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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNDR AUILDI]R DELCATATION
<br />I hctohy rlfirm u $ Fnalry ol r.riurr_ ihar I an.r.mpt lnrnrhc Conh.n)n Li.en{ li* tu rhc t,lloeing kosr (s.c.70.11t
<br />Burifti! rd Pnna$irn Cod.l A.! City o, Cou y *hth rqlncs a Fmi t, dnr{tu.r, :lrd. i4n,vc, d.mnth or EIEn rnv
<br />(urur.. Err t, ir1 niuuc. 'lg, rcr|uc\ rh. rl'||liclnr ,{n 1uh Fmi rr fik: iiSrrl {d.m rhd h or rh. ir li..<rl nu,sd
<br />t. rh. nnnFionr of rlE (tnretoir t-ienEd lr* (Chrpt.r 9. (i'mrrn'F r h S..ri,n 7(XI) ol l)rr!1hn I ol rhc Au\ims rnd
<br />Pn,acsionr C{ic ) or rhrt h.orrhc ncr.mfl rh.r.lbhsnil rh. hn\n frr rh. ill.t.d .xcnrrrrir Any viokri('nofSeri,i Tlr.ll5 byany
<br />aprrrrnr rd, F ir rubFls rhc .mliranr to ! .ivil IEMIy.r.rl mrc rhr I ivc hu n.{ dnk^ (15fir)
<br />-1.
<br />tr o*F of rtu tmFny. ii n, .r+loJt6 rnh *!!l.i .! rlEi. $k orq.nqrbn. will (Il llE wrt .,n dE i&re ir r{
<br />irr.rhl I ofi.6d ror q!. tsd.7l)44, E$iE$ .nd Prorc$hnr Cin : TIE Co.tdoii Lj..nE lj* dt. br rp?ly ro m owmr ol
<br />rhc ptr'IEny wh. huill\ (tr iq,n,Er rlEmtr &d wlb d&! sh k) hiosclfor h.*.ltor lhbulh hh.r h.. owncmployccr.
<br />prcvid.d rhrr sNh ir{niEEnrt E mr irod<i or ofsd for eb lt hoBs. rtI tliuin* or i't *ftd t $ld *ithh m yat
<br />ordrrtbr-,tr rh. O*m. Auithr qll lrE llt hrrhortm\fi( rL lrn {E{n r{ hild d irrmF EF,6,r r FrFrcof
<br />-1.
<br />rr .wrer of lh. lmfdy. am .icluiirely conrndiDs sirh licctr{d conkrckn h on{rud rrE tmicd (S( 704.r. Bu.in.s
<br />rd F\r,ftsircrxlr Ih. Conrrr!tr s Lrcnc llu dms rn lmlyk'.nolNr ofpmp.ny rho blildror impmts rlrrarn.
<br />d $lfl olrslrfm *h fmrds {nh. Codddn lirn<n |[Kud hih. Co.rNmi Li.nE l,'l
<br />-l
<br />u0crcmn! und., Sdion-.B &|( ntrrhhru\i
<br />lllaf,EEslrlul,titAl]ltli
<br />DI'CLA TIATION
<br />I hcr.l,y rflnnun(ld pcnahy.t pcrJury ore orrhc rnlL,siry &(hrrridtr
<br />-l
<br />hrE r.d will ruinhin ! C.nifrl. of con<nr io sclf ln!!r rd srl6a Nft{Engra.. 8 lrcrih for b, Sdrir 1?(l} ot rlr
<br />btr, (in . for llE FfolrlEN of llE *xl ftr *nih rli Fna i\ kiucd
<br />-lhuv.trn,l*illma'nrrinsurk.^'romtl.n\inoirn\umn.c.mrcquncdhySc.rkin.l7(xrolrhcl2tnn(i..f{rrh.Frntrnm(colrhr \o'I lnr trhi h rl,^ I{nni r\ trnrd My*orkr,\rinIEnsri,,n insurlN.rtrtrtr rd Ix liy nrmbcr m
<br />lrrn'lyrhrr in rlr n ornlNnf rh.r,ror *hkhrhr Fnut r i.rkd.l rrEll ml.rmhylnyFmn inmy'mm
<br />o .\ r, tRr)ft {hr(r to rhc *n,tcF'.a'tr{En{tt'n htr\ or( r[nnnir. r 4E rhri irI\h'uld h.onr \!hFr hrtr
<br />*ods\.oqxn\di)nl)nrvishnr.lS..hnlTlX)oIlh.Llhtr(ixlc.lrh,ll.i('nh* h.onDly* hrhotn.ovNFnl
<br />WARNIN(;: l'ailurc n, ccurc *o,lcr compcnurior (o!crrg. i\ unla*lul, rtrd (hall \uhrur an cnuli,)lr l(' niminrlIrMlra\ rn
<br />cnil inN up t, otr. hu'xkBl rhotr!trxl dollnr\ r\ll l],Cflr. i. rddirbi ro
<br />'tE
<br />cns of co,r{ENlion. d!tur.! .i txotdd ror !h.
<br />Sr..rrn, .11176 of rh l rhn CrrL, i' .r.! ail !n(
<br />V</t t/zg
<br />DEIJJAAIIOB
<br />I hcrby rrrm unt . Fnl]r, ol rErrny rh.I I m li!.<i ud.r Inryni,n of oq{d 9 kr,nmminS rirh Sd-rn tui), ot Diision.!
<br />or rh. aurimsi ind Pn,fssbnl Cd.. .,n ny ltc.s t h rull r.N otrd .lTd
<br />7o422
<br />D
<br />t!r!tlralgu0NrNDMiltiEltgr
<br />I h.Esr_.lirn uol( F..lty or Fr,lrr rhd rh.r k. oddirn Hi.8.8.N/ for llE F,rtu of rlE q'rt for rhth rhis Fnr 6
<br />iskJ rsd: 109, CN C I
<br />knd.ii Nom
<br />-
<br />L.dld'r AddBs
<br />-
<br />AIELI(ANLIEIIIXAIION
<br />I hi$ynltianundc, rEnnlry ofNrjury om orrh. t)lk'wnrs d$lxr ionrl
<br />D.ftnr$h P.rm rArhc{os lll'ificrirn Ftrlcill R.3uldrnr{ r'l irlc rO. ld6)
<br />R.auirn tdG or Ndif'crir
<br />-l
<br />cqriry iut rlE f.n iilEtubioN Ee{dinr r*Nos Emvrl m ml +pltdbl€ ro rhil lbitr
<br />-l
<br />cqrily rh.r I lrw E d rlrir .p?li.ri- &n .1. rhd dr rL,rt intdtudhn ir.dr.<i. I .gE lo erPly wnh .U Cl, r'd cN y
<br />l{LlL L,in.\,lIL\l'n, t.l\\ l.lll b t{ ild ing .on<tu1ii, ,rl lErcby.urhrtc EF.{nrltir.r oflhtC yrndCornryhc.rd utFn rh
<br />rhrv. nurtr, d 0n)Fny ntr
<br />-^,"/o/11/79\ppli$trr,'rAB.nl Sill'ul
<br />7 t-4t / .r- -f
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framino t2-ll-l ,r.Y+,0\
<br />lnsu lation/Enerqy \-/
<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 />A\
<br />FINAL "16")"1 \.vjrq)
<br />Certiticate ol Occupancy
<br />Notes, Bemarks, Etc
<br />,'.."..,t,,.. 'D
<br />,",. L{t-4t
<br />Flood Zone Certif .
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