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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.OWNTR AUILDFI DIILCARATION
<br />I h.rhy .ffirm un&. FMh! of rErruo_ rtar I m .r.q{ fhm rlE (idmn'F' l-iinr t:r n, lh. L.lLr*inF E{$n rs& 1rll 5
<br />Businc$ onl ftdisi(,n Cndc) Any Ciry or Coutrry vhf,h rcqun.t s [rrn{ ro .on$rucr. 0lrs. impnnt. dcmnrh or rcI8n anv
<br />nrudurc. prhln, ils n\ue., do rcqtirr thc alPlt0nl tu ru.h Fmnl tu rL r iirrcd dncrnr rh.l rEordE n liftn{d Nrssnr '
<br />to rlF F iii,nr ol rlE (tntrr!tr s Lic(n{d l-$ rcrBfid 9. Com Emmg *irh Strnn Tltxr ol Dirniin I .I !h. Bu.nFr( lnd
<br />Phrc*n,ff c.ic)or lhnr lEor\fu i{eic.rfl rh.rcii.r tfrt rh.tusn r,trrhc ulk*.d.r.nrIrion Anrriolati,'norsdri'n?0.!l5hv;nv
<br />apola, foh Frmir lutiFh rlt 'mlk$t lo tcrvrlP.nllryo,n d,crhlnlirchund,.rjdollr\(35(x)r
<br />1, 5\ otrn( .f thr |I 'tEny. or nry en,pl,,]s( u h s03.\ u\ rhcn vtt .o'nri\dnrn. $ ill d. ltr tr itk rrl rh. indure n t
<br />inlcrl\l or nf|Ri l{r qlt lse 7(41. au\i,E!sann hnf.$inr C,xlc Ih.C',ntrktn. \ I i.n< Ijw&.r frn aPpltnr!nortui.l
<br />rh( FIrny "h' hiHr or inlnrs rh.rt)6. lrn \h, d{E {rh trtt{ t'nMlf nr h.rellor rh^,ush h^ or h.r .r n cnt*)!tc\'
<br />nnvdcdrh s(h inrnrEmnl\@mr c ldorofr.tn htr \rL ll. h'k\ cr, rtr ttr rkhn! or i't{rotmnr r\$kl *dhi.om X,r
<br />old,nplcri.n. rlr OwNr BuiliLr rillhflt rh. t{iLnofpmviry th! lt ur 'hc drl mr h{illor iqn,lr rh. fm{rnv nn rtr lurF)t.f
<br />-1.
<br />xr osftr ol lhc F,I.ny. !r €iclu\nal, .o.t&ring *ilh lienqd .ont!.nn k, don{rucr rh. nn,jr.r lS.{ 7(}l,l ltunrc$
<br />.l lrl0tsih C,xj.: Trr C.nrxft" r l.k.nc lrtr dcr Bn lpt'ly nr !.ormr nfrn,Fdyslx, t'!ild\ n m0nrt\ th.ro..
<br />and *ho $nrh.R n, such lt,,rr:r1 *irh r G,ntsdon \) l..trqt Pur \unr ro rh. Cudt*rm-\ l.Enc I * I
<br />_l !n.r.nllJr und.r s(tirn . D & PC t({rtis rrq)n
<br />I)al.
