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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.OWNEI IUILDEI DEI-('ARATION
<br />I lErlry .lltm uBLr FDty .)l Arrxry rhi I d rknpt rnrm rh. conrrnr' Lrnr l,* iix rll tolbrn3 Rra,n tsd.70ll.5
<br />Burtrrr rd Prclss! CoL): Any (iry or Coudy phrh r.quFr . rmr nr d,nitu!. nrd. ,rgiiw, &m)lnh or EFr ry
<br />nturm, Ftr h nr L( sc. .lo Gltr!.r rlE rptll.ur ,or (kh Fmr tu liL. nlErl {.rml rh.i lE or rlt ! l.tnc{ l'utld
<br />t' rh. F,vtri,h\ ol tlI Conr&k,i l.rc.EJ llw rou|llcr 9, ConftE-'m8 w h sfrrsn 7dl0 ol Drvr$n I oa lh. aurm$ .,rl
<br />Phn.rlon. (ill. ) or rh2r tE tr thc tr .(mfl rtEhn rn i rlE t'an\ ntr rlt !lL8.J c(nr,ii'n. Ary v[Lrx't or set'. ?O] L5 6y .ny
<br />.pplr.nl ntr r Fmrl suhrcclr rh. lptlklnr I' r (vrl FMhy or n m,Elh!tr Irvc hu ndE l ,lollur (5JIIO)
<br />l, !\ owEr ol rh. |rolcny, or ny cnrl'h,yc.\ Prrh ,'!.! s rh.n a,L rofrItnrdrk'n, will do lIr *{t .nl ltE {de tr ft,
<br />ur.trLrj o. olltrd aor qL (Sd 7044, Bu(tr( .nd PnrL$bns CdL: Th. (l,ntrt, t Lr.ns. bw &B Nl .Jt'ly n' .n o*tur ol
<br />rh. pn'Fny *bh{ 1! s urF,6 rtERd lrl *h, ds uh u** h'malf ..lsrlf .' rhrcu3h hn nr hr oM.ripk'y..!.
<br />lEoviLJ rh.i rBh umorcrr! s rd }rl dofi.nrt tur qL l(hrsE.rlrlx lua q lrtnr*tud s. *!16EF{
<br />or (mihr{ rlr owftr Buttr *'l h.( rll lu&. of Frvi,[ rlEt lE or {r,jrt L,lull n ltprDE or F Fr, tu r F,ID.or
<br />L r. olEt .l ih. rnFny, .n .\.lu{E!, ro'i'ar hr *rh lKn(t odran,6 r' onrru.r llE tFid (S& 70,t4, Bu.tr(
<br />!d fnftrqrclrj.: Tn Codfrb'rl-rc.n(l:r&Ern.mly!'.ro*FolfoFnywhoburld(o mPmE!ilkrd.,
<br />.nd *lnr .rd*ls ld sEh F,j.trr * h r (i,hhronr) li:nr.rl puFud n"h. Codr&r(\ LBn< lrw).
<br />I rnre\rnrfl un,lcrS.uiii
<br />raxf,E8s:cqufjBtAllgN
<br />DECI.ATATll}N
<br />I lE(hy,!lrn ufrLr trdli!ol Flnry or ol rh. |l k,*op &rLr.t.n(
<br />-l
<br />h.E ul *'ll dilnu. C.nltr!!. orcomd ro s.lf-ksuE tu kf,t6 orFddx'! r rtuvrLrl rtn by Saru 17m otot
<br />Llh, C!l., (tr llE p6fm! of rh. ft,t ft, *trlt ItE dmr . sxd
<br />-l h.rc r l *rll mnrrh u''kcn uomlr n$r!,n rn\uraNc. ,\ r.1urJ h! Sd rnr lrm ol rh. L.lxtr (ixl., k* rh. lErfdlll4c ol
<br />rlr woik fln whf,hrh,s pcmr rr sskJ My work.n'ohFnsdo. n\orrkccrrErd! F'lrynunh.r m
<br />c.,*, Aa.c.n'z .r- Z'.-drr
<br />_l un(y rh.r m rh. Frfotu. ol rl! vorl li, *hrh rhr p.rm tr srEJ. l rn I Nr .!pby uy tE*,n h.ny lMF
<br />r' r! k, h.!!m lut'F o rtE sxt6'Lr,,qEnsru l,*r oacrunro!. lhr {E rh.' ', I sn l tErrr tulrdr ri' 'llu'ri6' .i.r{r.\.1nn FDvsDnr o, Ssrxm t7mof i bhr GiL. I rtEll. fdhrin oqiy wrh itn! FrvnrtB
<br />WARN!!(;: Flht t, s*m **t F' NnIE,{$n otnlc s unL*r!|. r,rt innl .uhFr o mltlbFr ro d!u.d tElrar ,,n
<br />(Nrl lim! ul, t, or hudnal rh,ur.,rl dolh^ (llm,mo). h &rlrnn h rh. .o{ or comFdston, d., 3.r .t FDvnJ ror x
<br />S(n)n ]076 of rh. trh,, Cdr.. ,t.E{ lrd rtr(Ey r ler.
<br />ctlqltqTt-"
<br />I lEEby i-rn ulL. FEry or Frjury lhd I .n i'n ol (hrrd 9rummtum8 *trh S.rl[n ?u$) orD'vlrrn ]
<br />of llr Bure( .rn Atrfcsnn! GrL. nl ny la.r s i tuU foR. {n.llei
<br />t*,nn Lt *, Lto /2,t0 1?>7 )0
<br />,"," lt',.t,\
<br />t I'
<br />I hn(.hy.rll f), tr(l.r NmlryoltN,,trv rI i rh.r.[hJ'nr rrctuy ntr rh. Frtolmtu. ol rh.sork htr *h'Lhth$ Irmd N
<br />r.kd(S.( lo97.C,v C).
<br />L.nd.r! N.m:
<br />-
<br />APPI rcANT DFCI-^XTflON
<br />I hd!b, inim ud.r p...ll y oi p.rrry oE ol r& nnbrir! .k hd Dns:
<br />D.m'tui,n P.mreAsh.(os Nordirri,n trncd Rcsulrion! (Trlc{0, Pd6)
<br />_R.quftd trn.r ol tlollruti,tr
<br />I r.n'lyrhd rlrtiJ.rdlr.suhri)tr( (3!rlin! r$.nosr.fr'vJlrr nor ryltrhk l') rhn PnrFl
<br />I (.n rly rh.t I h|vc rc! InB .pflr:rx,n lil (.r. rhlr rlE thrv. rnhrmrln Lr .on(r I l3rt rD cdn{ t wrh .ll ( ay rd Coudy
<br />,inDB.r.nl $a. ll* rliIls r. ht'lmt con<Mrrtr.^t h.r$y.urEtr,. rF*dd rB 6f $i C. y .rn Counr, ro .nrn uF rt
<br />.h'v. ft.rrrEd FrtEny ld 6rFlr. Ilqr)rr
<br />ADDli.'nl or Atdl SiEmluF
<br />Set Backs
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathino
<br />Shear Wall
<br />Framinq
<br />lns u lation/ En erg y
<br />Drywall
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif
<br />FINAL //z//tc ,,-td4r^
<br />Certiticate of Occ n
<br />Notes, Remarks, Etc
<br />COMMENTS
<br />Forms/Steel/Holdowns
<br />Ext./lnt. Lath
<br />rF4L
<br />1/+"
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