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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE COMMENTS OTIN PI BUILDER I'I]LCARATION
<br />I trEby rrrtn u.dcr pctrJily ol ptrJury lhd I am ctc,rFr linm rtE Conlm.los Lxcnrc liw fo. rtt follo*i.3 dsnr (S( 70.11 5
<br />llo!n8! lrl Dnt \ri,n (ixlc) Any Ciiy or GMiy *hkh 6quue\ a Fnhn (, ..n{er, rno. inl|)roB. &frrlrh o' ftFn x,
<br />nulurc. Fitr to il1 issui!f,c. als BrurB rlE +plr.d tu \uct lErmir h liL ! siSL{ {dcmn' 116l h. or {E n lic.nen Iu$ r
<br />n) rhc trolnbns ol liE Conrrarlr'r l-iccnrd Liw tchlltli 9. C nnrcxirs silh Sccrbtr 7({,0 ol Divhi,n I oflh{ Busit$ !
<br />at{.shrr ('dc, or th.r lr or nr N qcnFr rtmno'n drn tnc bas. ror rhc.lkE d.rctr{ion Any qrlariltr ofsmri'n 70.11t by any
<br />smlicld n,s Fnn subr.,:l\llt lmlcrtrl h!civr|lcMxyof nor m,rcthln fivc hu ncddollrs(S5 r)
<br />_l.aso*troarhcll,rrny.n nycqoy(\*ilfi*asc\$rhcnet.!trqEn\dFn,qill&'rlt*oirdrh.tumn,
<br />inkrrlrl or ofcrcd l'or ek (Ss 704.1. Burirc$ lnd Pmbsn,n\ Codc Th. Onfidor's l.kemc Lf,s dxr ft, rFfly !o dn o*tur Dr
<br />rh nmpcdy uh boilrs or nIrcB rrm( ot *lF dEs sEh s,t hinsclf or rrrclr o. rhNu3h hi r h.r o*n.,lployes,
<br />|trorrk{ rhrr skh nqrDtmntre n id.d.d o,oltlr.d ft, nb. If. lME, lhc hilli.8 ni+.oElmr t stti *lhinm }g,
<br />olsn{]hrh( rlE O*8, Buiij.r will llk rh. hxrd.n of pmvn'8 rhll lr .. .he dil B, t{iti o, irl0r,k de l,qdly ror
<br />'h.
<br />pullrl* or
<br />-1.
<br />!s oqNr ol thc tmpcny. rncrrlu\ivrlyc.nrrerir8 w h licenEd conrrlcr sro.o (ncrrtrpmJerl$c 7or4, U!\irs
<br />!'rl PmfGrir CoL Th. Conrelolr Ltu.n{ t , d.Es nor .prly !, M ourr of n.orEny sh' bnikh or imFot s lhomn.
<br />r&! rho conLdk to. {ch F(r.r1. rih tr Conrmt.ne nan{n Nrua r,,rh.Gdr.dn s lirfls li*)
<br />-l
<br />u.tumF unlcr Sd&n--- A. & PC tulhi!dsn
<br />I) r ()*n..