<br />ll (,Rl(FlL\' a(l1I l'r \s^ I l(,\
<br />!KLr&Ul!l:
<br />Il'.'.1,rxin'rtrnl(lr rlvolrulUryoNolihtn'1,,trn]a,l..lirni N
<br />-l
<br />h:tr rn s rll ruinr.,n r (tn rttlrc ol ConEnr kr S.if l..ur. lit *rrko. .onqxnd nn. rs F ril.d lm hv SNrrn l7ll ol ilE
<br />kh, (.dc. nn rtf, Fnamtuc rr rhc uod tor snahrhe p.nnir h iriu.d
<br />I h:rt and * r ll romrlio f, od.r. .nn!i.{r xr rn{ttB.. !1 rqun.J ht SR1i.'n l?lx) ol rh. l,lrn (ixlc. lot th. Ffortun ' nr
<br />rhc sork Li shichlhn l.rn,r is,sucd My*ortsi compcn\trri,n in\xramrcurEr onl F,ltynunlb.r uc
<br />Dr.o-x L;Y at€l --
<br />.DNi y'tuC- ol \.i'7 f,,..>JztLn
<br />-l(cdifyrh{t
<br />in rh. Frlornuft. of rlEtrork nn shi.hihtrFrnn n6(ui lthrllft .nll)htinyFCrqtr inrnt ronrr
<br />q, !s n) rt{onE \ubj.{ n' rhc s rkuis'..n!Enq(i 1.*sol'(llifixnir. d 4rcr rhlr irI \h,ul{, ri.om uhi.d n,rrt
<br />rorlr^' (rlrNr$r bn pmr n(!N ol S(i,n .!?{r I ol ilE titrn C(iL. I {Ell. i)d h* irh dmfly ulh rlst nn,vi\i)nt
<br />WARNIN(; lN'lxr. k) curc wnk-(, Lr)n{*nsrx,n nr.dac ir utrl!}ful- ud sh,ll \uhFrr !n cmnlrFr t, mnnMl lEtorlra !d
<br />rxr. n kn' r. rlr ro( fr (1nnFI ktr,. ,lxtrrsrt r\ frdli(krl l,n th(civil ftrs up n, on. htrndrcd rh.u\an,l ,ltlhn
<br />Secrrr lo'ra,'lrhc l.h, (d,c. tr .rc{ rnl,tro
<br />D.,.: tt] 2,{l I g
<br />^ppl
<br />U}:C'.A8AI1IJN
<br />I hcrhy llllrm tro q ncnrllyol Fdlury rhlr I {$ lnrtrlrd undcr pmrni(,n of(-hrDld 9l.onlftfr1n8 qirh Sc.riin 7lrx, nrl'r(tr ! 1
<br />ol rh. Bu\ir$rxi ltrnl.siht (i c.,nl m! lf,.n{ s m lulllbttdd.lfd
<br />-
<br />.*xb iotL171
<br />Ds,r 'ilultt
<br />I0ISIaUCUQNTIIDIIG.AIjE!(I
<br />I hrfthy affiflh undcr FMllyorn rrnry rh,r rhd. ir a.onnrucrhn kndirs aEctuy ror lhc I'ctfornlttc orrhc worl fin ehich rhn !.rmit t
<br />il.Kl(sc .ID7. ci} ( l
<br />trftld'(Nrm
<br />-
<br />Alfuc/rlfDl;l;lA8Alr9!
<br />I horti, lr@ un&r Fn.[) ol FUur] or orrlts n,lk'rin8 iL.l&li,n\
<br />tXnr'lilion I'crni( A\tino1 Norificalion ftdcr!l ll.Sxlarioh (Tirh.ur. P.n6r
<br />_R.nuirrl l.rr( orMrifmrin
<br />l.cdifyrh rh. rinurJlr.EUlnrknr'cSddrnt r\h((o\ '.trx)ulxre rn ill,llohlc t, rhi' lmJ(
<br />_l.rn,Iyrlur I ha\. rrrlrhisrmlEarrrJxl{rrr rhrrih( nlinc r1o' i,r ^.or..r I/g(r'lv\thrll(,r) rn(l (,in )
<br />rrr ,lCinnlvl,' cnt, rJxr rlf,r. r t hcr.h\ nrlxtr/r '.trr\rnr,i r.(.lr
<br />lllr l; fl :';I ^',):il li:iillil iili
<br />norr*, * a**, a,**u'*r/-
<br />'emn,rnrnr,prin,,: // zo-,(-r\^rJr7
<br />1/zr lrl
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Sublloor/VenVlnsu lation
<br />Rool Sheathino
<br />Shear Wall A.
<br />Framing )tr'vfil
<br />lnsulation/Enerqy^/rt,Drywall PEQ-I.Y'Wv^^
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />T-Bar 1 1r tk I ',tntl t<Ytz'I n-./
<br />Handicap Req 'tll I
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />tl
<br />FINAL b '-Jtr +*1PrL-,sr'
<br />I'YI 'Certiticate of Occupancy
<br />Notes Remarks Etc
<br />&:DtrY v4L v
<br />COMMENTS
<br />K-l5ir
<br />K-21-l\
<br />Pool Fence
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