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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE OWNER BU II,DER T'F:LCARATION
<br />I lrad!, illr$ unLr F.urry ol,'$tllr! rhll I r c\ctr{tr tn,m rh( C nknnis'trd{ tj} |,trrE Int*!} rcr{r (Sf,(ro:ll5
<br />lnx'n.s ant ttolc$ur C,rlc): Any c y or Counry ehrh rrquR\ J FirNt rtt !"Nrru!r. !lkr. rmnrNc. &m'fitr "r npair rny
<br />{nErurc,ortr6 ilr Nn,Nc.,l$ i(quucs rlr annli! n'\khFm t, [hr r'smJ {rrcmnt rhd lr or.lx t lto*.| Iluhunr
<br />n' rhc ,B'vAnr,\ ol rlt Conrrc!tr's l-f,.n\.d lr* (Chlnrcr 9, cdnrftRrn! *rrI S.(rrn .7fixj ol Drv$trrn .l ol rltr Blrncsr 3[d
<br />I'tulcs\rrN (irlc) ,r rhar lE or \lE i\ crcm tlsckom rnl rlE hlrr Ltrthc llk8.d cr.q{on An}vrn{ln.fScliDr0.!15lry.n,
<br />rmhutrr k, . ,.rhrl nrhr(h th. itlliclnrr,' a(vilp.nrlryolnol mdrc rhnn liv. rrnBlrcd dollrs (t500)
<br />_1. a\ owrcrol rhcpn,Fny,nrnrycDployccs wn[wrIcr as lMr i'lc(onrpcnvlr]., sill'1. rtt *olk {nl rh. llelurc r tur
<br />d(ftlal or ol lctll ntr ql. ( S( n]r.1. llusm\J unl l'inc!.r,n! Ctrlc. ItF (i'nkrdr'\ l-.ctr* tlw JN( B{ l|I y h r. D*kr .f
<br />rNnn'Fny wlx, tniJs or rnll)roks rh.a,n, & whnd($sk1rs' htrrs.llorhcrs.ltorrtr !h h,\ or h.r dwn chfh,rccs.
<br />lhrrtlJ rh.r {Eh lDrrouEnl\ e rn ! o!.i or oflcEi rit slr. lr. lr'k\tr. rl{ hn,!n's ({ lqhNmn' tr $! s{hn,m y.,
<br />or .omtbLtr)n, r,E Owtrq Iltr lc, w,ll M* !h. hd&n orlln)vr8 rnar li. .r r Jrl *,1 h{[, r rrln,lc lh. F,tE1y r',r th. IiurIrM r,
<br />l. r\ owNr .l r lr nn)IEdy. rn .r(lN,v(ly ro.rrr.rr! enh l'..nrJ ro trdd\ n, on{ru.t rlr' Irl,r\l lSc.. 7(}{.l. llFRs
<br />irrl lhi-sr C, tr|. 'rhc cl, tu.n, r l-,(n.. l,av .tm\ tro' ilnly k, !tr ,,!n.r nt pnrF,ry *ho hu r ld\ or mpn)vcs rh.,ron.
<br />rnJ lho onk(B ktr {u(h pi)nr(rr wnh r Cdnrfl.krt \ ) l(cn\ctl pur\uitrr i, tlr' Co rr.(r'\ ljrctr{ I f,q )
<br />I anr.\.nr u.,l.r S(,rDn-
<br />,r,,. 'q?'?5-Ll
<br />DE(]I AR TION
<br />I h.Eh, Jllrn mncr F-ntrlryol Fijurt oR_ ol rh. rnlouht Jc.llrarknr
<br />_I hrv. ml wru mrran r Ccnrr.k dl (l'n$nr t, S.ll-lorurc tu sorkdr d)mFnillu. r. F)vactt Lr by Sc.rD l7m of rh.
