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BUILDI}IG. INSPECTOR RECORD
<br />COMT$ENTSSITE-WORK ID/SIG.OWI\EI BUILDER DETARAIION
<br />I hd!b, rrm undd Funy ol Fjuy rh, I d qdF ttrB rh. Com6.rm l-ic.nF Llw for rhr lolbwins r.&n (Sd.7011 5 ,
<br />ll8ind lrd Phasion Co!.) any Ciry or ('.u,rt, wbi.h ..I!ic r Ddsn ro cotr{o( .lrq. inprove dqnolilh or Ep.r uy
<br />c^(tuc Fi,
<br />'o
<br />ir3 i3slmq rlo Esi6 rh.lrlic!,'l tor tuch Fnn to 6L. risn d nnGrEt thn tt or dE a licqs.d
<br />'lr:dlo lt! FovirioB of tlE Conrrl! r L@cd l.w (Ct 016 e, comtrir8 u,ih Sdio. 7dr0 6f Divisio. I of llE &aiE !d
<br />PrlldbB ( od.) d rh.! h. o. rlE a adq( th6.Go6 &d rh. bGi for rlE rlLr.d 6dprion. Ar, rbhi@ ofscrs 701 I 5 by ey
<br />.rplker for . pcinh slbjdt 'h. .lplid b . nvil p@hy ot@t er. tho nv. hu&.d d6lla (ltm)
<br />I. N om6 of lh. FDFty, o. D, @phr6 wirh w.s6 B rh.ir 51. NnFadion. will & 0r *orl at E tM@ ir Dr
<br />i'nc'd.d or ofi6.d ls sb (Sd.I0{4, BBi,B ud Pmf<hE Cod.: Tn (onr,.clm r Li@ l^ tlE mt +ly lo u oqE ot
<br />rh. FDFry $h. bil& d i,Fn6 rlE@ tn s !o d6 ndr wl hiMlf or hd*ltor rhousb h6 q tE 06 dpk r€.
<br />ForiLd lill uch iErDr-Er! E d noi.d n otu 6r rl. lf. lr$68. E hllriif, d irvr)ffi it rld with m
<br />'aot.onphi,l\ ft (xn6 Boilld wil hrE lh. h!&r of Fotirs rhi lE or dE dn d hnld or inqm! dE FnFry ft)r tlE F,F* or
<br />_1. a orM ot rh. FoFry. m ddBircly .ond,B *ilh li.du.d (offio6 ro .o.fud rlE Ftrl.d {se. 7{x.l. ts6!6
<br />.al Pr.iss ( o<L: Tt Conr&o., Lt.@ Lrw d6 mr.pglyro &o*Eof FoFrr- *lb bcid.or nq.ov6 ihr@..
<br />rnd *ho Nlirrrt for qch F.F vnh. Codrxro(r) lta!.n prl.d rorlE co,r6dq ! Lid Uq)
<br />_l,ncx.mfl !nd6 S(rio
<br />Ir .: Ori6:
<br />woR(Erlr'airMrms rmil
<br />Dl]Ctl|lartoN
<br />I hd.br lmm undd palhr otFjury oe oarh. folhwng r!..l{rioB:
<br />I hrw!d will robtrin r Cslificrt.of congl to s.lf-ler. for mrt€l mmForli \a Frvid.d for hySEIion ]?m of$.
<br />Lrho. Co&. &. rh. Ffolrte. of thc sort fo. r'hth rlE Fnn a in!.<!.
<br />-lh6c!.dsnlui.in*oit6,conFdioniNltr.,arqtliEdbrSclhn!71)0ofrlElii..Cod.,forth.pgfollMcorth. *ork ro. whch lhii Fnit i! b$.d My Nrko omFMi.n iNule..ei, nd polty numb.r e.:SrAlt' FwO.
<br />L l- ol- I
<br />-l
<br />c6lrt lhd in lh. psf.lrffi. of th. worl for *hich rhis Fnn ir irsucd l rhlll nol mploy.nr rcMn h&ymu6
<br />$ 6 ro bdomc lobjdt to ih. Mrrd' @np6dion las oac.lifomi., dd aer rhd ia l ltrould heom. lobjet b lh€
<br />qo*6'ohFsrionpmvnioB.asdio.lT00oflh.r,hor(odel3lEll.fMhwnhmmplywnfilbrFlvniod
<br />$ARNING F ihG ro su. s(rt6' 6dF$iion orElSc ! ubutul. ,.d .hrll $blr a mpldF ro cinin l lEdiis lld
<br />cnil fffi up r. om hud.d rhourad drlLE (lloo,om), o rdtnbn io rlE (d of c.mFNrioc du!88 6 FoeiLd for lh.
<br />s<ion 11176 oa th. riLor Co&. dd.r ed rrl$B ! lc
<br />6aW?;'-Pd"""' rz -M.'- /F k6&tu--
<br />-LIffi
<br />\ DICIAIAlrtl!
<br />I hatUy.rm udd lodt, orpqrrr) rht I o ltrqEl uri6 Ftrvirbn olchetq 9 toffiilu r t SctDn 7m)) of Dirabn I
<br />of lh. BuitB.rd Df6hN co&. !n ny tKm b in ful! for..,n dld
<br />A 'lt/lLl
<br />*" 1/-a('- lY ,.",-","., wJfiifl'E 4,"WLhdt '
<br />qa.N alcua!.lldll!!.AqENlr
<br />I Hy lmm usl€ FEhy of Fjlry lhd ths. ir r @tr<ru.lion kx|Ilg lgdy for llE pqfolr]lec of lhc *!rl &,t *hth fii! Foi ir
<br />irs.d (Se l()97, Civ C).
<br />ATIIICAILDECIJTAITO!
<br />I h!d,.trm !n& po,ry olFjory oE of E folbwirS &.L.aildl
<br />D.@kir. Pmn&&b.no! NotifE rion Fcdarl Reulnio6 0 nb 40. Prn6)
<br />_R.q!n.rl Lard of Notitrcdhn
<br />pt,t, ,* ,t t o", ouLtioB Egtdilu lbsros l! t.l & @r Tplalblc ro rhi! FF
<br />_l .qiiry rhd I h.v. ad $! @lirtion di n.r. lh, $c r!or. nfoourio. ! c6nct I .sc ro @ndy *nn dl Cny rd County
<br />odnincB lnd Srrrc ln$s rclmins n, bu'ldr!hdchylulhoE r.F.6rar iv6 of rhk (_rt dd Counl, h 616 upon rh.
<br />ltrrv. molion d fmtdy for iBp.(lio
<br />^ppriotrr
<br />or lrdl stmrur.
<br />8lrQL00 e.d l*.
<br />Set Backs -<;)
<br />Forms/Steel/Holdowns .t - ,t.^.'1?
<br />Erection Pads 7 I +1 ['
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUlnsulation
<br />Rool Sheathing yF.
<br />Shear Wall I
<br />Framin s ta<
<br />lnsulation/Energy llr )\
<br />Drylvall lt t)t/q bA tl/|st-E&?
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />En gineer Final Report
<br />Flood Zone Certif.
<br />a
<br />FINAL 1-l a-J )
<br />Certificate of Occupancy
<br />Nofes, Remarks" Etc.
<br />\
<br />5+5m.tD Wsza-onq-
<br />vpDi\L_,>Lock,qltrus
<br />6\-8<
<br />DATE
<br />L. ,l.i! Addrs
<br />+Tz
<br />, .q
<br />ttl-,,PcrJ P/
<br />Pool Fence
<br />TO(.
<br />I
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