<br />_l({i'lrrrrl'.1!alerxr.!trLrtrtrr\'.Iddtririrh\[,!r(r,vil]rrorrJ!tllrrhl.n,r['\|]l,)..r
<br />l.r
<br />'fy
<br />rhd I hrk r cad ihts .|,,l rit)n ui rrirc rhu rhc rhlrc itrnnurtrr i\ .o'rrr l Dtre h'domPlysirhrllCiryrnJ (,,unry
<br />i,rd,BB.\iJrlsrrrljr\RL 'trFr,t{rlhacon.rrtr{.JDllrlrhryh w.nF.{ddrsnrrhFCiundInunrtr,cnradF'nrrr
<br />\r\hin nUlFEcl|,// , /
<br />Apo,ion,or^!6rs,rB,uE g-y'fuao"/Cwry-,,', /'33. 2al I
<br />F.mi,(Em,pnn,,: MA21o VASAO5Z
<br />Set Backs
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathinq 4 ll tg J-?A$L3+lr
<br />Framinq 5 R
<br />lnsulation/Energy x 0_lz,u
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coal
<br />lvlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req 7-t!.tY Il+-ld,
<br />Deputy Final Report
<br />Enoineer Final Report
<br />Flood Zone Certif
<br />1\
<br />FINAL [,W-)ir]
<br />Certilicate ol Occupancy
<br />Notes, Remarks, Etc
<br />ID/SIG,COMMENTS
<br />'7s@1y.1
<br />,"",-",,,,J*":%^"2@
<br />Forms/Steel/Holdowns
<br />Shear Wall
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