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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNET BUILDEX T'EL(Tf, TION
<br />I hcEby lmrd odd pc&lly of F rury lhll I m .rcq, n$m dE Conrdm Lir.( tjw ro. rlE folLrri4 ,!er (5d )01L
<br />auriBr .rt Pr.rdrn, Cod.): An, Cily or Coutry whth rcquiE! . IEni lo oirMi nls. nrimv.. d.mlirh .. r.trn my
<br />qMtE, Fbr to irs issllm.,.lro EquiM rlE +rltdl for ch Fmi ro liL r tisi.d rl.lcr th.t lE d tr i lirnsr, purln
<br />ro rlE Fova.it6 or rt Contrrrot r LirnEd L!* ich.pl.r 9, Co.imxing uilh Sdlio.,(m of Divbi,n ll of lrE Buituri rnd
<br />PruLsions Cod.) ihd h. orih. n cr.npr rhd.fr.n&d rlE b.sn,or rlE.lLs.n crcrlFion Any vnLrhnofsdrbr 70rl.ibt t.t
<br />lPpltd ,or ! Fmn !!bFB tlE +plkrnl lo r civil p.mll,.aml mE 'ho nv. hudlrcd dollrs (t5m).
<br />I. tr owEr otrL ttuFny. tr m, erylo)r.r *ith !!gcs $ lh.n $h comn rslrn. wD do ltE \Gk dd rh. tu1@ E el
<br />id.i.Ld n o,Ia.rl for rL l sa 7(x4. Buli6r .nd Plof6rbn. Cod.: TIE Codrlq r Lirr L.* {tE tst rpply lo e orE ol
<br />rh. pmFdt ehot ilil\ or in[rcrr rlEMc urd wno dE sh m* hims.lro. h.rslror rhftuBh hh d ts o*n.qrLyc6,
<br />Fovildi lh.1uh inrmw.rs m d iddd qolIdrd 6r st lr. ho*tc. dr hriUins u i.qmErrr n s! wihir om F,
<br />ol cot{'Ltbtr ItE OvB Blild.r wiu h.w tlE t!r&n .f lrcvir8 dd lE or nE dil d hiild or inprsE 0E FoFry 6r itE F!F* or
<br />-l-
<br />f,r ovEr of llE pmFny. er.r.lusiv.ly .odrdins wirh liencd .ontkio. r0 conrtrucl rlt I,Ir{r (Ss. 7044, Burmrs
<br />.d Protsih CdL: ft. Conr.&ro* Lacns uw dN3 mr lPply ro u orF of FoFdy *lI hlrldi or inpmwr rh.rtun.
<br />,nd wl'o c!nrr&_li for luch Froj..rs *irh. Conrtrr.rls) Ii...*d puftuu[o rtt Conrrrtoa. Li.iE Li*)
<br />I n rrx. rjn rn{l.r Sc.rtr,n
<br />l)ele: (rrEr
<br />rv{r{(Ftt{,coMPINs TxtN
<br />D!1;I.AIAIIO!
<br />I hcrchy flrm und.r p.nnlry oflf,r,fi! un. olrh! lbU,,!rnS dcclartons:
<br />-l
<br />hrh rfrl eill minriin r Ccnifrrtc of Con*nr ro S.la lnMc fr Rilss on{Enn'rn. .! Frvrt d tu by serb( l7@ 61 0.
<br />t bd G'&. tu th. Frfolrlm. of llE *rt for phah llE Fmir i i$E!.
<br />lh$c"ft1*illnuidlin sork.r( cotrrp.n\.r{ xnukruc, ( tuquircJ hy Scd nr lTl rO of rhr tjhtr Codc, ,nr rhc pc ornun.c .l
<br />rh. k, rs lhrhlllr Fmn n lrDl Myent6 onp.nqD. mffi c.,E.A,* 'fra-+- Oq /-s €-l
<br />,",*,^",*, , 4 l=4! ll-2.- Erri,!A-t 1/
<br />-ldilyrh{
<br />inlh. F rormmcolrrE sorl for ehichihirIt nn is iiiocd.l rhaU hr cnploy.nr rf,isotr in.nymnn6
<br />s, &rbtffr rubF{i ro rlE *{t6'o,p.ndior L$ofc.lirom!. !n.8N rhr irI shrE b..om bFrrorlr
<br />m*64 sn{kNr hn phvitirn! 6f Ssrion l?(I) ol rlE L{hr Crnc. I $rll, tonhsifi snFly * ilh rths pbvtion..
<br />l,VAlllINC: FnhE ro Re v t6 ontE6cir. @rr8c i! unLrhiL .!d ddl .ubFd u drphF b dimiMl tE6xii .!tl
<br />ovil lii.\ u,, t) otrc huDdRd rtk,u\atrJ dollu'\ (S1l ), in eddnhn ro rh. con Dr cotr[f,nstion, dnmE r !
<br />Sdrrr tO76 olrh.l,t' (.& 'nr.d.-...- //lL ID'i' '/ ll '
<br />DECIJAAIO!
<br />I lEr.by !n!m {nds p.Elly of Frjury rh! I .m liu!.d u..Lr FsrGir or Ctlrfld 9 l6,l1l'Ein8 l.th Saln.
<br />ol llt BuriBs ud PrDL$ioN cod.. r,rt hy li..trc i. ! tull tu ! ,aj c fldr
<br />Lan(cL( e/-,.7//1L l
<br />c+e {"-!25 r2_
<br />I hcEb, nrtrm ud.r Fn yoaF.iu.y rha ilE! t. din n&rbn bidi.8.s!fty 6, rlE pdf.,ffi ol E wl 6. *htn On pEEi !
<br />bern (sd.l(,97, civ. c )
<br />AITI.ICAITI.OESAAAIIIJ!
<br />I lEthy .fm ufl,.r Fmlry of pcrpry or of rlr folbvin8 del,nrions:
<br />D.mlirion Pcmik.AllBror NdirErbn rd.rrl tLcslLrbnt OnE rr0, Prn6)
<br />-Rcquid
<br />tarool t*rifiqia
<br />f l diry lhr E f.d.nl E&hrbr clrlitrs Etiaroi Emhr e no{ ..prirtb ro rh! FoF
<br />ial c i y rhd t h.w E d rhE .ppltrbn .,n r.r. lhll 0E &ov. inromrir n of,&1. I r8r ro driply *ith rll Ciry md coury
<br />ordir.k6 !n St'. lr$ chr!! b htildirg conrr\1bE dn ffiy r hrir EFlidliE of lni! Cn, !d Cou.ry ro cn'6 upon r,r
<br />rthh ft.rktrEd thFn, rfl in\r:$,trn Dr/qtlql
<br />n Orr" *, o, n*r *-*r/@.-=*n^,*^^",0"^,/$') q;4 ilbl
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUl nsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />Handicap Req.
<br />Deputy Final Beport
<br />Engineer Final Report
<br />FINAL 41,.12.,l,s ?^,
<br />Certilicate ol Occu an
<br />INotesRemarks, Etc.
<br />T-Bar
<br />Flood Zone Certif .
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