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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE COMMENTS OWNET IUILDER DEI,CATATION
<br />I h.ch, rlftrd oll.r Ftulry ol F ,try rh,r I m .r.mF lion trE Grrndors l,$n. L.w nn lh. nrL,*ins rcNh (S.r 70ll 5
<br />Aunncs .Bl Protisi'. CuL): Any Cily or Coutrry which EquiEr d rtmir h con{tocr. .lro, iqtdw. &n Bh r (Fn 6y
<br />tu'q., F, ro , E ua.. r1$ Equft.
<br />'h. {dr.n! ror 3uh Fml n, rrb . r(Fn nccrnr rh, lr or tE 6 lE.nhj pus..t
<br />t, rtr F,hsB of E C(hurd.r Lr.nrd L.q (Crqrrd 9, ColtBNhf Ulh Sdlrr 7im oa D'vnln ,1 dt rlr lrurEr, .nr
<br />Pn{itlB Cnj.l r rlur li q rlE r .icnr' hsdn,n .d rh. b.s for rlE rlk8..l .kn{fur Ary vFLhtr Dr Ser.n ,,tr rl., by uy
<br />.!!,1(&( rorrFrm shF..lttlE.,Tlk.nlro..rvrl!.nolryofn'lmrcrhrnfiv.hutolr.JJolltfi(ttoo).
<br />_1, Nt osE. orrhr FDp.ny, d my.nploF! v h wrs.r 8 rtr! $L.utrrFMtion, vil do lh. unt drl llE {clft s [Jl
<br />dftld or oiidrrl fir .L (Sn 7Xa, 8ur,6s .ftj Fn,f.rsr,.! (irj.: TlE Conr&lrr'r Lrac Lrw UE ui q't'i, t' 6 orE of
<br />rlx F)Fny eh' ll'lt lqna rrEF(.nl *E' E dh kd hm(lt or td*lf nr rlwr!8h hr r ls o*n.m0lry6.
<br />pn'yrLd rhar rEn hpmErnk c mr ,roiql...ltrsl frr elc lt lI,kE dr ln ry d nqh,wmd i! $U v{ho ok F(
<br />or.rlnoLrD., ttu owmr Builr *rl h.E r h@Ln otFlvin8 tMr lr or nr,jij ml hr!t! or ur{ntw l]). pn,Fry Io. rrr puqr,* or
<br />_1. B orM ol rlE F)F!. o .trlurkl, odLrr8 pnh liusl .odrd6 b dldul rll F!r1r ( Sd. l0l.l, Burs
<br />rd Er,ftsrCoJ.r Tn Cort-kr'! Lk.ne L.* &E mt .t{'1, ro u owEr or rtuFny *ho 60r!r d mpr6h, rh.rdE
<br />!trd wh conEkl. tu fl(h FrFrr *irh. G,nlG*lo(O liqsLt 0lhuer nrdEGr.raloas ll..$ L.*).
<br />_l d.rcnpr unL, Sarion_. B & P.C. tu ln! E sn
<br />D.r.. Offi
<br />!!8f,!8si0!lt[lisarl0!
<br />DECIABAIIO!
<br />I h.(hy rlltm undn ,Enrlry ol Frirtry otrc ol thc,,nl,wnu d..lmltr'nr
<br />_l hrE.hl w l morrD r C.nfrdc orcord b S.If.lIff rrr qrl6 onrEB.lB..! Flvirlql ts by SEliin ]?m of dE
<br />tihr CdL. f tlE Fl'm of rlE *rt fd rnlih llE Fhi ! BnEl.
<br />IhikunJ*illnun Jr workcr( ron[.n\aton nxtrn'N.. trs r.qrtr.(lhrSc(ron ]7(trnl rhc trbor Ci'd.. ntrrhcF ortrrtucsl
<br />dtr *o'[ ntr *h'.h (lx\ n rm i\r\\rrl M)vort.^ !,.tr{yndr'nn m\urrtucljrr drl Fnf,} numh.r d.k t"^!4.
<br />iozozza ,I tl
<br />|(.nni'h.trrhrErrorflkcol'hcw.rlnrwh.hlhirF,nir6r\ucJ.I\nluo.nployrn,FR)nndy.'mtur
<br />q' n h) tEarr shFrror& w qi L rqtrrrun L*r of Callfom!, mj !8ft rhi r I lhru h...m ruhFl x, rlE
<br />h,rldi on{iNrx,. F,va.tu orsdrxn l70o of rlE Lhtr Gi., I rrEll ldherrh.r,r'I|ly wnh rh,s rErtrr'r
<br />WAtNlNc: F.rtur. k, nR strlcii' co,{Endr)n ..v.n!. s unLehrl. .'n d'.ll tutrFr e .4!L,F !{' .ful FEiB ul.
<br />.Nn fin.s un b oB hunlrcd lhourMd dollds ($l(xl,lxx,), in d{ll] !,n n, rhc o{ ol.onllt.larion, drm8.s .s F,vrlcd fo, rhc
<br />Sc.xon 10?6of lh. IrhtrOr.l., .rc{.ni rttomy r 'k'?."0" tl",-t.L:_ Apptol
<br />UC!!$D.GqNIEAIIqB
<br />DEIIdE{IION
<br />I hcEhy .tftrn unlcr pcmhy ol Frjuly rh6l I am liNnsn undcr pfl)visrt oi Chttrd 9 (ommn.in8 w h Selin rmo) or Drvision l
<br />ol trE Busrtr rnl lhrfcrsac Od.. &rl ny l.cnr ! r tuU loN {n .atdL
<br />s 6zq
<br />Drt(
<br />-
<br />Conld.io.
<br />taBsrtuclloErlBDMclliENqr
<br />I h.Ehy rrrm ud.r Fnrtq ol tErrury rh.r rhs. u . .rB(tu1bn LftluS rrcDy lor rlE Frroe-*. ol th. rfi (tr *h.h rh! Fmr 6
<br />xructr (se 1097, crv c.)
<br />A@ICANLDECTJEAION
<br />I ho*ry.fmu d Fnrty ol Frjury oE of tlE loltrwinr d.cknlbnr:
<br />tJcmtion Pcmrl^rb.rlot lrdirlrlioo FGrdtl RcrlLrDtu lTnlc a0. Prn6)
<br />_R.q!i,al t Ic, ot lldifEtu
<br />-l
<br />c.nify lhn rlE f.rt ..l r.ph ,u E!.do8 atEdor Emvrl rc not qtlti$L lo lhit pru,c(t
<br />-l
<br />.fiify rh.r I h.E Ed th! .pp[.rh. rn sr.r. rlu E .toE irfort nn E rIrBr l .!G io .rtt , vnh .I Cdr .Bl Cooni,
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />Roof Sheathino + -)"t-7 )\,wil|fo\)\ (ilq-
<br />Shear Wall
<br />Framing
<br />lnsu lation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Depuly Final Report
<br />Enqineer Final Report
<br />Flood Zone Certil.
<br />A
<br />FINAL 5->'zt t)/n(fi)
<br />Certif icate ot Occupancy
<br />Notes Remarks Etc.
<br />2od tt L4 p4.l
<br />ID/SIG.
<br />Erection Pads
<br />oilen.r.nl Sr{. Ilwi Ehr3 b ho,Uh8
<br />rb(,w tunrx,rd ln,lxdr ld frtF nn
<br />.urhtrE Elrcrrx.r.tr ol ::,;LJ;:
<br />I
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