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BUILDING. INSPECTOB RECORD
<br />SITE-WOHK ID/SIG.COMMENTS
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Rool Sheathinq
<br />Shear Wall
<br />Framinq
<br />lns u lation/E nerq y
<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 />Enqineer Final Report
<br />Flood Zone Certif
<br />II
<br />(FINAL /o //l/lX
<br />Certif icate ot Occu nc
<br />Notes, Remarks, Etc
<br />--t
<br />OWNET BUTLDEN DELCARATION
<br />I hrr.by rffirm (nd., pc@lly or Frrury rhar I on .r.mpl fmm lhc Conrrdtu l-i..nr l,v aor lh. follosins Er$n lS( ,{r'l l .l
<br />B!rii.r\ r l Pn'f.$ion Cci.I Any Ciry o, C:.'onr, whkh r.q!ir.\ a ,cnnil r. con{tod, !lrd, irProE, d.nxrhn or rcplir lny
<br />rrururc. Fi, ro ni ts1rId. r1$ Equi$ rlr {Dlirt for rEh rErmit ro liL i rilrJ {lcmnr lh.l lE or {E i\ lirntd Pulun!
<br />!o rlE F$risk.r .f ttE Cdtst(\ LiloEn lrs lchrfld 9, C(llffifti.3 *irh S..rb. 7(xl) or Oirnbn I of !E Bulik( rnd
<br />Pn'lc(ilB C.d.) or rhal lE oriE n.r.tplrlmrNn.d trE t!$ lor rlE.llc8cn crrt)tiin. Ary vi('hrhnots.di 70lI t b.ny
<br />lpnlic.nradoFrmirrubF.kttE.Iplicanllo!ovnpcnsltyorflnNErh,nnv.hunnr.ndolM(551)0)
<br />-1.
<br />0r .sEr of lhc rmFn!. (, my.rploy6 *irh u.8.s $ lh.i $L otr{EMhn. rill d.
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<br />ptrrvi(d rtui soch i'qmv.ftnh e ft inkdcl o.ofi.rd lo s! lf- tnffi. rlE hriuin3 irrnBmnr is sld *irhin oft )t-
<br />ofcoftrldion, ltE ownq Euih( *ill hnh rh. hrd.tr of Jr.rin8 rhur h. or $€ dn fr hriU .. in{toE ttu trnlEly f(r rtE Pulpos ol
<br />l. a. E orrtE F$Fdy. M.rch8iEly odrl1ins *nh lirn(n.oddm l,'.rnrrh rlr rtrF Is6 r0+1. ltciE*
<br />r,n ht,6sim Cod. Th. Cdnrsroa. Lk..s L.* dE! mt .pply lo r o*F or pmFny *ho hlild. or inpDEr rrErNtr
<br />rnd uho 6n(Brr lor sEh rmFr wirha G,nrdto(rr tirnrdl pusu,nr ro rrE ConFacroir L6ne bw)
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<br />DITLAXAIIU!
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<br />hlE .rd Ull minr.h. C.nirr.rc o,Consr ro S.r lmE r rnt6 otrthdir.. s Frt'iLd for byS.dbn lTsJ ofrll
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<br />lhihondrillftn oin worlcri cor.p.niarnnr inruhn.., ts rcquircd hyS.crimlTfirorrhc trhorCodc. turlrE I
<br />rtr *urk lbrwh{hthF Im, ! nvhl My*olo!, np.nurr{ hrurlR (,n t' url Flr y nunth.r e
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<br />$ ! h b.roc $hFr ro tlE sll6 dng.Mr bqt orc.lifotni. Dd+Grhd rrI ihull h..or ot'Fr iorlr
<br />ro d\, comrrnerrn l,ovilrn\ or Sdr ir. -1rtn of rh. t trtr(ixL.I dBll.rhrdhd'r{'ly *irh rh'€ pmrrr,n(
<br />WARNIN(: I'r'lnr ri rctrr. trurl.r\ lrrmp.trlrrrin ..rrrr!. ^ trnlJql
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<br />DEIIIXAIION
<br />I hcrcbyannn undci rEdhy or pcrJury rh.l I.m lnta:n urdc. F eirt,. orChrll..9 (.omEmins *nh Sdrk. Tul)l orDivhii,n l
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<br />I h.Ehy .mrm un&r F@xy ol Fqury lhd rlErc n r onslto lb. lciiin8 rg.my for rlE Frfolrrm. or rh. lod f{tr *hkh rhn Fnn ir
<br />isrucd(sN :1097.cie c )l.h,lr! Mr
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<br />AltITlANLIIECIdf,AIll)!
<br />Ih:triyrtrm!tuld Fnrhy olttrrury orc olrt l.ll,*in8 d.i lr,r i,n\
<br />l).r)lilir Pcrnit A\h.dor Norif.d n. ,*rrl R.auLr bnr ( T k 40. Pd6)
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<br />i.qur..l l!(cr ol NdifEdi'n
<br />l.cnift rhlt rh( !.icral r.!xUr ifls Eeirdin! $t rrosE ,vdrc mr qipli.rbk ro qhryar
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<br />applkur or 48.tr1skdun F
<br />P L///C t o)a O"4J /d
<br />.//
<br />DATE
<br />Set Backs
<br />Subf loor/Vent/l nsulation
<br />_,J
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