<br />Lhtr O!,c, i,tr rhc J'.rtnrruRc of lhc *o l(trvhrhrlrll.d N r\u.al
<br />lhiv. lBl wrllnM'nr{n sorl.ri.o,hFn\rron nru tr.., r\ r.qu rJnrSc(rn)n:r?(X,o,rhcttrh.r(dc.ntrric!.rlorruR.ol
<br />rlr w.il ntr uhi.hrh,\ Itrnir i{ L\\Bl M,wo ch r.nn n\rrtrn 'nrutrfr c ( anrr .N ,rtlf,y rumt'., {c
<br />Ir,,lLcyNun rr
<br />I Nrrriylhir mrltr pcrlornlur.ol lh. work lnr*hrh rhA l.rm rl tssrJ,I \lElltror cmnl()y.ny Fr$,n in{ny m.nrc,
<br />n, a n' t\(oB sut'Flr n, lhr u*tda.o.IEn{ar Nr ldes of C![toma, !!rl rBE rh]r I rh'lLl h&sm.!hF..'! !'rtr
<br />s.rI(dnrlcn{rnnp.vi$n\.lS..rn,n.1?(x)ol'rhcl,lhtrCir]c,I\lull.IodhwhNnrtlywnhrh'{!n'vntrN
<br />$ARNIN(;: ,'.,lurc t, s. rc *nk.^ .rhnolrll'n (*!,at. '\ trnhqlol. anJ rh.ll {*'r(r !n cnrll Dtt r. urlMl Fulr( rt,
<br />.A LS n (irl.. n cr.( anJ.norry'r 1..
<br />.La{ }-'--L\t"^
<br />IIECId8AIION
<br />I hcrc6) rlrtrn undcr JEnrhy o, ,ErJUry lh.l I am lNnst uBrcr lnrlFrD ol Chafl$ 9 ((trllmtuh8 u'lh Ser$n 70001 ol Dlv$ion .l
<br />ol ll* Bu$mss .nl h.hsnonl Ciic. .,n hy li.n{ n D l![ li& rnl .lI(..r
<br />_L'(nsc NnmtEr
<br />la!$A!.!:Ir]NIl8DU9A{iEIICr
<br />I lErchy atnrtu hkr Fnilry ol F4ury rhd llsr ir 1 con{rucrr)n hlrnry .8crEy lttr lh. ncnnrnEBc of th. srl ttr whth rhK ,Mn (
<br />tr\u.J rscc n197 (iv C I
<br />lxoLh A.lnrs\:
<br />-AfTIICANLOECIdEAIIAB
<br />I llExr rl]lm trh'1., lcnahy o, Frjury nk of lhc n,l[]w[8 !.!ldrii(nr\:
<br />l).n,l Dnl'$mn$ ih..t,itltrlri(dilnFaLhlRc*uLhon\(T lc.llr,llarr6)
<br />R.{und ldlLr ol N'lir'E.l.n
<br />_l rddy rhnr rhr ldcr.l rci.lnin$ E3d,lin! !\hcsr'srcnrld.B nn qdiabk !, rh's !nra!
<br />vlt*rr,t,t*.,u,n^r|t?lrdri'nrln:icrh.rrh.rh)v.nitr@rn,,i\ordt Irsi(homnlyu h.ll ciry.nii ctr!trry
<br />o !'rn(.\ and Srarc li*s FLroS b burl.l,n! coh(nrrbn, !r1h.rchy {ulhtr,c rc!rcsnlatrEs nl rhn Ciry:nd Colnryh.nrq uFrn rlr
<br />rhtrr Rrr!'NLl Inrlr.ny tu !\Ftr$nfrry\r\
<br />,,-,..5'-2s'rLlAppli(snl or Arenl si!nalur 6r\
<br />x t,\,^ \e\
<br />Set Backs /:->.
<br />Forms/Steel/Holdowns ,/5/2t otu6 w
<br />Erection Pads Jt
<br />UFER Ground r/s/at tlhbs 7K)
<br />SLAB Floor
<br />Subfloor/Ven s-/a/>r hbntk tff zt
<br />Roof Shealhini o,/,2/,UO4)?,tW
<br />Shear Wall I ///2/%4./4 'zdl - n
<br />Framing (,/98'/A/MM/fr f4t7-
<br />lnsulationi Energy 7/t tzt -Lfubt ,4rx
<br />DrlwalL-^D,7/)/"/ryru/h ,/t.-
<br />Fvill n I L t v////tu&t 'bfrt
<br />Brown uoal ,7/?/x w,{d {1/V
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flopd Zone Fertil.I I /Ai-rf(1t fi\)d 5nfl"WdeS 1W
<br />Tla ry hn0h 14G 6l2d'at
<br />FINAL U t717Dl Wlthfr.tEo,tro
<br />Certificate of Occupancy
<br />es,ar
<br />--t
<br />tD/stG.COMMENTS
<br />I
<br />\ttln+rt @tir6tdt ' ard
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