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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNER BUILDER Df, LC R.AIION
<br />I hd.by !,Im undr po.lry of pdjury lhn I E .rmpl 6od rh. Cot r.clor' Lic.N. tiw lor $. aollowing r&n (Sd ?ollj
<br />tlulind .nd Pofdion Co&) An' Cny or Coun' r'h.h ,.quiE t Fnn ro o (tu 1. !lld. inprove &ml6h ot E .n av
<br />ntucrd., Fnrb tu su!E..Lo Erui6 ir +pltrll lor sh FDn b 6L is..d rndE dt lEot Jt it licd.d FDd
<br />ro lhc FovitbN of lh. Co.rrlcloa, l.'c.nt d h* (Cl'!rl6 9, ('onmacins wnh Sarbn 7i)o0 oa Divilion I of llE BBilB od
<br />Pol6aonr ('od.) or thll lE or shc ir crmpl Ua.ftoh .nd lh. b.!L lor th. .U.s.d d@P ion. Any viotd io. ol Sdrion 701 l.J bv 8nv
<br />ip?lk&r ror . p6,nn objd. rlE .pplicol lo . civi! r,.MlIy o I m! morc rhr iiv. hund,cd dotla! ($m)
<br />t. 6 ow of rlr FoFnt, or ny atrplorE wnt tr'.s6 B llE; 5L @mFsrhn. *ill(h llE *sI nd dE rrdE i mr
<br />!1l4H orofid.d aor el.ISe.rO44, BuhB ud Prur*ioB CsL: Th.Co r.clM'!Lic@t w&6mltpglvloMoetdof
<br />rh.Frpary wlh tsil& o. inF.!6 $da.L,td w,F dG sxhm hiMlf or h.*laor lhmu8h hn or hi o*f, .nrlovs.
<br />Fovid.d rhd !.h nr,rmffi E rcl nad.d d olhld ntr rL lf, hor6q,lL tlilCir8 o inqro@ it sU wnhin d t€
<br />orN!9labn 0E O$E Builda sill hlw tlE hlttgr olForirE dr lr d JE dit ml h,ild d !4.ott tlE FlFrv ft. rIE F,lEof
<br />-1,
<br />sowE ofrlF FrFty, u d.luiv.ly codr&ril! *nn li..Gdj .o'nnclo6 ro.odM tlE Flj<cl (Sd 704-4 BBuE
<br />!d Eokn Cod.: Th. ( onltdq t Lic.M L,v &,6 El tpgly lo x o*G of Iropsty *ho iiild! or inprer6 lndsq
<br />dd {h. ftffi! ld sh FDj<r. wnh . codnons) lk B.d purln h rh. Co ncld ! Ltoe t*)
<br />I dncrclnt, 0nd6 Scl
<br />llrr.: ().rd
<br />\t oR{Fns' collPF sa llo:_
<br />DECIAlAr.llll
<br />I h6.bt omrn und6 poulry of Fjury om oI lhc follt's in3 dcldar(16:
<br />-l
<br />ts.!n will miln.in r Cdifid.oacodd lo s.ll-lB@ f ffiidt.mP.n-ri,\ E FotiLd lor bvSdbn 1700ofth.
<br />L.hor C6de am th. Ffotu. oflh. *orr 6r $ti.h rh. Frn i isu.(L
<br />I h.v..rrl will i .in erl.ra coqsrion isuec. s rqlun€d bt S6lior l70o ol rh. Llhor Co& for rh. Ffotuc. ol
<br />rh. *qI fo *-hih lhi Danit ir isld My *dtd Fnlp.Grhn 'Nuffi. ffi an Fky .umbs e
<br />Policy Nmbd:-ErPtd
<br />-l
<br />ualrfy rhd i. thc Ffolrl@. of rrE *orl for f,hth lhir Fnn L e.iL I Jrll mt 6PLy y Fsn !n o, mmo
<br />s s to b.cod. lubjdt ro rh. $ort6' comFs.lo. hwr ot Cllilomi.. ad lsr lhgl if I .lblld b.toE rub€l lo rrE
<br />*tn6' .omFsiion p.lltioE ot Sd'on l?Oo of th. hbor Code I nElL fon h*nn onpl, wilh thos pmvisioB
<br />'i!ARNINC: !.ilu.lo B@ v!rl6 compqEiion ovors. ir uL$tu|. &d lhdl !bi.t! , dphF lo ainin l FDIE !,rl
<br />*:To""ifrs*
<br />&lLB (ll(](,.0OO). in.ddirbn ro rlE cor of .6,lp6di.tr d.,I+6 6 F.ridcd 6r
<br />'lE
<br />IJCEMIDI;OtrIAAI]ABDESIAAI&!
<br />I heby allri undd p.nnry or Fjury lhd I m l(osqr u.dn ,hlsirn of Chqns I lommftinS silh S.dion 7l]0o) ,]. Drviii'n 1
<br />.f rhc lrBind 6d PmfBioB Cod., trd mt lica* n in tull fo,cc od .ftal
<br />,..fu,)?.
<br />Lcndd ! Ad<lo'
<br />AfIUI]AdI.!!SJBAIII!
<br />I hod'yrFh undq Fn hr oaFjury oE of lh. fouo* ms &.ltn ioE:
<br />Dsmlnb. Pmnetub6lo! Norificsrion F.ddl R.{ul.rioa (r nl. 40. P.n6)
<br />-R.qunal
<br />l,dla otNdlficdi.r
<br />-l
<br />.dift rhd tlE a.dd.l t.suLlioE Esonrs dtsror tm1.l &c ml t pla.bk io rhi I'\].t:r
<br />-I
<br />cdiryrfi,I herr l rhn rpplkdirn dld nrt.lh.l lh. atov. inlotuion ir!oEc(.I tsrE
<br />nJiMc lrd sld. t.6 cLnB to b.ildins $'dnElntr rd lE t't idhort icFedird o
<br />\
<br />.h\. lHrrrn.,j Fopsi)
<br />Appll.rnl o. rent Skni
<br />tofrmDly! hlllCnyMd('ornr,
<br />rrh! cirt ud cou!] ro.andupor
<br />,.,JU'ZLIY
<br />Set Backs <a.
<br />Forms/Steel/Holdowns 'l /'/)_ eo
<br />Erection Pads -"q=t j/lr
<br />SLAB Floor
<br />Subf loor/VenUl nsulation
<br />Roof Sheathinq 12.4,.,3N
<br />Shear Wall , ,'/ /t *-,
<br />Framinq I/o ,,,^
<br />lns u lation/Energ y '"/lq *
<br />Drywall vah a^,*z
<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*9t lh+/r 9']ir
<br />FINAL Tlztlrl-a 'za46q
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />6Vltfi
<br />c0lslEucllo!..tElDr(QAGl!.(a
<br />I t@by amnn u.d.r Fnlhy o t pdjury $.r lhqc ! . .odtudion tndins asdcy fo. rh. p-foffi€ of lh. *orl for wfiich riis p66i i
<br />i$u.<l (ss 1097. Ci! C)
<br />l.ndd'r Nm.
<br />-
<br />UFER Ground
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