|
BUILDING. INSPECTOR RECORD
<br />DATE ID/SIG.COMMENTSSITE.WORK
<br />Set Ba
<br />Form Ste /Holdowns
<br />Erect I S
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathin
<br />Shear Wall
<br />Framin
<br />allD
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Mason
<br />Pool Fence
<br />T-Bar
<br />Handica R
<br />De Final Re rt
<br />rtEnineer Final Re
<br />Flood Zone Certif .
<br />FINAL
<br />Notes Remarks Etc.
<br />OWNER !UN,DER DELCARATX)N
<br />I herctry smrn un.L. Fnrhy ('r rcrjury rhsr I m .r.nrPr itufl lh. Conr&roF l-itnr li* fir lrE rolr'*ir8 rcr$. l\..?l)!l 5'
<br />Bori*$ .rn ProLshn Od.) A., Ciry or C@dy Nhth r.noirr I IEn. t' lnnitu!. .lr(. rf'rov.. ilcm'trh or r?at rnv.'
<br />{ru.rur., prinro ih i\\un... Nko Equirc! rtE lpPticant lnr re h Frmit lo lih r risn rl {.l.mnr rh.r h. o, nE ir lt.n<n I'cdd
<br />h rlE F.risi,.r oa rlE Conrrrd\ l-kc.tn b* lchdprs 9. Commmr.s *nh ssrIn Tfit) ol Diviliri I ofrh' Bu!!m( rnd
<br />Pmf.sion" C({c ) or rhr, h. or rh. ,s crctr{'l rh.r€fom rdtl rh. h.\n ln 0t .lLsdd .x.nption Anrlirlrlbnofs€liJn?0.rl5hv'nv.
<br />ry?lkrnr for. trrnn obFls rrE q'rlkr brotrlFMLyoln, m,Erhln lir. hundEd dolllr (l5GD.
<br />-1.
<br />$ o*Er or rh rfrFny. ( ny .ipbF! *irh r,8.r .( rhc" slc $ntin€rr'n. sill Ll' llE f, rt .,rl r,E rlErm F r
<br />inrcn&! or oficrcd f(tr qh ( S( 7044. BuliR$ lnd t!rnf.$i,'nr C(xL ]'tE Conlrr(trt l-t.tr* I rw d'.s noi tl)llv h an o}mr ul
<br />rh.IFFny *tb t{itk d rqmF Ortur in wh lts .rh uxl hnnelr or lscll or rhmt8ft hF m ls o$n cqrhtB.
<br />|nrvrLrl rh.r rucrr iml,[mnf m ft[ ir dkd or ofliRl ror sk. lt h'Es rlr hurrlin3 or iq,mEmnt I $ld ]irhih om ]td
<br />;rcoryLrrrn, rtr OrEr Buith,ilt rsE trr hrd.n oI Eovi,! lhc rE d {r dil d h{ilt d iqn,E dE FTdl, rn rlr n FEol
<br />l. r\ .u N of rlE prop.n t, am crclu!\.1, (nr{r ng { h l'..icd ..nrr&ro^ t, .onsnd rh( FrFr (Sc. 70{4. llunms
<br />trrl lt)tssi(h C.d( I he (i'nlm(ktr r l.i.cin tf,* r,.cs ft,l lplll t' an dr ncr ol ropcn v slk, huild\ or imrrrv.s rh.r.o.
<br />znd rhr .o.hlrl{ \eh F,FB * hr O,fi&1.n.r lftnsd rur1ud r,rnc(i'.troDi\ l-Fn{ ll*)
<br />I sm.rcmnr u ., Ssri,n
<br />l).r.
