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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS owN-i iuiLDER DELCARATtoN
<br />I h.Ehy.nim uni.r JEnllry ( Fqury rh{ I h c\chpr rNm tlE Codr&,n' tr.he uu n lh. n'[owr[ E y'" lsd''io]l.t
<br />Bu\e* ' Pnndu,n (-ul.) Ahy C y or CNdr ehrh Equr.r r rEmil !' Lrh{B_r. .116, thpniv., .kmlsh or EF! ,nt
<br />nNrc. Frtr n' ir nli]&.... .la' Grrf$ rlE {,pllsr f(x *h Fmr h lik r !3m! rr.lcB rt r ,t or ir . l..n<n ?lNd
<br />ro rh. Frvskrtr .l rh C\nrak . l-rcn(n tl* ((tuFcr I, Co'ft dB *dn Serr'. 7(II) ol Drra$n I ol !& Blims 1
<br />Pmc$r,nr CdL),r rhll lr .lr r.r.q{ ltstlNo drl rlE bars ror rtE ilcsdl.r."{irn Anyvllii'nolS.(iMr0ll.5brsy
<br />{itl*mr rttr.Fd ruhj.lr rr rtpl..nt b.urrlFMlryof ,r E)E rh$ t'v. hltlftrl *lllnr raJ{ll)
<br />l. .s o*F ol rlE Frliriy. r, n, .'qrtrFr. * n *.!6 I rh.t $L dnqEN.l!'n. * l ttr rl! 6t lri rlr cErE . r*
<br />dorldl dofi.r.d rorrLrs(.7(x{, Bu.G(.rd PrDLilrE Crl: Tlt Cffid'! tldt tlsdx.dr.t lyroxomror
<br />rlE Frllmy *h. t!&. r !qn'a r,-mtr rd wb nn rh Nr* hmcll or lrrs ll or ih^,Wn fi d lEr oM.irFbys.
<br />povrl.d rhr rsh n{mRrtrr c rll !r.nl<l o.ofi.Bj for qt. lt h,sw, rll ln luu { lqrNEd ! sll *thh d Jd
<br />orrnrphu rtt O,B A!&, *ln hlr rtr hiiLn.rFDvi,u rhr tEqn llltnnt dl or lFoE lll F)Fry r(tE FrFdol
<br />Lr\d*ncr.lrl(nn'|(nl rnre(lu\tr.|v( ntJ.rrE srh I'r.nk_'l(n r.(ntr\r).!,Frtr'rrilf,F rd(S.! 7rl.l.] trtrnk<
<br />Jrl Pn)f.slnCnl. lh.(itr,rnn'\1.tr(n\.1-J$,1,$norlnplyr)rn.wn.r,!lUoFaryqIthoLlJ\orrnll]rnc\rhct.on.
<br />rtrrl whn .unrrrll,n {'cht!o,.(rr* h r (.otrkr(rin9lkcrncd l)UFtrxrrr'rhr(i) rkni'\l'..n(l.rt)
<br />I rmc\cnli un&r Sc.ron
<br />-,
<br />B. & P.C ttrrhk E.son
<br />loSSEeS-.caUfEdSArrON
<br />DECIdATIIAN
<br />I hcrc$y.lltn unds Fu,ryol Friory dm ur rh. ftnhu63 dLlr.rirnv
<br />-l
<br />h:w a l,ll Ndd r C.nnirt. ol C.n<d h Sclr-lduE for qnlm' .onFnui4 1r pn'laid nn h, SdrDn l7m df rlE
<br />L.kr Oxr.. n{ rh F.i('lrl4r of rlr rrrt fir wfirh lh. Fmn s E U.i
<br />Ih.E.,nullMrr.h*.rrqr'.orr{'.nernn'n.!8.,.rEquir.!byStlo.l7morih.llor(lrL.rorrlEFnMcof
<br />llr u,t nr wnth rl$ rcmr '! lq6l M! k i.r $ns.nds. ffurd...ftt rDl Fhy mmb.r e
<br />PolayNun*xr:-$ $ft!
<br />_I(cn,lyilrr ilr lirlornrk.ol rhc work ntr*hrh rhr p.rn tr r\tr.J. ! \hrll frn rltll'loy ryr{-r nrn.nyronmr
<br />n) .s rr h.!)nr hFr n' rh. *o*.n !omrn\r('n lf,wtolCrl'turnh, rtrd.3rccrhrr,l I \h{'U lirom \ohi(r n,rt*
<br />w.*cn.onlpcn\$orpn,!trr,tr\orS.crk,nl]lX)olrhrltrhtrCL{e,lsh!l!Innh*ih.on,tlt*'rhrh){t'r,YN.tr\.
<br />WARNINC: Ii!,lui. ti) {cur wukfl\. onnlrnernn Nvcrug. '\ unlr*lul, lnl shrll {n'ic(r rn.nll)l,,y.r r' lnnrrrl lltrrlrrs !.d
<br />(,vil hn.( nn t, oR hu,rlrc(l rhotet(l (l lhB llllx).lxxr). 'n ddrn,n r) rh. .o{ Dl ronllln$lrrn. ,hnu8cs rr lnrv*tcd iir lh(
<br />I lrEby rnimu kr Futyol Frlo,, rhi I rn lFnrJ unj.r pdrvni'n ol Cnqi.r 9 ((Dmk'.8 MhS&rrr?()0) of D'virion l
<br />of rh. Burrs [l P^n nrrh! CirL, ,rt my lrm< r o tuU ldr D!.fi&r
<br />h6R..
<br />*,,, z ,/zt /r q
<br />QBIIBIJCIIQNTENDINA-A{iE!$
<br />I h.Ehy rrrtr undq Fn.lry ol Frjury ihi rndc ! r $n{nd$. bnJht 1s.By nn rlE Fri,11@. ol 'rr k{r nn rhlh rh! Fmr E
<br />,iskJ (SG.'.lll,)T,Crv C ).
<br />L.dL.r N!m:
<br />-
<br />kndcrr A.lLlr.$:
<br />-
<br />APPLICANT DECI-/IRATION
<br />I hdrhy lnim undcr Fnully ol ncrlury.trc ol rh. blb*ng tLrl,rdk,nr:
<br />Dcnx,ln[n P.rh sA$({r\ N({ntrdrr fcdcr.l R.3ulnrrr\ rTilc 40. Pd6)
<br />Rcqumd trrrnol t{r rrrn
<br />-I
<br />(d y rh, rrE l.&ri rc8!hr.n. E8{i,h! !tt'.(or '.mvzl d n {d..|'L r' rlr |n Fr
<br />l..n'lr rhj I Uli Ed rlur rttlrrr,n,rt {:rc ihd trr.hrvc rnlomDru tr.m&1 I rlR t' d,,q y *rh.ll Cryrat Coody
<br />odlietr .tll Sr.r. lj* Ehrr! b tto ln! $n{M.r ,rl lEr.t'y .ulb@ RFt rx6 or rlur Cry .rn Coud, lo cds uFn dE
<br />rtrnt m r dPrurnvri{o\Fr:,({
<br />.\ppli.hl or AE.nl Sieml m
<br />c14
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />SubllooriVenVl nsulation
<br />Roof Shealhino
<br />Shear Wall
<br />Framino
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Reporl
<br />Flood Zone Certif
<br />FINAL UN?o 1 l+)at <)l {.t+ )
<br />Certilicate ot Occu nc
<br />Notes, Remarks, Etc
<br />4.)
<br />I )I
<br />Sccrion:1016 i rhc lnhr(id.. n .r.n lnl rr.rBy s
<br />^,, zr/iy't<
<br />I
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