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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.owNl:R B(rrl,DEl{ Dt:I,( ARAll('N
<br />I h.rcby llfirN utucr p(nrlry,'f p.rJury ihar I Mr tr.nrfl n"n rhc (itrr'n.ttrr l.'..d\. I]w n{ rhc r;llowi',P ruvn (S.r 7011 t
<br />Bu\inc\\ anl Pn,fi\\hn Cdlc) ny Cily or Comry *hi(n r{un \ Fnnir r, con\ru(r. rllcr. nnP(t!c, d.nrnirh I ru|!tr ry
<br />{tu.rxrc, lrnk) ir\ il\urrcc. rho rcqnirc\ rhcllnlltrni tur io.h ltnnd I' lllc u {i3ncd dd.nrnr rhrrh.'tr \hc i! li.cn\url ,rtrntr r
<br />n' rtE pnri\n,n\ of rh contdo. Liccnscd lis ((hrFcr 9. (i,mnrm l*[hs.(rt 7(xrr ol l)niltrr I.(rh. lilrirrs !trd
<br />ftotd\$ons Codr r or rh!r h.oish. i!crctrDr riurcfnnnrn,lrh. hlii\ kr rtk dllr!.(l Ncnrri,r, Anyvi()l!ron.lScrinnTlrll5hyroy
<br />rpplicanllbrrtemil{uhtclrrhcuprli.snrtrscivillcnrlryofn(rnr{(rhrnrn.htrfrnr(ldollurlilt(rr)
<br />l. ss owmr ofrh. prcFtly. q my.ryllores *irh *r8.r $ !h.n {b cotnf.ndion- *ill& rh. uik rrn tlE \rdr@ n d
<br />i,'lod otolIc,.d nr sJ.lse 70{4, Butimsr ud Pr.rcrtunr Cod. ItG)dh.hll-iinElr*dEtftn+dyro.novmt.r
<br />rlE potEdy elFt ildr o in!reB rh.Dr rd *h, &n kh kd him\.lf.r h.r{lf or rtFuBh hn or h., tun cnFloF.!
<br />prclidcd rhd sx.h inFrwdr c rn id. lcd.r orI.8! rn eL ll lr$tE. rh. hortlm* or intnNrnr i. $lI rirh, oE F,
<br />.fmnpl.lion. E OrB Build.r will thE rtE hlrh or Fnrvin! fi, lE r dE dn r, ttiu d iqn'w rh. InrEry [, rlF llr,IE or
<br />-1.
<br />f,\ o*Mr oatlE Ft!.ny. .n.r.tusiv.ly mdr(ins rnh lirn<rl.rdrx]6 ro on<M1 llE F,F! ls( 704i1, 8u(E(
<br />rrd E!6arix Codc: Tn Conrmroir Lk.nr trs d(s mr lPrrly ro u .*mr ol F,Fdy wlr' huild! or hrrnr.l rh.Er.
<br />rnd wh. 6d*ts rd h FoF! *nh. Codrl:ronr lhtrsrl pursd l.llE C.dncroi! l,iflG ti*)
<br />-l
<br />rnercmpr uni.r Sen(
<br />t).t. ()rmr
<br />lt oxxFis-aoit Pr'{s^'n( lN
<br />ll[gJaaro!
<br />I lErch! ,mrn und( rEdlry o, F,lry om of rrF folloriry d..hrarrn\
<br />-l
<br />hrE eit willmidrin r Cdirr.tc olcongl lo S.I NEldk*r6 oqEG.ri.n. $ F.vi.n rd b,Stiion J7(noallE
<br />LrlE C.nc fq rlE FlqnlN of lll H,i lc rtih llt Fmil ir i<rd
<br />-l
<br />h"r! r.d will @i.hi. *dldr' cor{En{lion inrur.E.. I Rquftd tySdM.Ulnot',E lid Gd.. tu llE FtlsnrN o(
<br />)rlr .-qindrr inurr
<br />(.*;q/t/$7b,trr-o 7oq 518'l
<br />-l..nifylh.l
<br />in rlE F.forlr].N otirE *ork for shah rhir Jrtn! i! n!!.d. I rhr,lmr.rtLy nt F5n in.n, |MEr
<br />s a{ ro hdom slirr h d. m*6'@nIBr.liD L* of Ciirmir. .nd .3r rh.l i,I nr Br$om{t'rd roth.
<br />*ort6 ontEnqlbn pmritioB of S.ction lT(n or rlE Ltu Gx,.. l rltll nfihrnh onPly *hn rln. Foriri,nt
<br />WARNING: Frilr lo qft sul6 onpcdir mEr8. n unL*tu|. r,n rhrll sbld u.n?L'F ro miMl Fflii.i.tn
<br />cnit fiEs up ro orc hu'dEd rlbu{d dollfr (llm.m)), in rld'rnn b rlx ed ol oqEtroion. dtnrg.r r. F,tn.n (tr llE
<br />6il${#.. inrft$ !d drmy ! I
<br /> ppliol:'(d,'l(
<br />DECllllIllIB
<br />I h.rcby.iftr und.r Fmh,ofFrrnry rhd I rm lirn*n und., Frvirh. of Cn:fld i) (nlmnrBnIS *nh Sdi,n 7(llrr .f lh i.r). .1
<br />.f rh. Busim$ r.d Profdshnr Codc. and ny li.cn{ t in fuu fttre nl clldl
<br />r\""
<br />b '?";,'lz Kses-gto/t-./,X lr<
<br />coNlirllJcu0ulElltlllillilNgr
<br />t hccby altirm undcr rEMlryofFrjutyrhar rtm is r mn(ruction bnirr sscft, n). rlE tdrormkc.lrhc aorr i), whth rhi\ F .rir k
<br />issu.d ( sd. 31197. civ. c ).
<br />ATTIIIANLI]I;ILA.BAUO!
<br />l lmhytrlltDUndrr |xtrrlry or lujurj_otrc u1 rltr li'll(i*irr!,1..lr'rrnr
<br />lXnDlIir)nPcnnir\ A\h.no\Norili.nrtr l.,l.irl R.3uhrtr!xII l. Jr). l'rrr{)r
<br />-R.qunc,l
<br />I r(.rolNorLlidi,ir
<br />I ccnily lhir rh. fqlcrul rc3ulrri,n\ rcgrdtrr! !\trno\ r.trr,vrlr'. tr.r xPpl:(xhl. r' rhr\ Dn)1.(r
<br />onlinrnccs itrd Srrrc ljs\ rcbr' ! t, hu'Unrt .nf {uri( .h.rchyrurhtrrr rtrc{nt.rirc1('l rhn Cilyrnd Counry t' cnl{ uFr rlt
<br />rh*d mnrion d lnrtl.nyl in$.{l 1"f,'fG
<br />\P.mire @h. rpdnr,*t/t^
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />Subf loor/VenVlnsulation
<br />Roof Sheathino
<br />Framinq
<br />lnsulation/Eneroy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coal
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Beport
<br />Enoineer Final Report
<br />Flood Zone Certif
<br />FINAL l0rl,t6 O\^ffir lK),2
<br />Certiricate ol Occupancy V
<br />Notes, Remarks, Etc
<br />COMMENTS
<br />SLAB Floor
<br />Shear Wall
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