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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />Rool Sheathing
<br />Shear Wall
<br />Framing .22"vN. i
<br />lnsulation/Energy t\
<br />Drywall I
<br />Ext./lnt. Lath il1
<br />Brown Coat
<br />Masonry
<br />Pool Fence A
<br />T-Bar r-l i-tu
<br />Handicap Req \J
<br />Deputy Final Beport
<br />Engineer Final Report
<br />Flood Zone Certif .
<br />FINAL I /l-s>Tu;6 )
<br />Certilicate of Occupancy
<br />Notes, Remarks, Etc
<br />_,
<br />OWNET AI]ILDER DELCARATION
<br />I lEEby dftm urdcr pe ndry of pdiry tlDr I d crrrtir inm llE Co ,..166 tj<ak Lrs ror rh. rolbsh8 lten (Se.70J 1.5
<br />BuriEss !n Pmlsbn Od.) Ary Cil, or Cody wh.h r.quiB . Fnr lo m(nrl. rr€, itrpmE &mli.h d nF, x,
<br />rr.En4 ,r ro i|5 i!.l&t, .ho rquiB 0r.pdi.d tu sh Fmn h tu. sigicd nr.nEn 0. lE or Cr ir li!,Ed ,rtr{.rl
<br />16 llE Fovnionr or tlE Cmr.rld 3 Lirn.n Lw (Cnrpr* 9, Co.ftri.B enh S*rio. 7frD ol Diririr 3 of rlr B8ift, .rd
<br />Pmrcsh.r Codc) or lhir lE or nE i .r.rf'l th@from .,n llr b.rir ror lhc rlLsld dml,lion. An, vhhtion of Sdrbn 703, .5 b, m,
<br />.ppli..,'r for . IEmr $btrls rh. apf,lksr h . civil FMhy of nd mE th& fiv. hudnd doll8 (Srm)
<br />_1. E o*M or rE FoFnr- or my.,rrloFc! whh st36 ! rltn $l onFn{.rio *ildoftwiddEolxrEi rbi
<br />hlod.n or ofi...d for d. ( Sd ?o44, BuriEsr .rid PhlBrs6 Cd.: Tll C.dr-ld r LirnE Lte 6.r ml El, lo u o*r of
<br />rh. pbpdry etn boild! or iqhB llE&( .td *tr dB ch h* h'N.lf d lt&lf nr lhhugh hir 6 k, oen .m9lorrd,
<br />pr.vi.Ld $a .uch mFota'll E 'd iddLd d ofisd re s! l( ,rME, lrr trildit q irF.!@n L sH *.)lh * Ftfd,,pkrir OE o'mr Bdrl6 ein hE ir trdd or pDw! d{ ll or rlE dn d hiB d inpre llt Frdry ld rlI FrF* ol
<br />L J\.wi.r nlrh.I6Fny, rmcxclD\ivcly contmrnl3 *irh liccn{d cotrtudoN b con{tud rh. pn,Fr (Sd.7O4.{, adsrE\s
<br />!tol lMs\irrC(rlc Th. Cunralois L i(.nic li* dixr not aptly ro !n rwrr of on'Ir y who hurldr or impo!.r rhcrsn.
<br />lnn rh d'dr,.t ! ftn uch lrFcr ! s,irh ! (tnrrrbn o lEnsrl purunr b rh. C,)d,{roa\ Licre l8 )
<br />_ I m .rnF ud.r s(t
<br />D.l. O*n..
<br />worxr*s' cutrpr.'rsrrron
<br />D[I:!JXAIII,I!
<br />I h.Rt'y rfiim rnd.r p.elry or rErjory oE ol rh. ,ou.'*in8 .k ladbns
<br />I hlw En wilr mnr.in r Cdifsl. or Con-nr ro s.li lmm ld worl6 oElE.srio.. c F$viLd lor by Sclion l?fri o, rlE
<br />llhor C.d.. ror rlE Ftu of rlE fr,l tu {t!th rl! Fir'n k i$o.d
<br />I nrE rnd,ill di'rin trrtds corqEnrdi,n i6unr.. a EtuiEl hy S6lion lnl) or rL l,&r Cqlc. lG r,r F.l{mE ol
<br />'h. *olk rir*hihrhnrn rt
<br />crrr . Sla
<br />nnl6 My \'lrlsi mn[ttrgrion rnrunLc ffir unFli, numh.r eta |-un)
<br />o?o
<br />lc.niayrh.r itrltu rErfnnrrcofth. worl for whthltn Fmil is i-$ud l shdll d,l.rPhy Nny F en in dy mntr
<br />r, $ro lx.6m obF b rrE w,rd o,tEnsri,n Lws orcrIromir. ]d i8E rhd fI stsold b..od !'nj.rl 'o r
<br />s,*6'odFNlbnFllvnirBofsdinl7mof'hl,trrCod..ltrllfalhlnho.tr'ly*iltrlrEFltii(B .
<br />WATNINC: l".iluE to sr wtcr'onrEKrbn oru8. n unL*fll ud slEll *ubj.!' D nq,loFr b dninn l'E!!r !n'*zW)E::"'it*t1*#1pru"tr#;
<br />DELIISAIIO! , ]
<br />I trrcby arftrm und.r FBlryolFrrurylhll t rh lienEd undc r@qrntr o! ClBnrgI (smrrtr8 ! h sJ\9i)firr ofDivtbn l
<br />of E auriBr.nd Pmf*rbnr Cod., !n ny liffi n in hill foN !n.lfal.
<br />/?>,v7tt 7
<br />SAISIBIJSIION.LEIINIjISBI:I
<br />I tr(by 0lltn udcr lttulty olFrjury rhll rtf,rc is s cooilruclion tftlinr oscry for lh. Frl'olrMcr.l'lhc work for which this tfrmi n
<br />isrun (sd lrH7, civ. c ).
<br /> P?LIC IT NF'T AIIATTON
<br />I horty.rm u.d.r Fr.Xy or Firy oE or llE folhri.r &rl,nlion3
<br />Dcmlitio. P.rnirr-Alb.rkn Nitifrc{bn k !l R.8ul.l hnr Onh 4r}, Pan6)
<br />R.quir.{ l.ncr of Ndili.di,n
<br />dity rhd rlE tuLnl Elrliir.. rcSrdina 16.{6 lmvrl ,. Bn .r?la.bL kr rhil poFl
<br />ifyrhrrlhr\.r.J'lrhnrpplirri,n,r,xl{ricrhirlrnh)vci',lor uitrtrt^ronc.i In!Ti{t'(nr\ryeirh!llCIyiddCoudiy
<br />.il srir. bws ald in8 k' hildhS i,^ url h..cby .ulni,. E r.rnl.riEr of lhir Cil, &d
<br />xnr,i lln)Fi! f,r ,n\F.rrrn
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<br />Rov 0B 07'2015
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