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BUILDING. INSPECTOH RECORD
<br />SITE.WORK DATE IDiSIG.COMMENTS OWNN AUILDF.R DELCATATION
<br />I lEEb, affrm urd.r,cn , ofFrj!ry rh, I m.rir{, nonoECo dou Litnr L.w for llE folhving ren (S€.?0]l.l
<br />BusiRs .rn Prof6sion Cd.): Ary Cily or Coutry *nih EquiEr . Froir ro 6drB. .Id. imPbE, .Lm&h or EFn uy
<br />.lMW. Fix ro ik i.rurN, rto E!ui6 ih..prltar for Gh tEmir !o liL. rtEd rcrnt rh.l lr or slE i lir(ed p@.rr
<br />ro rh. Fovnioc or tu Conndd . Litnrrl L.s (Chrpr.r 9. Co.mEinS wnh S6lio. 70O) of Divibn I or rlE BGiEii .!n
<br />Pmr.sioB Cod.) r dx rE r 3lE ai.r.trpr rlE !m.,n IE l,(rn ror r,! rlL8sl.rcngb. Any vbldai, ors<ri'.7011.5 by{y
<br />rpgltur for r pnntr \!bl.rr! rlE rppli..fi ro r .ivil Fflly or k, mE rh.n liw huoitd dolbs (3Jm)
<br />l. a orffi of dE rmthr. d.ry.it,lolE rirn w{.r r dEn sl. onp.Ntlbn. ri! &r dr rat rd 0E rnEE i
<br />'Eri'rs'd.d roff.,td fq rl (S€ ?Ol.{. BciB dd ltDr.sb^r C.d. Th. Coddd\ Li.ttr trw dca d .@ly
<br />'o
<br />s ow of
<br />rlE FlFiy who h,il& d inv.oq 0!s& rn *b d6 dl k'L hieu or rEBlr or rluou.,l hi. d rE oq.t'9bF6.
<br />Frvidcd rhd sh inpm@dr a d -rdrLd d oirdut rd el. l[ noffi, 0E h,idiq G inFftrElr i! Fld *anin m Jq
<br />oforplii@ dE OeE Boildd rill lrk t r hnl.n of Fovq dr lE d ir dil br hild d iqeE llt FbFry h 0r F,ro- ol
<br />_l- s o*e of rll FDFry. d celusiwly odr*ri.8 pirh literl .offim ro 6NM rlE Fit1 (56. l0r.{, tBiEs
<br />.,n hlisbo Cod.: TIE Conf-ror! Lk.nE L!* dod ml .pDly lo d o*B 6r rDFny *ho build! d ireoEr rlEtu(
<br />rnd !t 6ddi rd trh Foi{! wah . C.ddr a.ddar'! Iicne ll*r
<br />I amcxcnor und.r S(rrn
<br />,
<br />$)af,Es:.c0Mr!dtAu0!
<br />DECI.AIIIII]B
<br />I h.Eny .mrn u d p.ndly of pqJury oB or llE lollowins dcls.liotrl
<br />-l
<br />harc ui will minroin r Ccn ifr.rc ol Cons ro S.lr ln\urc rtr worl.ft Fmpensdion. as Fhvid.d ror by scrio. r7L[ or rh.
<br />Llhor Codc. lor lhc ,{rfornunc. ot rhc *ort loi which rhc pc,nir h nr@d
<br />_lharc rdwillmln ain wortcs conD.Nrtn,n iosur!rcc.4\ rcqun.Jbysr.ri,,n.l70Oofrh.tiborCod.,forth.leYformn..of'
<br />rh. work rd whichlhis Fnnit ir nsuoi My uorksr .onqrosron t'\urrE-'c (eirr ull Fnay nunb..4.
<br />_l eniay tlEr i! dr F omN of rh. mll tur ehth rhi, F nn n isE4 I .ll B ctrphy rn, FEo i. dy tuB
<br />s Bro b.om $bFcr ro rlt erl6 @nvEtu rion L$ or C.liromq md *c rhx irI 3hrU beor lubFr to rtr
<br />Mrt6' @q.norbn prcvirilc ors<ri'.l7q)6f E Lrb.r Cd.. I .hl!. ldh[th otrdy lnh thr Fovnbds \l\t\r,unLEtuL .,n dB iubFt u crplorlr ro qiminn FErb dd
<br />.ivil fms up ro oE nunnr.d 'lbKrn &t E (tlm.m). h r tlt @r of .onF6ri6tr .i.fl8c. a p(
<br />Sd'ion 3076 of rlE L.bor Cod.. irr.Eq ]n dbcy r i
<br />.-A-ro 2-r
<br />ufraltrlu:
<br />coNsTRUCaloN I r,lnlNc
<br />^(irN('YI hcrcby ofatrn undcr rEnally oI Fqury rhll rhsc i! ! Nnrro(ri)n lcdih! rscmy ror rh. Frr,)mmc of rh. work for whah thi Fnlir ir
<br />tsu.d (se.309?, civ. c.)
<br />AfILICANLDEIIA8AIION
<br />I Imby dlm undcr p.nrlry ofFrruryonc ol ric ltuowins dc.l([lion.l
<br />D.@lni.o P.rnns-Asb.sos Nonlicdri,n rrd.dl R.8!ldtio.r ( fitl. 10. P!n6)
<br />Rquftd t trc. ol a{dif.dbn
<br />-l
<br />cqrily rlur rh. Lncd rcsrrhii68 ce,rlfs tlErtr Em,val ,. mr rr,r..6L
<br />'o
<br />lhs pmi,
<br />741 diry rhd I rEE Eid rhir.rplk.rqtlluIE md Srrr. L:r! GLrru ro bri
<br />i.n !d .r. ri.r Ih. rrnE inlorrMir ir.Imr. I r8B ro odply pnh.U Cily!n Counly
<br />F( lrl hcEby ru'rsr@ ErE*tuiB of lhii Cny &n Cood,
<br />.tov€ mntiomd i,oFny for iriFd
<br />Arplienr or AAdr siaMlrF -r.tCtud**t,,tn.t,_L__L5_pJL5 _A4 +/
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />Subf loor/VenVl nsulation .7^
<br />Boof Sheathinq 6-/( 4 Fc),n
<br />Shear Wall
<br />Framinq
<br />lnsulation/Eneroy
<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 />FINAL il/2,J/[ *a )
<br />Certiticate ot Occupancy / /I V
<br />Notes, Remarks, Etc.
<br />-)
<br />,(n-lo -2, ,*^
<br />I hdl6, .rfn ltilq pq'.!, of Fr4 du I & li.ord ulda FovtiE of OrFs 9 (@MiDt rin S.db, ,m) of DivitiE l
<br />of dr Aui6 .tn Profdior Cod.. !n ay lite b h tull loB rd .lld.
<br />UFER Ground
<br />Flood Zone Certif .
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