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BUILDING- INSPECTOR RECORD
<br />SITE.WOBK DATE ID/SIG.COMMENTS OWNEf, AUILDIjT DT.L(ARATION
<br />I h.r.b rrltm ud.r Fnrlry ,,1 Frrur, rhri I m .r.n{,r hrm rlF ( odrtukm lr.n< l.r ktr rlE n,lllu6a rc&rn (Se.n).l l.J
<br />Itrrn rs rfll I'mlcsioh C,ri.). Any Cny or Cou.'y eh*h rcqu,* i Fml nr (onrlruLl. .lr.r. ihr'!'v., &m'hh or ry'{ir uy
<br />nru.tuc F trt' rr! ssuim.. rln)r.qutcs rh..t'dr!nr rt sr(hFrdr (t riha riSEd (rr.tr"i rhd lF or .lE tr lic..*d rsrud
<br />n' rtu lrl,lsnnr or rlr Conbrrh'r Lr.ql l-e ((-lEI{d 9, ConmLrt wnh Sar,n ?(xx) of Div,rm .l .l rlI Burtrr! $J
<br />PNlcssi,nt (iik),tr rhr h. n ir B.r.rqi rlE.kon.d rlE h.!! tu rh. .&!..i .r.qi nn Any vriLr.. of S-rn 70ll5 br.ny
<br />ttplMnr tui {Eml $hF8 rh. .nlr.nr (, . dvn Fuly ol nn mtr tlur llv. hrllrcJ J.lhr (S5OO)
<br />_Ld!uwtu1orrh.FoFny,orhy.mployeswirhwr8.r$rhcttulc$mp.nsrron.wlL!,rh.wterlrlEntu1@isnor
<br />u .niui o, olli.J tur eL (SR.. 7044, auriR$ ,nd PnLsiDns Cdc: Tn Conr.ct'tri tr.n. li* LnB n .l Jl, ro r o*rr ol
<br />rtE Ih'IEny *h, rlrllr.r urF)B rh.q u! *rrr (ls uh k,t h'h(ll Dr h.Mlf or rthlulh hu .r h.r .s cnpbyccs,
<br />FolrLJ !h.r rkh mFtrwftdr e nn dcdai { .ffml nr Bb. lt h,w. dE brlluts r lqhw'H ! rlll }rh, d Fr
<br />ol lul,Lr,tr ilr o*r. Burlr6 r l ha{ tli h,tkn ar FD{A th{ rE (, rlE ,lrl d tu! d trrFrE th. F{Et, ni dE FI,IE i{
<br />L ar owftr.rlhc lnrFry. mc\.lu$v.ly(dtrkrulnrr *irh hcnsc! (o rurkn\brotrinrd rli ln*rrlscr.7044. Busm.s
<br />r h\'trf,$fl C(i].: Th. Conln(ttr i l-E.nE ll* J,B nn {,ply t, rhn*n.r oIt^,Fny wh) hunds or ml'n'v.s lh.rcon,
<br />rhd wlx, d,nket fttr skhFtrr(h u(h rCD .*riln]),rcnsl l!^ulll n'ilEO,r r(tr'r Lrrrr l,r)
<br />-,
<br />oc$n rudcrserx'n-.A &PC tarhir F&,n
<br />wol{KERs' conrPtNsart(rti
<br />DECId8AIIIIN
<br />I hrby rlltrh u.dcr Fndry urFrurroErf rM LlhsD3 J.rlnrN'.\:
<br />_lh:krnw l moru r cd'ti.ic of Coh( bS.lalnsmntru dr.rn{xflerrh. I Fv .riirhySd.n]7mofrlr
<br />bhtr Cnir, ntr!h. Frfolm. ol lh. k'rt fu *h|h lh. IEmr n niu.d.
