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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Erection Pads il7{il lt Tl D)
<br />UFER Ground U i
<br />SLAB Floor
<br />Roof Sheathinq
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drpvall
<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 />Flood Zone Certif
<br />FINAL rZl$lu i \*.r,rP.t^,{?/t )
<br />Certificate of Occupancy I t.
<br />Notes, Remarks, Etc
<br />OWNEi BUILDER Df, 1I'AR tION
<br />I hqcby lrm u.dd Frlly or Frury lh.l I m qdF fom dE Conlncl6 l-i..E lls for $. followitB @rin (iia itr I J
<br />BBos sn Pyof*ior Cod<): Any Chy or Coudy shth 'quc , Fti ro 6dM, rns, ulproq damlith or tlF! ev
<br />1rucrB.. rbr ro irt !s!ft., !t!o r.quid lhc eplksu for lucn Fmii lo fr|. r lisodi ftlc@r rhn lE ot C'. it li.dB.d prsd
<br />ro rlE Frvirio6 or E Co r*rdi Lic..En l,w (Cl+ra I, Conmd,nB $ nh Sdion 7000 ol Divnb. I of lt. &strEs id
<br />PbtsioN Co&) or rhlt tr 6 lrE b .r.6pl lha.ftoE ud llE b.ri lor lhc .lLS.d ddFion Any viobtio. olsdion 70ll I 5 hv uv
<br />!p?lic. lor !Fmi.utJclrrlE lpplic&l lo ! ciril p.tut) ofrct norcino fiv. hu'xttd dollr! (1t00)
<br />-1.
<br />s @6 olrlE FoFry, or Ey ddolc *nt w.s6 ! lh.n sk omPadbc vil do tlE *qI dd rlr rnd@ . Dr
<br />inlarLd or o,'s.d for !.L (Sc 7o{4. B6i,B ud Proadios Cod.: Th. conlrrdo* l-kru t v &6 not @ply b M .w of
<br />rh.FFry e ho hlili r inglE 0E@.. .d *ho dE nrt ert hirelf m lE*ltor llrouBh hn d lE oM qt9ldr.a
<br />provid.dlhll luch inF!'vqeE @ mr i did.d oto6qi tusL.l( hw*,l& trildnr or unprowi n$B *ihnorc)u
<br />oforpldi4 rlE GrG 6uitl, ri[ h( tlE h!&r ofFoii.B dr lEdtr di, @l U,ild d i'4.M tE F!Ft] ti lt F,Frof
<br />sL).
<br />L d om6 ofln prondln d .r.lNi!.I, co.rdins wnh li.aE d mnlr.c166 to o.drucl llE pmi6l (Sc 7044, B6ind
<br />!!ld holsin Co& T1E Conl.ulor', Lt@ Lr* d€ tut.prly ro { olM of FoFy *ho htrildr or inPreve lhs@n.
<br />md who odds for 3uch Foilri wnh ! Cofrrrto(, li.as.d FlEui lo rh. Conxrdd! LtG kw).
<br />I m dofl unda Sa1ion-. B. & P.C. fo, lhir r.Mn
<br />D.r. Or.n woRxxns'6 rPEN..a-oN
<br />IEO.AIAIqB
<br />I hs.by.fim unds Frhyofp<jury onc ofth. follopiq d*ld ioa:
<br />Inv.drlsil!mliorlh.CdriaK.or(ocdrioS.lf-lElEfdsdtnt'onD.ndion,sFovrL<ltorbySdlion1700ofth.
<br />t bor Code aor rll FfolM. of 0E srl a@ trhi$ t Fnn ir iso.d
<br />-lh.v..n<l$ill@i.irm*6tcomp.GdionilM.tqBr.qun.dbySdrio.l7(r0ofrkL,h.rCod.forlhcFfollm.oarlE x{rt f whih rht Dqmn i. i$cd. M, w 16 omFdion iBuffi. wiE nd polt} Dmbd el
<br />{o,nttyr h r"rh n -
<br />I
<br />-l.ari!
<br />rh.r ir lrr Ffolffi or$. *orl fr *'hEh $n FrBn i5 is!.4 I {!U ml urphy D, pcsn in sv @F
<br />$ s ro b..on. sbid ro rh. w*6 onpiEaNn laM of ( nifomn. ed ts6 rhd ial lhould bcoft 3ubjdl $ ttE
<br />$dld frmrdsriotr Foviro6 of Sdrk'. ]7m of th. t hr c.de I !h.ll. ldhwnh mndy lnn lhi rm8hE
<br />WARNINC, Flluc lo su. mrt6' emFrdior N6!. n unb*tu|, md lndl iubj€1 e mploF lo mintl FEib di
<br />c l nn6 up ro ok hundr.d lhousd lloo,om). i. rddnign to (h..on of .omFMio( d&r36 B pr.vil.d fot lh.
<br />s..rion .1076 ofrh. tibor Cole inl
<br />DECIASAIIA!
<br />I h6.b! arrm u(ls psuhy o f r,6ju.y th.l I m licasdi unds pmririoo ofchsplc 9 (commocinr wnh Setion 7000) of D*i.o. l
<br />of lhc Bsrc id Prof*68 Co&. tn my li..M n in full fore sd.n.t
<br />b t03 0zoq
<br />,"," t-olz4fta l, C{rn S 4r4ch'kL--.
<br />SI!flA!CUqNTE!DI!G.{OE!CI
<br />I 6y r1lm u,xld palXy of Fjot,ltt rhe it r ordnElion lodls .Scr for th. FftrIrlc ol E *.rt for rtth rht Fni ii
<br />isu.d tsd 1097, civ. c.).
<br />l,!d.', N.ft
<br />-
<br />Lad.r'r Ad(t6
<br />APPUCA T Dg(.I-^f,-ATIOiI
<br />I halhy atrm undq porly of pdju.y on. ot 6c follo*in8 d4ltnriod
<br />D6Ehbn Pd'GA!b.r6 NdilicdbD [t(|g.| Rcguljio6 (Tnk 40, Psr6)
<br />_R.qui !d rartd ol Ndifcdbn
<br />-l
<br />.qtify rhr UE fcd-.I ESdnbE qldins &Ddd @vtl r. Do{ +lt.bL lo th! F!r.d
<br />I cqtit rhr I hw dd lhi. sliaio. .td itl. ltlr rlt $oE inlirtr.riot ir ffiEl l .grc lo otplr *nh .I Cnv .nd Conlv
<br />odde6edSr.l. L.*rElant d
<br />,h\.nEUion dF.FlyfNlYtl
<br />dd lEcLy .r.tmiz E rs .ln6 of lhi. cil, rd cou,r, ro ai6 uroD ltt
<br />Appll(rtrr or rt86rl SignrlsreL ,.,.1olzlf lX
<br />Forms/Steel/Holdowns
<br />Subf loor/VenVlnsulation
<br />0lqq -go - rz_ ,
<br />_,.. iof z7
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