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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE tD/stG.COMMENTS
<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 tlH lrrfi t ;p,A,c, -d.7-Y9't Co(tklU Pa
<br />Framing U\F.\Yhcna, s€88,1/.
<br />Insulation/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 />Engineer Final Report
<br />/nl
<br />FINAL 3*-@Ft-yu=-'
<br />Certificate of Occu -6nc
<br />Notes, Remarks, Etc
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<br />7
<br />OWNER BUILI'IR DELCANATION
<br />I hs.t! rlrm uida ralXy of paju,y thr I h crdpr fron rh. Cofficron Lic.M L.w for lh. lollor-e @n (Sa 701 I 5
<br />BBinB ed Proldion Co&): Any Cny or Co! y whkh ,.qui6 r Fmn ro @docr, rlE. irprove &rclirh or re.t &y
<br />sto.tG, Fbr ro ir5 irll@c ,L Eqln6 th..pplEd lor s.h pdni ro nL r rign d drml thd lE or sh€ ir licq!.d F!!o(
<br />to rh. FDvtioE otlh. Co!t&b! L'en .d ll* ((n!pld 9. Coffirs snl Sdtit. 7i)00 of Divkir. I ot rh. Bdls nd
<br />Piofesb6 Cod.) or Uul IE M dE i! dd9l thq.nn6 .,ld rh. tr.i for rh. dL8.d q@Fion. Ary violrion otsdDn 7011 5 by Dy
<br />.prli@l for . Fnn $UEr! th. .pplicel lo r ciril Fn ll, of ml mE fiu nrc huldlrd dou6 {1500)
<br />_1. 6 ow ofth. Fopary, m ry anpbrB enh *ry6 . En sL omFdiotr wil do tlE rnt .d ,. srtlE 6 6r
<br />i'ro!d.d m offdld lG sl. (Sa 70{,1. B$iB sxl arof6i'E Cd. 11E cdndd r 116g lr* doc d +ply b e otrE of
<br />rlE FrFq s-h hil& d qD6 lhda rn who &6 rdr sil himlf or hdxlf or tlh!3h hit s lE osr dploy<
<br />Foyild lh. uh mFD6Er. e d -rciLd dotuld frx rt l[ hos6q. tlr bntirg d -rysgd t $ld sithn m ]E
<br />ofoqkiE lh. O*E hiEd *'iU llE tll h,rld! o,F!t!B tlr h. d dE did ml hdd ( i!FDE lt FoF,r* br dE F4o,. oa
<br />-1.
<br />sonE of rli rrDFr', e.rclutr.ly conltlis *nh lK6E d conrlod ro sdrld tlE Fnir (Sc ?Or,l. Elir
<br />!n ftD*si- Cod. ]lE Co r..roa! Lr.e l-.r dE fl! .ptly r. i o*'rq of FoFry *ho b{ild! q iaFo\6 rhdon.
<br />od *tb @'rr8l3 [, $ch F!j.tl! rth i colr.don.) [cd!t {, Fdor to rh. conlr..rd t LiC* L.w).
<br />I m .rdp( otuld Sdion . I, & P (- lor rh6 r.&,n
<br />Orr.: Oinr
<br />$Qa6E!5:CAU[MATIO!!!c!a8allQ!
<br />I lE t, alrm undd Fn.hy of Fjury on. of th. follo$ ing dcltrlio6:
<br />I hav. &xr * ill mind6 a cdincar. o f (insr n' s.lf.lBUr. htr nu kdi cdn,p.n$r$n. s Foridcd lor by s(rnrn I7Lx) of rh.
<br />lrbr Cod.. for thc Ffolr1e. ofrh. soi( f.r whi.h rh. pdn( n [u<rl
<br />I h.v.rnd will'nainlain workcrr co'rpffarnr insor.nc.. d rcqon.n by saln'n l T0O ol lhc l-sbor Codc. lor rh. Ffommc. of
<br />th. $ork aor $hjch thir p6nit is isd My *or ldt compsru! io. iNlrMc. cffii6 ud Frlicy numbd E
<br />fucl<- lo FS (,*l1zz1-+vt o(t1
<br />-l
<br />cdiry rhar in rhc p6fol1rra. of rhc sb,t ld *nrh rhB Fmn n N!cd.I rh.llRn dpb, dy F$n i, uy ME
<br />s a'oboon.sbiitrotl'.m 6'comrdui.n hwroa(niaomia 6d aGlhd if I tlEuld b..om $Uc1rorlE
<br />trDd6' omFdion FtrririoB olsalion rT0o olllE t bor ( o&. l tldL fonh*nh snplr snh lbe Fori3iodw nnrNC F.ihG ro tuc ffiLd NnFI!i,. ordrsr i! ohwa!!. .nd ihnl sbj.t e anllors ro qinhol Ftlir rnd
<br />.,vil nn6 up ro oft hu.d.i rhour..d &,lld (llm.(t[,, i, &lddrln !o ..r ol comFNtion. deus6 6 For:d.d aor lh
<br />r/zslt
<br />Coda idad .!d .nde- r f6
<br />UI!}TIJL(A:ILI(Ia.8lllrlfr&!.ur:
<br />I hqlt,y.rI! ut!.lq F!}y of Fjuy rhr I 6 liG!.d ulxla Fyirim of clrFa 9 (offii'B win Sdb. ?0m) of Divtion l
<br />ol tlE BaiE !d Pre66id Cod.. r'd Ey lide ir h 6lll f.E rn.l[d
<br />c i1 z(zc'{7T^,^,.,,., 1$lrsJ"ttOA tl,*"5 6#f/
<br />Cq!!IB!SIIq!II!Dj!.GIGI!IA
<br />I hcEty lfrm undd pd',Iy of Fjury rhd lhs. it ! conrrudion bxiins .scy fo, lhc Ft6ll@.. of E mrt 6r *'hth thi IEnl a
<br />isucd (Sd.309?, Civ. C.).
<br />a[futANfDlictdaaua!
<br />lhs6yaIImunds porhy otpsJtrry on. olrhc f('llosrnt d.rltuilionr
<br />l)cmolirnrn Pmirs-Asb6kB Noxriclxon l.rjrul R.3trlarina (l irl. t0. l'anh)
<br />-R.qun.d
<br />l.lts of Nor'licdi.n
<br />I .diry lhn th. tnnd r.lul,riiJB rtsed'ns ah..roi ,mul uc nor qDlarbl. & rha pmjd
<br />-l
<br />.diry thd I h4! Ed rht !pdi..hn rd dr. rhn rlE.t \. i.aotu$n ncorcl.I lgrE io @hply u'nh,ll CnyandCounrt
<br />ordjffiG Dd Sta. t.s Ehla lo
<br />!to!. MrDn d Fopdty for i4p<t
<br />Xrrlod or Ar6t sbBrE:
<br />\-n*-.,rn r, Lu t9 ft7
<br />*"'**'*,'E)fr*"*
<br />Flood Zone Certif.
<br />cllJ\dl
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