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SITE-WORK DATE
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />Roof Sheathinq
<br />Framinq
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Beq
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />/l
<br />FINAL l0--i9
<br />Certif icate ol Occu n
<br />Notes , Remarks, Elc.
<br />I
<br />Jal'
<br />IV!!DDI
<br />BUILDING- INSPECTOR RECORD
<br />OWNFI BUILDER DEI-CAB IION
<br />I hcEhy ,rtum oodcr Fnrhy ,,r p.rlury rhd I m .x.mpr fr6m rh. Qinlrrx's ln.ns liw ln lhe folk,*in8 n*$ (s.c 70:tl 5
<br />lrusiBi trn Pr.f.rshr C,rLr Any Ciry or Cenrt *hich rquiE( ! Irfin !o dm{d. .116. in{mw. d.mlilh o. ,q!n (!
<br />nncroc. thr ro ii\ km.. rl$ E{rft. rh. r0tl.rnr ror rkh Fmr h nL . .i8Ed nd.rnl lld tE or {E i\ litnsd ruulr
<br />h rlE Fnvnbnr of rlr CrnrEtols l,ilnrd La* rch4r.r 9. C.nrEE-i.8 sirh sftrk. 7{xxr .f Divkhn I of rh. BlriE( rnd
<br />Pr,tlsiro{ (t'dc) or rhrr h. r rh. k cr.n{'r ih.rcfrdm lnd rh. b$!ir ft rh. alk8cd .rcn{,lhn AnyviolllionnfSFrkn70.ll5byr.y
<br />.nrli.. for. Fmi sbFrrrr lr'nlictfl! ro.civil[.Mhyolmr nx'Ethu fiy. hond'.d rk Li (ivl)r
<br />l. $ orE.of rlE FDI'qry. o.rclliiElycotrddhs wnh lirtrsd coddon k' a,nlml llE FlFI (Sc. ?04,1. BNiftlr
<br />PDftstn Crn TlE Co.r-ror'i l-irnf, tr!. &F mr .pplt r. e ovF of ,mlEny *ho hraldi or inomws rh.ron.
<br />*lb @lrffl]fc rchrmi{r *nh. Corrrd'tn lEnrn l{Ed roih.coffi r lir.E L.*,
<br />I rf,crctr,fl utrJcr s!.ri,n,
<br />Dr!. (r{ftr
<br />ttt rttx u lts' c(rlt pt:tstl(lw
<br />![clrr&rua!
<br />I h.,.ht3finniun,l$ F trlry"l ttrjuryotr(olrt611"trr*d.(lnnrtr \
<br />_l h,rt !d wrll tui,nrin i ( difr.r. of Com n,5.ll INE f1* nrl6' onFN.rhr .r F,vitcd fd by sdbn l7m.l rh.
<br />lrn Co<lc. fm llt ,Efmr of tlr. *mt ,ry *hth rlE Fnn n n!!.d
<br />lhrvcxrlnillnEinrainrorlrra.of.nuii,,ninli,rn(r.r\FqtrrctlhySc.ritlTlr) lrh lihor C.,lc. r,niht F*nnrtrufc.f
<br />th. rork f'n \hf,hiht Frmr '\ N{rt Nll uorkda.o'nFnqri htrrJ(cc fl I pnir nu'n}.r rr
<br />D.l.: Appllonl:
<br />r rcrlsm iolrr,rc-nrr
<br />txl:Ilaarlo!
<br />I h.Eby am.m udd FBlry ol Frjury rh.r I !n li!.an u'ldcr |'olti'i ol Ch.prd 9 r.$nlmrr8 uirh Sd irn Ttrl) or Dsnirn l
<br />o, rh. Burin.s ,nd Prolisrio.t Cod., erd rny lkcn$ t i6 tull ro.c nd cficcr
<br />[aNiralgrcM.ElDtNcllElcr
<br />I lEEby aftrm undcr Ftulry ol F Jury lh!| rh(. a! a .sn{turb. Ldin8 .gdy ror tlE Fn()lmm. of rL krk rdr whih rhir F ni .
<br />irr.d ( Se. :1097. Civ. C )
<br />AIII.IgANI.IESJAAIII!
<br />I lnby .farn udrcr Fn![ y ol Frlllr] oE or llE folb*irr &cLrd irir
<br />I).frnnirn I'.rs +Arlt(.r NdiaE.rhn F.n d RquLrirns (Tirlcro. Pm6)
<br />-RcquiEd
<br />l.llcr oi Ndiaruli,n
<br />I cd ify !fid rlE f.d..!l kauLrir.! Eardir3 mlElor rcmul e nr .at li'hL b ih; ,xoFd
<br />-l
<br />ccn ify th0r l hlvc Ead rhn llplicurn,n ud (urc rhrr rir d,ve innrukln k c.n..r I 08re lo omply wiln lll Ci! y tnd C.u.(y
<br />.ilmmcs .nd Stlrc trw. ELrins ro huildiis con{nd ion. rn h€rciy 'urhrie r|'.*drl ircs oa rhn Cil, .fl! ( ou.ry tt .nrd ulsn rlE
<br />rlbft m hrd thFnt rn in.Fdb. plrFrr
<br />tDDlntrnl.r t!$l Silnrrtrro
<br />ID/SIG.COMMENTS
<br />Shear Wall
<br />_1, a 6*B.rrltF6Fdr. my.irhF. *nh rr8.. r. rlrir ril. d'qENl.n. wiu &, dE kri rn 0i cndE i D{
<br />i €1Lrl trolt Ed for sL (Sc.7O!4. Bulim$ tnd ?mfc$ion. C.d.'Tn C6fl6.ror'r Lirne tr} d{rs m +!1, lo an owE of
<br />rrE rrordy wlr t .t or inv.Es ttEMtr !d wtb dc trh slt hinrllf or h.rclf or l,mush hii or i.r o*n.'r{L}er.
<br />,myiLdrhrr ruh inFD\tfuflt E d irod.d orotu lry ql l(tnffi.UEllill,BdiqnJwdi!$ldsahrGF,
<br />of dn?lria llt owE Build6 vi! hE llE h,,&n or FD{uts lhd lt ( dE dn rd hiiU n inFm lrE FlFry ftr llt F,FE o,
<br />-l
<br />ccnifr lhd hrlrFnorBrcof l& Mrt f( snih lnn Fri N i.\tn.l rn I mr.nnby !.y,Emn in.nrMB
<br />ri !r k, tr.oft ubr.d ro rlE rb*d< .onp.nsrhn bql .t C:.lifornr. . aSr rhr if l ihouH t <oft ohFr kttll
<br />Htrk(r'comF.nrionlftvitirnrorSc.rion.lTlDofrh.tihnOiic,lrhlll.fonhenhconPlywhh!tu,.pmriinrns
<br />WARNINC, l.iluE h slE *rl6i orqEneri)n olcn3c ir unL$rrl. Jrl .hrrl sbFl u c,r?hF b qimnd Im[ii rnd
<br />livil nEs up to om hu.rdEn rtnusd d'll,s (ll(r,.ltr)). in .ddnion h' rrt co{ of otrtEKria d. 3.. I ltDvid loi rlt
<br />S€rFn -tor6 .l
<br />'lE
<br />bktr C.d., intcE( .rd .noEr\ ritr
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