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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.OWNEN AUILDER DTI-CAR TION
<br />I hcrcby lrltn undft l.orlry dl p.rllry rhrr I m crcnyr rn,n rhc C nh*B l-ictrk liw nn rhc nnn,*irs rcrv,n ( s$ ?olJ 5
<br />llu{inc\\ rrd Pnnis\6n Culc): Atry City or Counry *hth r!qun.! u F-.mil ro .on\rtu( alrd,
<br />'nlpn,tc,
<br />&nnnh ' r.Frn aiy
<br />{tu.ruc. I'U kr s issurMc. nl\o rqurc\ !h. npDl*aN rnr \!ch !.nnn h iL , !i3n '.1 {dcmnr rhnr ir or \ll. n lNnql nlrsrd
<br />r() rh! p('vtnnh ol ihc (iurracrorl l-icen\c'l Lrw (('hi cr 0. c.nrnrftint Er[ sc.notr 7m(, ol Divi\tnr 3 of rh. ltusir.$ md
<br />l'r.lcs\nrN CtxL) th, tu rr slk ir.tcmnt rtr.lirn!d rlr hNis ntrlh. llk8rdcrcmprn,n Any vhlnri,n of Sdri(8 70.l l 5 by ffy
<br />rmli(!.r ntr r ,xirnn {ut'J<.rr rlE at]t icrtrr !r ! civit il! nrll y o, fr, nrE rhr. iv. tundnd d.ll,r\ I S5u]t
<br />-1.
<br />si osmrorlll rorE.lr, or y.rq,lorrr\ unn *,Ecs or r,E! alk cohFnsti,n. r'ilr do th. rdk cnl rlr tuurc n B,
<br />mr.ddl or offer.d ror qL ( se.70.r'1. aurm\r !.d Pi,i.isionr ( qk TlIl Conhds r l.tcn{ lj* dds {{td,ti!ro{8,or
<br />ihc pDFny who hoildlor iqroh rhcdr lnd whr JrEi sah MrI hrnNrlfor hcrsrllor thnDgh his or hc. ow.emfk,)tdi
<br />|r(rvid.d rhrt such inumE Enls N r inl.'d.rl d oid aor elc lL hohs. rh hoitlire or rtftrkmnr ir sU w hin oru J4r
<br />nf or!,hI[ rlt OsB Boilt r wiu h.E ih. h,n n ofFovins rh{ lF o. {E dil m' hoitd rtr irymw l|r FstEry for tL ru{ns of
<br />-1,
<br />!s ouRr ol lh( ImrEny. rn! crhsnrly !1'dr l mr *ilh l!(rf,{{ .onkrn^ h ron(nd rh. l,.Fl (SR 7{).l,l, lnNRs
<br />0r,l P!trrs\bn Codc: Th. Conkrktr'r Li..is. tiw du.\ m' nf,,ly ro,tr !*ncr !frnpcnyrho nlik]\ or imfn,e.{ rhcreon.
<br />ltrd rh! .onrh.F fo, \uch nmlcd\ wirh r codr4-r.r(r) li...sd pu^ud tu rh. conrr kr'\t.mnrti*r
<br />I rn.{cnrnt ur,lcr 5crrtru
<br />lr.r. ()rncr
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<br />DECIA&IIIQ!