<br />])lJXtrl&i:!.QUlliSAII0!Dlll.d&u&r
<br />I hdcb\ !rltro, trnarr Fnxl!J ofl{r)urr o'r ol rh. nnn'$'n3 (lNlnrJrtrrN
<br />I h.w .rn sill mdiain r C.d rfrd. oa C{,flEnr io S.lf lnruE f(tr s(t6 a,.VEndi,n..s F)vid.n tor hvSsrirn l7{x)'Irh'
<br />lititrGrlc. tu lh. Ocrl{rlmkc orrhe work ntr wntl rh. Fmir ir i$Nd
<br />-lhak 'nd *illturnroin $nrk.n cof,Fnc.ri,'n irrur!h.'.. r! (qutcd hySc(lion r7d)olrhc lrtnr(ixL. f rh. l.rf'rrom' or
<br />rh s,rk for yhth lhi! p.mii i\ irul My worldr' Nryf,ndir inunE crrir lrl F lav numh.r i.
<br />::,#erreqzE z ''q
<br />sdren 11,76 orrtr lihx C,d.. hrcrca d' ,,rt'rrNr
<br />D.,.: 6-tl'Lg ^-,-.
<br />t hd6y tmrn udcr FMht ot Frury rnrr I rn rie.-l unrt "i.hn ,,f Ctsnrd 9 ((rmrming wirh Scdion ?flX' r irr Oir Fi'n l
<br />ol rlr Buiiftis &n Pnfcsi)trs (ixL. si my ltcnk ir h tull aort .nl .r[al
<br />'.,^*,n. & ct'L-
<br />-,, 1: /lLe ,r.nrcNu r, 9?fiC1
<br />I hrrcby lllirflundcr F.rht.fr.lury lhlr ihcrc ila conrution l.nlin8 '!.ry (tr lhe Fihrmtui nfrh. rork tu {hrh thr Fmi i\
<br />ar<:alfl)E(LaSallLl
<br />I lrr.i') rllm uftkr Fnrlt y ol lEriury om of rk r(nh{ nr3 d..brrt i,n.:
<br />D.nniii('n ttn.ih A\linu( Noriliculi.n ljdlcrtrl R.Subrions llilkl0. Prd6)
<br />-Rcquncd
<br />t,rr.r or N.r,fr.lbn
<br />-l
<br />cdiry lhrr lhc rcdc6lr.ruLlhns Esertins.$.{or rcmrv.ldrc noi rlllklhklo rht Pn',.ti
<br />-gl
<br />cdtify tn{ t hrx cld lhr rmttark n ,,n n(. rhol rhc at{vr inar,rurk)r i cotur l.Sts lo mryrv trnh tU Cnv ind Coonrv
<br />odi res;d SId. h*r EllrirE to hriBins .ondru.liotr rn t.!h,.urlIriEEF!-ri.riB.lthir Cnv!d c.u vlo6rs'4rnr'r
<br />rb.rr trnri,ai fli'Fny rd in\D.n
<br />.ipplidnl or ,\A$l SiAur !m 8/'/-/377
<br />I .cnily rh0r iD rh. Frformfr. r'ilh. work fitr *hih rhn Frnrir is i1rkd. I 'h!ll ml cntpbv cny Frsn i..ny 'Mmrs rl ro ti$m \ubFi hrrE *rrt6a dnqE.uion k*rolCiilomn. rnd.aBrhd i(I \h!!ldlE.E bjt{rrotlE
<br />sorkc.' .omn tr$r ('n pmri\n,n\ ol s{t inr l?u) ol lhc ljhtr C,rh. I srull. fiflh*irh .on{rt wiih rbt P.vni'ns
<br />wlnlnC i.ltu. t, ou. "rrtc^'i)qEndi,h nr.,.8. I unh*Iul lnJ rh.ll <uhF-r m.i{'k,}tr k' aioiMl pcMri\.fti
<br />.Ml finr\ uI)1,' ot hundrdl rhuusand dollsrs (tl(x)(Xn,. ir sddirtrtr nr rh. eon of.omFnurnin. d!nE8'r as lrrvil''l ln ilr
<br />-1-,?a
<br />'-( /'6 'W
<br />\\-7 \ tq -./la4rx,
<br />UFER Ground
<br />lnsulation/Enerqv
<br />tt ./)
<br />7 /c//iq/u lkv/tu vw
<br />tl
<br />7//-'I{/t'I
<br />Certilicate of Occupancv
|