BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE tD/stc..COMMENTS
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUlnsulation
<br />Rool Sheathino
<br />Shear Wall
<br />Framing
<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 Report
<br />FINAU
<br />n
<br />-Certificate ol Occupancv
<br />Notes, Remarks, Etc
<br />OIVNER EI'ILDER DELO{NAfl ON
<br />I lEr.Dy rfrrn ur&r FEly of psiry tld I m ctunpr ltDd rlE Codr-r6 Li6* tre to. (E lollowhS ,!&n (S4.?0!l t
<br />BuiBr lid Prefdion C.d.) Any Ciry or Colrly *hih Eaui6 ! ,Eni l. ordin .rd. i,p.m, .l.Dlih r E!.r xy
<br />(Mre Fr ro ils itM.. tlso EquiB rlE rydirr for rEh ltmi lo fik r iignad rrd.Mr rhr lE or slE b li.lnrd Fro.rl
<br />io rlE Folti,ns or dE C6rrd ! Lir.sn Ur (clrprd q Coffituin3 *ah Serbn 7m) ot DrviiJn I or
<br />'h.
<br />arriEB !d
<br />Profcsbn! Codc) or rhrl li or nE i! cx.ng rhdttom (d rh. t$is for rlE .lLr.d .rtrSion. .{ry vi,hrnn ofs..lbn ,ol1.5 t'y uy
<br />+rlicrd for . Fmir $bFh tlE +?li@r ro r ciil F lr, Dl i mr rhlr liv. hud..d dollr. (lt&,.
<br />_1. rs oeEr orrh. FFny, dr my.nploFr wnh wr86.r rlEn $h {mprnnlion. will& llE wl !n 0E i,urE n ml
<br />i 6!d.d d ollcrd ad slc {56 IX4 Aori6r .n<t PrsfBirnr CorL. TIE C.ddd r trrc t w &.r ml tpply ro u o*Er rf
<br />rlE Fordy wln h{ill or iqmE llEq .,n lho dc ixt qrt lilrelf d ltEllr rhDnSh hn d hd o*. nribFa
<br />prolidcd thll ruch irFownls s mr id.dLd orofls.d lr sl Il trrcE. rlE htilliq 6 inrnllril i! sld *thi. @ )6of.flrpLiia dE OqE Buitjs eill lrE tlE hd6 of rrsl,ts tllt lE ( {r dil rr hild d r,!.@ UE ,r.nF y lq 0E FrFr of
<br />_1. r owd or rE lfr)pdrr. n.r.b!i*ly (frdht Mh lr..rEd .o ffi6 ro otr.lrua rh. tmir1 (Sd. 7044, BauK
<br />.d h.f6.rn Cod.r ]lE C.nftro, t Li€n* trw d{A mr .pply ro - owE of preFny sho buiLi or inprcwr li.G,(
<br />lDd who anti.lt ad ffh roinr eith r C.nrrh,l9lf,dsd ru ml rorh. C.drsttor'r lic* L.*).
<br />_l dm.r.mrr un&r Salion_, B. & P.C. ftrlhk rc!$n
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<br />off.rrorrrrs' coux'rsrritx
<br />DICLAAAIU!
<br />I tftby rlfim u'xlr FEhy of F,lry or ol rlE 6lt)*iB dahr.tb8
<br />I l[E rn will d,,ru . C.rrifrd. or CoEnt lo S.lf-lni@ tE soll6 .bn+c6d io.. I Fbvi,.d for bt seri,n l70o or ttE
<br />t.{br C.rk. rd tFtmof lrE wi fr rnin llE Fmil ii irird
<br />,l h.E rid *ill tui'nlin *n cn oi{Innrbo i8!nr.. ( rcqui,.d bt sdion ln$ olrlE Llb(r c.d., for rh. pdforlnm. of
<br />rh. *rk rd {hi.hrhnFrmir t 6 dr,V.ndi,. rlullm odi.r rn lDliy numbd E:
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<br />(J-O
<br />:j/@c)t fiuger-
<br />Il.l.lJll\llr.l:
<br />I lmby .tftrm u,ns FNhy of p.rj!ry lhd I d lhn*d u,r.d Fov{tio. of Clrplg 9 l.omncing ,ith S.clion l()ln) of DivniD l
<br />oI lh. BonEs ,rd PlolisirB Cel. !n ny lirm b in tull lor .d.ift.l
<br />(ffUorksZ;-W
<br />ta&ulucuourEDNcloEdcr
<br />I h.r6y.rm und.r Fmhy of Ft,ry thd rlEt ir r otrlnflbn brdh, .8m, rd E Ffornrm of llE mrt for *hih dir Frnr i
<br />nrucd (se 309r. civ c.)
<br />lc.nr[ rhd rh. Icd.El rc8uldrk,m ESgdinB oittnn. rcra*3le mr q'r'lk rbk ro rht nhFd
<br />Itrc& rl, rh.r I hlk md rhu ar,,lkr.n ,n dd. rhrr rtE .tiw infornrrbn B oftd I !t r ro odpry win !x cn, rst cou[y
<br />idmn.}! .d SrEhws El4 iis ro huildhs con{rud ioc ud hcE.hy .urh.ir EI,tollriE. or thi! Cnt .,'d Cirnry ro rid uF. rrE
<br />!&M ftnrh*rl pbFny fd nr.pdr-n
<br />,\mlier o. '\r l Sirtrtrl 44-
<br />44-S
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<br />IIIIGD:^7/UD\ryttru
<br />Rev.0B 07 2015
<br />Set Backs
<br />Flood Zone Certil.
<br />z la ),^ /' A, t-
<br />I diry ttu in t,E lEnnmE of rh. yml lm *hth rhir D.ftn ii n.ErL I rhrll d .r{,ro, y Fmn in m} IuB
<br />s, .r ro tK.m {l'Fr 16 rlE sdoJ coqxo$tio. lrw! ol Crfiromh. .In $r lh.l il I ltnuld tEafr $r'ixi io th.
<br />s,l6 odtENrsnpmviri,6of s.dir ]nDof rL L&rcod..l ilrll n hwirt onlply wnh dD. pDvnion(
<br />wAtNlNC: FlihE ro *e xrtsi @rF.drin 68 8. ! unLstuL .nl slEll rubirl u otlloF lo qiurl t4ri!.,n
<br />civil liftt up ro or hundEd tholu.d ddlL6 ($1m,00)). in tddnnn lo llE.Br oacoq.nstion. ddmscr N provilcd fttr tlE
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<br />AIIII{:/\trI.DqIJ.A8AIIQ!
<br />I M, dlm un& Fdry of Firy om of rlE folb*iry &.Lrdionil
<br />D.mubn P.rnii.^3b.jo! t{difE{kr. rrd6d tr.lolrbn! (TilL,lO, Pln6}
<br />-R.quiEd
<br />Ldl..of ltrif'cdin
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