|
SITE-WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns 11.(rl(t PkTW -*-n
<br />Erection Pads
<br />UFER Ground
<br />Subfloor/VenUl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Fram ing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />----) r - I )- c-a--z.-\o vqot l6l--n o /
<br />D-,g)l . - -4FINAL-f -T-'fl zra ,l f - Lt G(H sr/hratV
<br />cate of Occu anc
<br />Notes,Remarks Etc
<br />1
<br />t tr
<br />]T'E.4
<br />,
<br />r)$ \t R tlt rrl k rrl t.( \t\ ()\
<br />I hd.by .llm undd FDry ol Fju.y rhrr I e adF nrm rh. Cofrdo6- Lk.e Lrw tu lhc hllo$ins l@,i (S< 701 LJ
<br />Bui6t ud Proaaion Codc): Ant (ily or ( ou,ry *hth EquiB ! Fni lo otrrrucr. .hd. ir{rore rbmlkh .r EFtr ey
<br />ntucru.. Frro il3 i!sle.. iho rcquc llE plicd for Mh Fmn lo 6k ! 3iEi.d ndffit $i lror JE i ltc!.d lr,f,d
<br />ro rhc FovilioN ofrlE aonlE.roii Lic....d trq (Chlpld 9. Comncn ins wilh SalioD 70oo olDivi5ion I ofrh. &Bin.$ 6d
<br />Pnt*hB Cod.) m thn lI d ilE t GGqr rna.fron &d rlE t3i' lor rh. !l!.s.d .rotrFion Any i)Lrbn olsaiior 701I thr!
<br />!ppli(. fo, i t6frn llb.iccti rlE .Frli.ul ro . civil ti.hy of et oorc rhs fiv. hund..d <hllB ( S50().
<br />l, 6 o"c of llt FoFD, ( hy mplo)6 $th $.s6 a rh.ir hlc conqElnnn, \ill & tlr *vi !d 0r rnrrE ! mr
<br />idddcl or ott6.d aor $L (Se 7or4. BBinq dd ProfsioB ( od. ftr Conrr.croi! l.ic6r tr* d.6 .oi ,qpl, ro .n o"nd 6r
<br />rh.Fnpd!, srs tlili u iqN!6 dEE( rld slF &E sh slt h'mslf or hq&lf or rtFur.h fiis or hq or,. mphyG.
<br />Fovd<d lld {.h 3tp..rglEB E mr -rdrbd n6llq d tu sL l( lr,s6s. rE ttrildiq or int m\ffi i! $ld *ihin oft ]t
<br />of compLtiotr
<br />'lE
<br />otrtrr Boittn {ill h&c rh. h[(l€n ofFovins thd h. or ih. dij m! t iii or inqftv. $. Fqcl, for th. F[,o* of
<br />I. a o*rs ol thc rroFnv. dn .x.l$ircl, c.nrdihs * irh lico6.d mnlrrror to connNcl I h. piojd (s6 ?044. lrxrins
<br />&d lh.tsir cod. I lE Cohtdor! l.ic.e l,u dt6 mr .pf l! ro e o\nd of FoFn,- $tr huildr or dprord rhdhn,dnd $ho conrrxi' tor such l,.jdt *nh ! ( odtuoni,lamr.d plBuh hrh.conirocioir lic* l!w)
<br />I o crmF ur*b S&rirn
<br />rlraf,ESs:cQaltEBsAllo!
<br />DECIdSAIIA!
<br />I hqtb, .flim un& Fully of Fiury oc of tlE fouowiis dcLfllioa
<br />I h,v. ed will minlli. . (.nific.tc oaco,sl ro S.lf-tnrur. tur mrt6 .omFMrion, E pmvid.d aor b, Serion 1700 oflh.t hd code 6r rlE F6.Ijl!E ott,E *!rt tq *nth dE Fnir it i$cl
<br />I h.v. ind *ill mlinlin wor[6 .omFN.rio. iBur!G.. s ,.{utcd by Sd 6n ]7n0 ofrlE bb.. Co&. for rhc Ffomft. of
<br />t,r srl ,or s hth rhir Fnn ir iEEd My ssld onp<laan iEl,G ffid .'d !olt, r@h6 E
<br />Cffi
<br />Polict NunbG _ Erpn6:
<br />-l
<br />Mit dd ir rlE Ffol1rm of rlt *!,I fd rtth lhir Fhn it isu.d. I .lEll mr dpk y rr FaDn ir oy ffi
<br />e .rro tELom. suhr(l ro th. soltdl .onrpamrion \ o, ( dL'rnnri. nklll!'r. rhr rf I shotrl\ltr{.trr rtrht.d r. rh.
<br />sortn comFsriD rror iiFB orsd ion 1700 of Irbor ( ole I drll, fodhsnh.ompl) q{h rt .F\tioa
<br />n^RNING: lj.rlur.
<br />'o
<br />su. $ork6.iil rinca ut to o.c hnfldr.d lnoNnd
<br />fln@t. ir unhsful uJ 3hdl utld m dphrs ro ainin l rEEii! md
<br />r1 r.rn)o), tr' ndd trn, r, rtu rosr ,,..n,|. n,t(,n. rltrra!$ trs n'.\icd f(r rhc
<br />1
<br />-t-l4r Dir4
<br />DE('I-A RA rcN
<br />I h6hv llIm undq ,Ealr, oI pgjury rhn I m liGen undd F.rtn,n of (1+ld ,) (drn@(ios wirh S..l irn 70(x)) ot l)n ieion !
<br />of lh. BB|IB &d Prclsn6 Co&. !n m) lrcB s
<br />'n
<br />rull forcc .n drar
<br />L.m.(.hs t5
<br />".,.,/Lsr7
<br />Z/-wo
<br />{<;*;t/7e uDrt)
<br />I rEErl.a .lT(m un&r FuIy o r FJury th, th6.Lndir*.*d! for rh. lEfdrl1@. of rh. *@k hr{httthnrE il s
<br />i$u.dts(. :r09?. crv. (.)
<br />AIfI.IIAtrfDIS.AAAIIA!
<br />I hoq .&n und6 Fn.ltl olFjr4 oft of tlE aolLs i.s &.l{nioN
<br />O.nohrion P.mirlArtEdd Norifi..rion F.d6.l R.sulilio.r (l n|.40. P0n6)
<br />R.qut
<br />'.1 tdr( of tldifrdiE
<br />! coEdl I ryre lo .onply sith rU Cny !.'j Colnt,
<br />EF6drriv6 ot thn Cny .I(l Cod} ro @ld uron llr
<br />-JL)-r uu ".," //-s 17
<br />BUILDING- INSPECTOR RECORD
<br />SLAB Floor
<br />Masonry
<br />Pool Fence
<br />Flood Zone Certif.
<br />I t7 a
<br />t.) tX
<br />r l'rz
|