<br />!985rls:g!.lufrnura!uiljln&ulQN
<br />I rrr.bt rlliitrr u,lcr IxNlry lIrrlIyom "l !hc tu]n'ri.B (l(lir r r\
<br />lhlvr rlwiUnri rirrCcniticdcolConenrroScllln\u'cturlortor'c qxn\dFn.,r InvidcdlinhyS.rrirnlTlX)urrhc
<br />trhtrn(|.. Lr ttE nst nrB,tr.ol rtr 16* nnwh{hrh. pcrni ( n\u.d
<br />(ltr ro.l 1., shf,h ths ,xflntl is nrud My etrlc^ conp.nstn.$Emc c!tr- !'n l[liynumtE cr-P,-,)wGLJ r\n r.r,^' ' ( f)+6l
<br />-l
<br />ccniryrhrr itr rh. F l6.tuEc of rh. *oll lor *hi.h rht Frni s nskd. I shall mr.npk'y my rErstr in my mnE
<br />vr !{ bh$m tu6rd h rrr wntd{ conFne'io. hus or Cififomr.. r.d +N thll rrt ilnuld lE onr sl'ler tr llt
<br />wo*s.onlEnsrri('ntmvirn,NolSernr]TtuolrhcLah,Cod4,lshalltllnh]irho'nplrrirhrk&ptuvisbns
<br />rdAf,NlNG Frillr ro \.-.na wk ri .'ntmerion ..vft8. ir unl"rtuL n sh l $birl u olnL''lr k' oimi l FrElr.{ .nd
<br />cn,l ,nb trp r, otrc fitrtrl((l rhn^ml )llm rsllx).lxt)r, n rdd i( t, th...{ ol conltr ?J"-*'*F;t;DIlTlajlIA!
<br />I lbrcbyrltliln uRlrr JEn.hydl Jrlury thal l!m lNn$d !trds Imvnionol(}JIis o (rom ED.,ng uirh Sdnn ?0(lr) ofD,!li,,n l
<br />ol rhc Bunncl\ rnd [tr{.*ionr ftrL. ,rl nry li..n\. il in lull f.ftr ril.lTs't
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<br />ZC,.-"*u"*
<br />'z
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<br />c(at[8trgll)NtlNDTNc-&crllr
<br />I l.r6yr,ftrud.r F.rlr, ofFl|ury lhd llrr ir tronrrudir hrxlirya3cEy for ilx lErfo'nEftc.l ih. wolk fo. thichihn Fmn i\
<br />n\ucd (Sc. log?,Crr C )
<br />AITI.ICAIiI.IIECIdSAII9N
<br />I h6:hy lim und$ !.nslry .f p.rjury om ur tl* n k'win8 dellrutn,ns:
<br />Dcn'lni,n I'trmar-Altrdo\ Ndili.{io. rd6rl Rt8uldion(Tnk 40. P.rl6)
<br />-Rcquiadt
<br />rtcrolNdirtdion
<br />-lccni(yrh.'rhcfedcnnrc8ularionsqlrdirylrttn$icm)!r!!rc,4pli.rl,fubrhistlhF-rld*rrr,^,**,.^rnir lppl$rhn a,n elk rn 0r rtn( inromrrn n.!ra! Ilsrlooqny*nhr[cty dcounrt/ onl'trdEc\r su.lrssrchtnBr',huildinsc.tr{ru.ri{,rnRlhcrchyi htrnct.pn\cnhrir.\olrhx('Iyand(')un
<br />rtxrc dnrrnrd p('Ir yn, rspr.ri,'ntuli
<br />ADpli{nl {r AA.nl SiIn.tun
<br />r,*,,1t. -,"*'r;,rr')4.
<br />llx
<br />iltu q.+frfu*,
<br />I
<br />IZ tb
<br />Set Backs tl
<br />Forms/Steel/Holdowns lu/o/&)4l>rbl i.'x
<br />Erection Pads I
<br />UFEB Ground
<br />SLAB Floor
<br />Subf loor/VenUlnsulation
<br />Rool Sheathing
<br />Shear Wall
<br />Framing tlzllu v*{-sy
<br />lnsulation/Energy I
<br />Drywall
<br />Ext./lnt. Lath
<br />[/asonry
<br />Pool Fence
<br />Handicap Req.
<br />Deputy Final Report
<br />Enoineer Final Report
<br />rl
<br />FINAL -t\q\r,r D,[ry{,q
<br />Certilicate ol Occupancy
<br />Noles, Remarks, Etcll24lu ->l sfl- )
<br />I I
<br />Rev. 08 07-2015
<br />ID/SIG.
<br />G
<br />Brown Coat
<br />T-Bar
<br />I
<br />Flood Zone Certif .
<br />t>697 |tr7 /L >5 -D*tr?q
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