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BUILDING- INSPECTOR RECORD
<br />SITE.WORK ID/SIG.lrI tlltl{ D}1.( ARATI()N
<br />I rEEhy .Itn ldLr p.MXy of !.r,!r, rh, I m.r.qn hrh rh. (\nr-r6 l'i6-LrPlitrllEfulbwn8rc.5n(SE7oll5
<br />Bunrc* .Jrl Pn .rrhn Grr.): Any Cdy or C,Ery whit rquB r Frn k, o'.rlul. il.. ftirot &mlnh or EF! uv
<br />socrur., Ftr b rrt nrorrt,.I$ rcqu'B rlF rpplErl lt" ruchFmr n,likI r'8n ! slrmnl lhrr tror slE n lE nkl lMruot
<br />ro rh. pmv(k,nr or rh. ci,nlr.rxtr'r l,..nr.rl llu (ch. cr 0. cbljftBh! wirt sdron 7ft'0 of Divnon I or lh' Burim( sJ
<br />Pnn sn.r CcL),f, rh.r It d ar n.t.n{'r rh.t!l^,h 8l rlr h.i6 nn rlr rlk!.d .rcnfrhn Any r.ltt.n ol SBr,h roJ
<br />'l
<br />5 hv'nv
<br />.r,plrur for r Fmr suhjcrr rlE r|lftnnr ro r dvrl FMlry ol n d)( thr frv. hn tJ JtnLtr (tStlr)
<br />l. .t o*Er or rh. lx)Fny. u ny .dploy..r w h wrSd .r llEr q,L .llmJEnsrsn. *il di' rlE wtt .,n lh. {drE E mr
<br />lr.ddi * olLRl li{ 5lc I Sq 7Oa4, au.mrt .ri PrnlcspN Cit!.: Tlr (o,rBnr'r lldr u* do.r nr q'lv ro s o*t' ol
<br />rh. pn{Ery *h'l. \ or fiIIFTE! rrrBn, ! th, &Ei sh xnt hm\clf d rEr( ll or rhn,ulh hE q h" o*' cnrll'r'\'
<br />,n,vrl.d rh.r ru.h mp$kn'd! N ftn hrcn!.n or off.tsl fttr tlL Il. bscvr. rh. td hB ouqtutmd s$li *(h'no*,ts
<br />;l.onrLrrE rlt (,err sufitr *ill h.h ttr hnJ.n FDvru lh,,f,,, \tE drl 'rhlltorui{nEtlEFrErvftf,llEluPsol
<br />I. ir *ncr.lrlx Frtr.ny, imcrcl$rv.lyronkrrn!3 q[h l(cnscJ.otrt.doF r'.ondru( rrr th)r.cr lsc'.70'4. Blnms
<br />rn Fn ir\rm (ixl. Th. (i,nket* r I -(cn{ bw J€s nn tplly h M .wE or llniFnv *hr horlJ\ or mprotr rh'rdrn.
<br />rnd *lr, (r' rlkn,tkhImF.kf, h I Codrardd t lr..sal P{rud tu rlE (.dr{d'l lr.nc L.r )
<br />! im.\enu unlcrS.rtnn
<br />lroxf,liEeloufENlArr)!
<br />DDCLARATXIN
<br />I h(r(t'y illtrm un'lcr Fnrhrol lEriury.,r olrh. k,lk'En! JdLr.ri)n\
<br />-
<br />I h!r. .nd w r ll ruhrrm r C.nia( rtc .i Con(nr tu Stll.lh\!rc fM worl.r\' u,mFtrstl{,n. r\ I'uvxlcd f{ I'v S(r rrn r7m 't rh'
<br />lihtr Ciri.. ntr rh. FrtbrnD.. ol rh. Mr[ l{r whrch rhc p(m r s{El.
