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BUILDING- INSPECTOR RECORD <br />SITE-WORK DATE ID/SIG.COMMENTS OwNiR BUIt.DER DETTCARATION <br />I hs.by rrm uids p<dly ol Ddju.y On I m nof,d tom rlE (onl.rci6 Lk.nE t * fot th. folh*ru i6)r {S6.7al Lt <br />B6in* srd ProtBioo Cod.,: Ary Cny or (6udy which r<quid . p6f,i' to odtud. drE, itr9.o\q &rd.i or Ep.a Dt <br />ntuc1@, Fi'r ro ir. islec. rto Egrid lh. qpl(&l lor sh p6oit ro 6L. sialEd tlitut thr lr.r JE i lic-!.d F!'d <br />b rh. FllisbE ot d. Conr&ld! l-rc..t d lr* ((]rplc 9, CoIllrlcins wnn Scrion 70@ of Divitbn 1 of t Eu!6 !d <br />Pmf.sioB Co&) d rhfl lr d rlE i.rd,l tha.{roh rd llE bdir ht 0E tlLe.d qdFhn Ary lioLrb. of Scrion 70al , bv sv <br />@li.,rl for ! Fmi $biEl! lL .pplt&l to . o I Ft ll, of@r mr. $- livc huldttd &,lla {l'm) <br />l. B olrc of tE FnFrr. or my .rrpLy6 r rh *{6 B llEu nL omFebtr udl {Il tlE tr cil .d $c tuE . mr <br />,rci.d 6 ofid.d fd eL (Sc.rotl. 8{16 &d Prnl.s46 Cod.: TIE Corrt ld 3 Lilg t& do6 d +ly lo d otrE or <br />rlE FDFry [ho htit{t6 itr+.€rrEa !n wb dEsn $o* hiElf or h@lf or thrcusfi fin lE os arPlot6. <br />prd ital rhi $ch inFDtlEilc d -ra.Ld d.rad turk.I[ lFtr6s. rlE bidng d inFr,l{l'd i' $ld sttii * t- <br />ofsnpkrno dE oltrr Eil& *dl h.r ln. hdd ofFNaB rtli lEMnE dii Er hild or it4.ort rFFry to.lliF Feol <br />l. som6of th. D.!!dr), mcrchrivcly.ontdms wnh li.dE d co,r8do6 lo oNrud rh. Ftjc(l (S< 7u4,8618 <br />ud ADf3td Codc: Thc Conrrrclu ! l,iccEc liq dr6 oor qiplr ro D o*nd ofProp.ny sbo build! or improv6 thsqh. <br />md sho @nlJlcrs tor Nch pojdrr{nh! C.ntd.(r li.d.d puEu.l tolhc ContE.loir Licar liw) <br />I m.xmd unds S(non , B & PC torrhisr@n <br />D.le ortrdl <br />utxliull:lallllillarqB <br />TISAAATq! <br />I h6cby amm unds poBxy ol Fjury oE oflh. folh$iru &{krdi,B <br />-l <br />h.r. rn *ill minl.h. C6tifrx. of CotFl r. S.lf-lM l @rld ompadiol\ s Forii.d fot bysct{n l70o oath. <br />llb6r Code fd ilE FfM. otlh. *dt lin rtth llE Fnn ir i$.d <br />-l <br />hr\c s.d ull ui,r.i. Bt-t corp.rEdior iM.m.. 6 rcquir.d Ltr Sdion 1700 ollL Lrb ( oae for tlE Fflfut of <br />rlE rDrt for $hth rhi! Imn ir isr.d My wto- coEFE F. nBtu. ffit tn Flar_ @nb.. rc <br />I'olEl Numbs:-Erpt6: <br />I cdit rhar ir lhc Fforllsc of !h. worl for Nhf,h lht Fnn it isu.d I .hrll .or 6pby ey p@n <br />'n <br />st meE <br />s s ro b..!ft rubid ro rh. s 6 oBpo!.lu Lsrotctlirom'& e{ tsrlhd rrl drukt bdoffi subjcl lollE <br />s,ortd'codp.@iionFoviereEofS.dionlTO0oflhchbor('od.,l!h!ll.fonhvnhcof,tly*nhrhoxFovnhnr <br />WARNINC: Failu.lo cu. *otk6 omFMrk,n 1016{. i! !nl.$tuI. od sh"n sub]..l d @phys lo nmiMl Flhis $d <br />.iril nn6 up ro on. hun&cd rhoudd dolld (llo(r.(]()0). in sddilion lo th. cos of.omFE lior. dms6 a F.va.d ror rh. <br />EECTJAAIIA! <br />I h6.br'srm unds FuI, of Fdjury rhd I rn li(aql undd Flvd'on oach,prc 0 (comnrdDr *'!lh sdio. Tu)O) orDNision l <br />Co&. &d my li..e L! h full lore lrn.,Lcl <br />61N\K <br />co!lra!.(f!0ru.E!!l!cicl!c1 <br />I h@ta .llm u,!dd Frlr of Frury lhi tlE. b t o.riru.lb. ladt ts lsdy hr tlE Fa(n@ orlli "ofi tot r'hrh rhE Fhl it <br />isu.d tsa. 1097. ciY c ) <br />L.n'ln r AddrB <br />- <br />APPI I('ANT NrI-I AFATION <br />I haEt'y .llnn und( p.fllhy ol pdjury on. o f th. nnbwFt deleal ions <br />Da.dhio" Pdnils-Asb6tos Notili$xo. r_di6!l R.sul.tionr ( I ill. 40. Pan6) <br />R.qut d tntsofNoificabn <br />- <br />I cd'ry rhar rh. Ld.r.l r.8uldioN r.sudins BIEror roo\ .l &. nd tp?ltablc lo rha r.Fr <br />-l <br />cdiryrhd I h.v. rad thi $didFn al niic rhd th. it r. infomdt o i5 cdB€r l.!rero conDly <br />ndnllG..d sbr. t *! ELirs lo hriktirs co,!.h.rha lrl lE br.ullrp, EFsrind otrhn Cny <br />!tnr. nhriomd Fopdrt tm <br />,\ppli.rnr or ,ttdr Si3n.l0rc <br />od (6d) r. drd upou t, <br />Iueg <br />Set Backs .//_ <a C4, <br />Forms/Steel/Holdowns /,4 I \JA <br />Erection Pads 't< (E- <br />UFER Ground /K -ltf <br />SLAB Floor <br />Subf loor/VenVlnsulation <br />Roof Sheathing lt-4y',s >ta, <br />Shear Wall tL/t-/\5r€1 <br />Framing \/3/A 1*k <br />lnsulation/Eneroy t/+,/4 a4r8 <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 />#3r ti/th/rs s\(t <br />FINAL 1lzrln ,l,cd(/,) <br />Certificate of Occupancy <br />Notes, Remarks, Etc. <br />;::Jei%ff <br />5 <br />Flood Zone Certif.