<br />I h.rc aBl will mrinl.h w.rkcrr .ompcnsalr'n 6urrRc. !s r.q!u!al h, Sdr i'h .l7{l0 nt rh. trhd. Gd.. itr llE IErti)l E... ol
<br />_l.ctrirhdinrlEFrlormL.oftlreorlli,wh.hthsllrmllr(ru.n,I!hr[ft.,!9hy.nyFrvrh.nylMxr
<br />$ .r to b.(am sbr.t to
<br />'tE
<br />$rt6 !r'np.iE lxr l,$ or C.irr{,|u. d ltN rhd {I rtr'uu hdm $IrFr torb
<br />sd6.urrNrrntiDBrsorSdrn.lmoor'lELnrCoL,Irldlnnhwirh.nflrnyrilhtln*Innvn6.
<br />tlAf,NlNG: htuE b sE s"t6 !$mp.nsi.n NwnB. Lr unLstul. .n, nrl stFr o diobF i(! m.,] F B +
<br />.'v'l linc\ trf n, oft hunJEJ rho!\rrJ doll,h (!l(x).lxx)
<br />S..ton 1076 ol rtu L.htrO)(].. nn.[{ !trrl.ritrny'r l(\
<br />), n idl'ri,'n lr' rlE.on 1
<br />I l,.rh! Jlltrn, trkl.r F.-mlirolIt,ltry rl rIMrl'(.nrn ,rortrnf ol ( h.lln , (onnN'x r.3 wrrh S.( rktr, '7ltx) r or D'vNrn, I
<br />or rh.lru!tr1$,trkll'n'1.$nnA (n(1.. nl nr li(.n\. I ii xrllr(rq. utrl(rre!r
<br />lo
<br />2-t1 -7 t con,s,or
<br />I lrrh, f(m uftrd Jtn lry ot Frl!.y rhd dE. s . (rln{ur.n Ln lh3 .3.r, nn rh. Fno*-*c ol rh. uit f!, shrh rh( Fm. 6
<br />AELISANLDECLAAAUOts
<br />I hsrty .trm uDLr Fn{lly ol rErjur, or dr ilr n'lt,w,n: .hllrrr Dnr:
<br />rkdnrpn Pomre^sb.{os Norrf,rr.n Fnlchl R.BULri'f,s (Tnlc40, F.n6)
<br />R.qntrc! llxcr of N ifErtr,n
<br />I csrrly rhtr rtE loler.l Egulrri'n! Nadding .!t no: rn)vrlrc ft, {f,l(rbL b rhn nn,Fl
<br />_-t cd y rhrr I hrE Rd rhr..pd. rr lrl s.r. rh.t rh. .by. hntrmlrr r.(h-r t .gr h Ldr$ly wih.ll C[y rll Cou.ry
<br />ornmNcs rnJ Srr'. Lws ELrDs ni lru'l]ns c.nrerkD !n h.rcny rurhw! rcF.cnlrlN.r ollnn Cny.nj Cou.ry b drd !F,n llr
<br />/htrc nEnrn nlt' rny i,tr mn(drtr,
<br />Appli.rnt or AE.nl SiaMtuE
<br />/,-/* << -+- t
<br />Set Backs It
<br />Formsi Steel/Holdowns ILL DA*t1
<br />Erection Pads lt
<br />Roof Sheathinq
<br />Shear Wall I
<br />Framinq 7l;l -l)DIfr)J
<br />lnsulation/Energy I I
<br />Drywall tl
<br />Ext./lnt. Lath i
<br />tvl rrt DWY'|
<br />Brown Coat I
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif
<br />,l
<br />FINAL n w\qff/
<br />Certilicate of Occupancy lt
<br />Notes, Remarks, Etc
<br />,4 !v" x\f,-
<br />.,13|J" _,)..
<br />U IL(
<br />UFER Ground
<br />SLAB Floor
<br />Sublloor/VenVlnsulation
<br />rr-\
<br />4 t ? ltZi -zo zl \-l -z'z-
<br />\a-Zl
<br />s
<br />*\o.JrS( .vl,,7, C,v. C )
<br />l.BLisN.m:
<br />,n, 3- F'-Z I
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