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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNI'R AU!LDER DET,CARATION
<br />I hcr.6y ofiifln urdcr Fnolly of perjury lhol I m cx.mpr lmm lh. Coor'Kt6 l,iccr* b* r'trrh. lilbpinS rcs r (s..r0:ll5
<br />Bbnn.s srn Prots\i,n Cod.) Atry Ciry or Coumy whrh r.qurcs d tErmir h .on{ur. !llc., iDpovc. d.mni\h., En{n lny
<br />slruclur.. prior lo irs *uMc. ltso rcquiEs rll. +plicanl ln ruch Fmi ro nh ! rsrcd nar.ftnr rhlr rE or rh. is li.cn{d ,,lbsudnr
<br />ro rh€ pmvtmns of rhc Conr.chr's Lk n\.d bw (alq'rcr 9. Cn'rnEftin3 *ilh Sccrnn 7(xD or l)ivti,i .l or rh. Busifts rd
<br />PDlc$ion\ Codc).r th,rlE or slE is cicmpr rhcrcfronr loJ rhc htr\i\ lnr rh. dhedl cr.mpri()n Any virb'i.nolSali)n 7ir.ll5 byony
<br />appli.a.r ror r Fmir subjd3 th. npplmnr to rovilFMhyofrur n$r lh{n 6v. hun&d drllaG ( t5{r,
<br />I. a owmr of ih proFny, or my.npk,Fr wirh wr&r 6 rh.t $h omF.!dn,n, will d. E qil en i. sltur@ s bl
<br />id.nfi or of.r.d for sL (SE.?O44, SuriEs ud PmGsion! Codc: Tlr Co'nn rd r liaE t,* ds dn +plr lo r olEr or
<br />rrE FDp.ny vho hoihs or iiprlr6 dEoc .,n vh drs uh qrl hincll or tErlr o, lhre{Bh h! or lEr orn ci9r,yfr3.
<br />pmvi,€d $.r sh unFlrmnt E ml itcdLd o. olTcEd ror slc. lt lr'ew, rlE bildhS or irynEmd ir -ld *lhir oE Je
<br />ofmn?kri.tr itE o',E Bulldd riu IEE dE hln n of Foqnt rh lE or ii dn d hild r inproE ilE Fjpqiy rd tll Frt i or
<br />-1.
<br />&! o*rcr of rtr FoFny, am d.l!\ihly mdrsiins wnh lt...d 6tud.n ro dmrM rhc I'tr d (Ss 7(rr4, Bu1'E(
<br />.d PrDasir Cod.: Th. ConrErol. Lkcns Llw d6 mr .rply ro r o*Er of pmFn, *ho buildr 6r impmGr rh.m..
<br />d who 6nd6 tor such p.ores *nh r C. ddrlir ltm.d purrd h rrr OflRlor'r LiraE t5,)
<br />I dcrcmtr uBl.Y S$rrn
<br />O*mr
<br />sl.)tf,!ls:gDl[l:$A!0t[lig.Atarla!
<br />I lErcby irrm und.r Fmhy or Frtury oE ol rlE rolk r h3 dcLr.ri,nr
<br />-l
<br />h.E !n -ill minr.in r Cdifrd. of CoMr to S.lalns lr 6t6 o,rtE 3.ti,n. ar llovd.n lor by sd.n l?u) otrrE
<br />bhi C.d.. fd E FfolIEN 01lh. wt fd rh.h rlr Fnil ; irqrd
<br />I h,tr tud *ill mmtin $o*.rs corrcnsrrm ins,trc,6 rqu!.d bysdio.:!'r(l) oalL L.t . Cql.. for rlE rErr,nllm of
<br />rlt wol rd *hih rhii Frmr n i$rn My wort6 on{rndbn,Brl.m rrE In |nl.y nuntq E
<br />/-ltp^ -y!
<br />-Er*,4/4aZ
<br />pa",;,,,,t-,,C 5T \o 217,64
<br />-l
<br />c.niry fid in llE FrfornEG of tlE Krt fm whah ttk Fml n n.un.I {!llbr cneb, $y IrB). '. !.y mrEr
<br />b Blob.<r bFr ro rlE wr6'6rp.nr.li.n Lei or C.lir6mn. .na .!R rhd ilI druld bccoE $bta1lo llr
<br />hit6 6np.Nri,n pbairirB of Sdio.l7m orrlr trh, C.d., I Jrll fdhw h $rply virh rlD. nd,vnird I
<br />WAXNING Frilurc ro sw rort n'oqENrrn oEnB. i unL*tuI. ud ndl rubrer D.'r{,lr,Fr ro dimiar Frri!.,rd
<br />.ivil fms up ro om hudtrd rhourn do[. (tlm.(m). in ldd'rirn ro rlE cos or.oqE.erhn, drm8.r r. Imrd.d r(, E
<br />Si:rrtr 1076 .r thc I f,l[r Cni. nr.rc{
<br />DEIIJXAIIO!
<br />I h.rt'y .rr,n un&r p.nrtry or p..Fry rh,, I m liensl urdd FDvnhn .f Cnlrtc e (oltmrins ,nh Sc.lirn ?(fl)r oa Diviiirn l
<br />o, rlE Blsieis rd PEfc$io6 C6d.. .nl n, lienr tu i. tull foE ud .fier
<br />tt**ct ", C'/5
<br />"",.,6 ,/3 />_/
<br />C(TNSTIIUCTION I TITNIN(: ACIiN(IY
<br />I turcby !ftnm uMcr pcnllry ol p.rju.y rhli rhcrc n a.r,ndtu.1i,n k'rJi.! qrncy r(, rh- Fl(trtrun.. ul rhc wtrk n, shrh rhh lrirnit t
<br />issucd iScc.109?, Civ C.).
<br />AIEUCAILDECIJI{UTN
<br />I h.n$y slrm undcr p€nelty ol Frrury ok ofthc follo*in8 dchrutions
<br />Dctulirion Pcrnrirs Asb.nos Noiincdion F.d.$l RcsuLtions (Titl.,4O. Pdn6)
<br />--1Rcqun.n L.rrq or NotirErion
<br />-11rdrlr rhd rhc rc'lcrrlreguhn.nr mgsJd'na orh({". r cmtr rl u. {altlrrhkn,lhtrtmFr
<br />Zl ccddy thnl I hak Md rhis trpplaarion rid shr. rh.t rh. ohrw infttrmhn n .oml. I r8r to .onpry r h .u c y .nd c.unly
<br />odimft.s dd st.ic tiwi Eldi.! ro btriklinS consmrtotr dd h.Eby rurtr)rE rctmct riEr ofth$ Ciry rnd Counryro cnr6 lFmrll
<br />atnrc mdi,md Imn n, ror inlnc.riog nurFss _
<br />^rrr,-r-n^rrn*,"* K 7# /.*
<br />P.mhR Mtu,prrnr,: )"^ilirtn € ^lzlJ
<br />b/44
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loorivenVl nsulation
<br />Rool Sheathing
<br />Shear Wall
<br />Framing
<br />ln s u lation/Enerq y
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lvlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enoineer Final Fleport
<br />-]\FINAL L-t7- 2/'a fD (C{)
<br />Certif icate of Occupancy
<br />Notes, Remarks, Etc.
<br />L*c.sc Nunh.r z t/-fn<Xfu* L'-
<br />Flood Zone Certif .
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