<br />IhrE. wrtl ro!{ln *.rt.r'.oqt ns.ri rfiuntu., .r rrlu!.J hv Seirn .\?m o( rti lihtr (lir., lor ttr F f'lllrEn' ol
<br />lh( u,ll !i{ *irltthis JErm( s Essr My wMt.u' !$mFnsrlrr ntunfrc cdEr.tl PIry.umtEr e:.-", 9ta+e truo&
<br />",,,,.,n,.*, tB{5381r-zotQ ,.,*.,-l-2s-z<)
<br />-l
<br />(nrly rh, o rk F rlrB! of lh. rort ftf, *hth rhr Fmir N rrBJ. I rn I a, ct{'}ly.nv Fren r ry |MEr
<br />er .r t' troft ruhFr ro rh. 6t6 .rinFnslr'n Ler ol (info,M. .[l .ar rhi I I slrrll lEor lohFl lo llt
<br />uork.^ ronllx n\i dr J'x)vNtrrn\ IS.Lrro lTlxrolrhc lihtr(ixl..I \lull. lonh{ hu'nIly!rhrh'{ln'vtrn'ns
<br />)voirc rs utrbwlul. a rhill \uh/..r 3n $I,l,w b lm'nll FmLis 'l\VARNIN(; l'rLur i, !atr'( sorl.'. (on]Iini rn'
<br />.r'l l(r\ u| r, om huRn.J rh,usJrl JoUr\ 11l(r),. r rljirh. k, tlr .or o, ltn{xnqtDn, J.ds.r I tln'qld] lor rtr
<br />s&1ir:1r,76 I rlr llhn (irlc, urcBn
<br />>zz-\
<br />LI( lt\sllr ( ()\l R.{( loR
<br />TECIASAI1qX
<br />I h.Ety !ftrh u,r]!, l.ndlly ol Frju,y rh.r I am lEn{.1uBlr pov(r'n orCh.Fcr 9(omEn.rs *ih Ss.^trn ?m)) orDrv(k'n l
<br />ol rrr Buitr( rni Pnn.(rni C-.&-,ri ny !r.nr s h ,ull IoN [l.llicr.
<br />r,r,. 1
<br />1
<br />.tq
<br />cartlf,lsuol.LEBlllg{iacllir
<br />l rEEby.lfm urLr FDry or rErrr, rhd l&+ B r.aNturln lslbs t!ftv ntr rlE F.ltrl114. of rh. x* ror wh$ rh! Ftr 6
<br />tr{kJ rsd 10)7. Civ C r.
<br />L.d.ir Nrh.
<br />-
<br />A.BIUCANLPECI.dEAIIO!
<br />I lndy rfm uBl.r rEn.!! ol p.riury.B ol rh.lolt,"rE d(ltlai'n1:
<br />DcnIl [h PlrmnsAsbc(o{ Notlicrttrr l+!.rrlR.gxl,r[n\ ( rih 4{, l'rn6)
<br />_R.qun d L.it.r ol tLrlitun
<br />-l
<br />ccnia, rh, ttE r.J.r.! Elllrtfi rclrilht $lEslor Emvd m ml .Ilrl..bL h ttur pn'Fr
<br />-l
<br />ettdi rhr I h.E Ed rhir .pplld,n lri {.r. !h, trF rt$w nlbrndDn 6 ffi{ I .!d ro !rnplr r h:llCryrDl C.unry
<br />qdmrfl rin Srdc L.si tlru{) trltlhr on{drDr ,rt M)y .ulhrM ttF.-drlrwr ol rhr ! Ciy.,n Cou,'.yb. € uFn rlE
<br />!tl,v. md[kJ n('p.nY l,r trr
<br />Appli.,nt or As.nl SirNtuF l -22. tq
<br />Set Backs 7]a // ct €rua*'L2-
<br />)ld lto Ortlot .52-
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsu lation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />ltrlasonry v/A/o frt**-tlf2--
<br />L
<br />T-Bar
<br />Handicap Req.
<br />Deputv Final Report
<br />Enqineer Final Report
<br />FINAL 4/4//r'--*Atztu r'^-.'
<br />Certif icate ol Occupancy '/ '/
<br />Notes, Remarks, Etc.
<br />- DATE COMMENTS
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />Pool Fence
<br />Flood Zone Certif .
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