BUILDING- INSPECTOB RECOBD
<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/VenVlnsulation
<br />Roof Sheathinq (.Lrl 1,1
<br />Shear Wall
<br />Framino
<br />lnsulatron/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />ltrlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Beq.
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />ll
<br />FINAL Lt thyil
<br />Certificate of Occu pancy
<br />Notes Remarks, Etc.
<br />O*NAT BUILDEN DELCAR TION
<br />I hcrchy "rirn !.ds ptMlly of pclury thll I m cr.n/ rmm dE C. rto6 Lt.nE tjw ror ttl lolhwinB nrsn ( Se 70l l 5
<br />Bu$n.ss !d ProLssion Cod.)r Any Cn, o. Ctunry *htl ,.qlircs ! Fnnit lo @n{tur. !lr.r. iry)mvc. &mlirh or Ep.n !+y
<br />\tto.1N, Fir lo ilr i\iw. rls r.9uiE. rtE.l[,lad tu rkh Fmi! k, fik . sigEd rd.ft.r rh{ h. or {E k lirdsd pu{lrt
<br />ro rh. Ftrvisions ol E ContuBt LE.nrd bv lcr!$d L Colierin! rnh Sdrirn IUD ot Divtb. I of llE Borir!! D<!
<br />P,.f.srb.r Cod.) o, rhrr lr tr rl! n cr.npr rhs.fiDm .rn rlE b.sn tur rlE .lt!.d crnrrion AryvioLli).orsdbnT0ll.S6yr.y
<br />emlkonl for r Fmir .uhi.Trs rh. rpllkr.r ro r civil p.ml', of mr mE rha liv. hundEn dolhB (t500)
<br />-1,
<br />n owr of ttE r$Fny, m my rrploysr wirh w!8.r.r lrEir sL NmFMion. wiu d, dE sdt.rld lrr rBrE n rcl
<br />id.n&l or off.rd ftn rk (Sd IX,l Sorir( &d PEf(rhB Cod.: TIE Cidarq s Lirtr€ L.* dB d +ply b & oeE ol
<br />rlE FDcny lh. tlilk - EFDB l,Esa rd Ino &B an qit hinrll or lEElf q rlmu3t lln G lE own .,phy..r
<br />pmriLd rh{ 3Eh inF.ffis c mr d.td oo$6rd ror sl. lt htrc. r,r t ildins m i'rF.dEf i ! $ld *ith m tdofo'rpkrb'\ dE OeB Buildd will bE dE hrl.n of Fsvina d tE m rlE dii d hild s i,rFrE 6. Fopsty td rtE Fltbi or
<br />_1. $ o*mr of rlE rreFny, u.r.luiEly cotuir8 *irh litnrn codrdon ro 6Nod rlE Fbj.rr 156 7(x4. aEEs
<br />rd Ari63ih cod. Th. c6 rroai l,tcn. L.* &B Er rpply ro.n orF oaProF ry *L b{ild3 or mpmEr tlEr6..
<br />ud *lb onrr-lrir ffhFoF<t vnh. C.lldo(r,litn$d P[lid h rhc C.nrd \t-xtet *)
<br />I tr cxctrrfl utulcr Srrn)n l, & f C. lor rhi\ ..!{,n.
<br />t.**"r*' !}L
<br />u, (-t'r.21
<br />ctsLKql
<br />,."r-,r,,,/,%V
<br />COISIBIJI:IIO!.J.8IDIN$JCEtsCI
<br />I h.mby cfirn undc! F llyof pc+ryrtul'hcrc a.snnMrion Lndin8.8.ky for rh. lErfolffic ordr w.rk ft, whahrhnFnir ir
<br />issucd (Sc..3097.Civ. C ).
<br />AEIIII]ANI.DECI.AAAIO!
<br />I hd$t arm u,i.r Fdlry of Frrury oN ot rh aollosins &rlrEtbnl
<br />DcDlirbn PcrnniAilEnos diakdirn kr.l Rcglld.m lTid. rl0. Pd6)
<br />R.nun.d k(o of Ndift?tbn
<br />-
<br />l .cnit, thd thc Ldcrul r.BULr i, rs kldli.g $b.no\ rc r,vJ ad ior lppl'.lbL t, r hi\ pn+.r.
<br />I .dify rhd I lbE cd lnis ppli.rlbn rn rtarc lhn llE rn'E infonEl&n ! .ml. I r3ra lo dnrply *nh r[ Cny .d Clun'yordim,n sht L,*1rhrlE ro t{ilding otrrirlior .rd lE t y lurhore EFstr.riB of rti! Chy.,!d Cou.ry '. d'6 utD, rtE
<br />rhn. nrtrri,nrdl)n,ntny rnr hpc.rr)n
<br /> ppllonl or Agcnl SlaN ",,," 6-n-2t
<br />crru
<br />Brown Coat
<br />1
<br />Dtt. _-_ (her_
<br />-rfiirs:couuuaorDECIABAIIII!
<br />I h.Ehy r,rm uods rtuly ofrE ry oB DallE followins &.Lrdions:
<br />I h!v. &d wiU mi.,.in r C.nifEatc ol Co.snt ro Scll.lnture for mrl6J @mpcnsctn,n. !\ Jmvid.d for by Satrn 37@ or rh.
<br />tjhor C.i., ror rlE Idirnre of tlE elt for *hth rlE Fmil ii i$En
<br />\lhrE !d BiU roidrii *ork6 conpcnqrion iBUrBC. 6 EquiEn by Sd1i,n lrm ol tlE tibor Co&, n rlE pqr(,lrl'E o,
<br />rrt *,,\ ro, $hrhrhrFmil it ise.d M, *0116 oqrnqbn rBur.L. (.mr.rd polEy nuBb.r G
<br />c-i". 9llr aorrearrfl oa lff J Pur..l
<br />pa"y r** ,, lQl{ fiO}-t,o ,.p*. t I - l- ?. I
<br />-l
<br />cntry rh.r in rL Frlormm or llE *ort for rh.h rhn lEnii i hr.d. I drll mr .nphy rny pd$n ,. .ny MFs * lo tf,.lB $bj.r' ro rrE wrt6'.o4rndio, lrh ol C.lifomn. &d .gd th.r if I oull b..oE rubrct ro rlE
<br />sorksl conFn.ltir,tr pmvBions ol S..lbn 3700 .f ih. t bor C.d.. I +.11. lonhwilh @mpl, *nh rho* tmvirionx
<br />WARNINC: F.iluE lo sw wdkr ' $np.ds.lion 6v.mgc t unLwful .rd rhrtl sbj.i' d.npb)r, ro oimid Fsnil .!n.iv n.ca up to oE hudEd dEur.,n dols (llm.fi[). in .ddnio. b rh. roc of coqrMio( d,rrg.! d FDvikd ror tlE
<br />sdrnn 1076 orrlr lrto, Cde h'ftr .rd l!)myi ldi
<br />,.,, t-r-}\
<br />-^*,^,
<br />Y2(& -ucllEDiolraacrof,
<br />IECIAEAIIII!
<br />I lEEb, .fm !id.r Fnnl, or I. r,.y lh.l I m lirEn undcr Flvnbn ol Cll.,rd 9 lonmEins unn Sdi,n 7(u) or Divni,. .lor rli a$iB. rrd Profdri,ns C.d.. !n ry lamE n ir tull fre.,r.lfer.
<br />t.d.r'! Add6i:
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