<br />Ih.r.hl rrln ,unJd,{arlrrol tf,rrtr'!rtu orrhc n htrtrUde(l.rdrnN
<br />I hn!. url rill 'uidrrd r C.n ili. rcofC,rMnrk'Sclll,h[cl $or[c conlnlnrJri,r, !s pn)vidcdtnrhySc(ri(,h]7(x)olrhr
<br />ljlrtr (irlc. for rhL Pcrturnutrorrh< $orl n*shi-hrh. Ffln '\ i\\ed
<br />_l lrrc(nd will rif,rain worlcrs co {.nr ion in1u6n.c. r\ rcqurcd bys..ri,,n-17(x).1thc trbr Codc, lor lhc rrfonlic. ot
<br />rhc *oll ftr *hih rhB Fdxr ,s irern I{r q.rks' ..mlEnerir in.u..txc crtr {n lrnEy nlnrbrr rc
<br />9,1atzqz+9*u-2n-2L
<br />_l ccnrlrrhri in rll FrntrnE(a ol !h. *orl tur llri.h rh's l.rnn ^ ilre{.1\hallml cnDloyuy pcrv'n in rny mnEr
<br />$ as io h.ro { {bFr ro rh. sork6 comPcnsdira b*s ofcllnrmia. !d i8e Iho, rf I drurj lt<oE ruhJ..r k, rhc
<br />mlkdr (uqrnsllion pnrvisioN .r Scdion .171n ol th. tib.r Oxic. I rhlll. nnlhwirh loirtly wirh I h)s pnv(n'n\
<br />IIARN|NG Fr ue io *tur edk R o'qEnerir mrcBSc is unbsful. .nd rhall {bFr r cnpbrlr k' simidl Ftuli\,nj
<br />,i\'l rnrl rn n) oN huiJrrd rh'u\ tl,'llr,\ rSlll).I[rD. d rdrl[rr' t rfu .,\r ol ronrFn\rrnnt. drn,rrr\ n\ pnr'd.J l(, rhr
<br />srri(r, ti)r., rrr l,'lrrri,tl.32:Zl n,,,,-.,,)4
<br />DS;IIAAIION
<br />I lErchy lmrn u'!d6 p(DIy of Frrrry rhll I !m liansl unds Fovishn of CtBrld 9 (srlemin! rirh sdir 7(m, ol Davi.i. .l
<br />ol rhc Busincsr,nd Pn,Lssions Codc. {r1my li:.n{ is i. Iull r'oE! lrxl .llsl
<br />,r,,. ' (_ 2
<br />EL\bt,
<br />\o Go51f
<br />a""r*t...&
<br />(0NllalJ(fllll{rElDaclc[lilr
<br />I hcrc6y !ali,,. undc. Fnalry or pcrJlry rha hcr is a .onid.rhn lcndinS Scry tor th.lErrornrmc oallE$rrk for *l'ichlnn fmi n
<br />i\rucd (Scc. 3@?, Ci! C.r.
<br />AEILICAUI.IESIAEAIIIIII
<br />I hod'y rlfm ud.r n nalry ol Frjuy or of rlE follo{in8 d..lforirnr:
<br />tx'mhion Pc nnlAshcskN Norir(rri.fl tolcdl Rcsuhrions lT(lc l(), Pd6r
<br />_R.quircd l.rcr of t{difsinn
<br />-l(u
<br />ilyrh l lfu Ldcrllr.guhlirnr\ rclud ign\b.{o\ rc n,vrlrr. torut,l)lir lc ro rhi\ !rl..r
<br />//44 -.,', ,n, , ",.
<br />,"J.],ntr rrpr,!J,,on rir {r,.,h. ,h. Jh\r ,nru,
<br />',{,ltrLn,-.r1,ls,rk lrtr'rlJrirE!.hund'/crnnru(rrf..nlh.,ch} J,
<br />ffi,::IH:::"'"
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<br />,h,tr'lc qn.srnrri'r.\ ol rh^ ( [r ri,lC.
<br />r-mne.rN(prinl): )<y'ua.a A&l-8'z-zt
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />Roof Sheathinq
<br />Framinq
<br />lnsulation/Energy
<br />Drywall 9z-/r-l*za
<br />Ext-/lnt. Lath r\)
<br />Brown Coat I
<br />Ivlasonry
<br />Pool Fence
<br />Handicap Req
<br />Deputy Final Report
<br />Enoineer Final Report
<br />Flood Zone Certif .
<br />It
<br />FINAL '6l2qhr J44?)
<br />Certificate of Occu nc
<br />Notes, Remarks, Etc.
<br />-+
<br />COMMENTS
<br />UFER Ground
<br />Subf loor/VenVl nsulation
<br />Shear Wall
<br />T-Bar
<br />\J
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