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BUILDING- INSPECTOR RECORD <br />SITE.WORK DATE ID/SIG.COMMENTS <br />Set Backs <br />Formsi Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />Subf loor/VenVlnsulation . //\ <br />Roof Sheathinq K^ll-21 D <br />Shear Wall <br />Framinq <br />lnsulation/Energy <br />Drywall <br />Ext./lnt. Lath <br />Brown Coat <br />lrilasonry <br />Pool Fence <br />T-Bar <br />Handicap Req. <br />Deputy Final Report <br />Enqineer Final Report <br />Flood Zone Certif <br />FINAL 3-tr -zr Cr.,-r? q t <br />Certilicate of Occupancy <br />Notes, Remarks, Etc <br />OWNER BU!LI'FI DI'I,CARATIoN <br />I hc..by Jtllr !nd.r i'.Mlly of p.rjulv ih.l I M .(rq frcd rhc cI) rxlo^ t^.n* l,s fo. tlr ftnt'qing E qrn (S€ 7011 5 <br />BNncs ,'rj horcsn,n Gxle) Any Cny or Cuutrry whah hqun$ r Fhi ro o.{el. q. nr{ror. d.mlnh r qln uy <br />dru.roE,l,r, b ns i$ud., lho r.quiEs rh. umlrr ro, su(htEmirro fi& ! shmd dar.tunr rhnt lror slE ! lkrn{rd polu.d <br />r) rh. F virimr of rtt (nnkrn, r La.n\.d lrw (chrpt.r 9. Cumftfting rirh Sdrntr 7fixr ol DivNi(,n I or lh. luritsr ud <br />Pr'l((i,ns Co&r or lh.t lEn3lE n.rcnlpt rn r.6om rnd llF tr..i1 ntr th !lLg..i crcmfla. Ant ri,l'rtunofs*rbr 7t,315 by8ny <br />ltnlicant lor rFrmn rubl(G rl! appli.nnr t,!civilpcdxyofr, n$E rh:n,lr. h!.drd dolhrr (3:t0or <br />_1. r{ o*mr nr rhc lh,F_d y, (tr m, cflnloFrr wirh w.8cs !s 'h.r s,L cotrrtEDsur ion. }rll d. rh. usr 3rn tu ndh t tur <br />id.rLd roi'ced lir d. (S( 7lx.l. Bu{iE\r'd lt f6'io Cd. Tlr C.nttu1or \ L.cn€ ljI icr mr q))ly t, r o*n.r ol <br />rh.ftuFdy *h hoius or in{rcE\ rtEE,n. on *ho &F.kh kx} hid*lfor lErcllor rM'u8h h,<,t h.t o}ncit,hy..l. <br />p!,vdLn r,Er \u.h iq,0emn6 m drcndcn n orcftd ftr qL ll lnwEr, rlE buil1i.3 or htrcEmnr i! hH *ntin oE r@ <br />oro'ribrba rh O*Er Buil(|r wU IEE Eturr.nollhNrffi.it ornE dil B,lh,!o,in{'mt of, ptr,rE1, ntih. puF)<or <br />_1. .\ n*ftr of rhc Isrp.n y. !m .rclu{ikly rontkrins wirh lic.nsc.l .onta.o6 b . triur llr lroicr rse 70ar- BFnr$ <br />anl tht rin CRL ThL Conr&roar LE.nr bw d*t mr apfly ro rn osncr ot prDpcny lho htikh .r ihtmr.s rhcrd)n. <br />rtrd wlx'.ontrdsfor$chon,trkvirh!C.nrrtrlrli.naiI'u^udn,rh.G,.ar.asL.$-tj}) <br />I rn,crcnDr u'rlc, Sn_Iion <br />Dnlr ()rnd <br />rvonx.ns'ioirlurs,r'r'itw <br />DECIJ&IfIUIi <br />I h.r.hv ilrirm un(l.r lIrolrl ol Ix!trrr_ o'r ofrh. r,)ll()ri',! dc(ltrrJrirr <br />/ <br />-l <br />hIc drd *,U m'nr n r Ccn 'l*!r. of Con*nr ro S.lf.l.r!E ntr worlcB lonrlEnr0lion. ur pn,vthd rd by Ssrbn l7m of $. <br />4 q/nr Co!,lor rlrFrorIu.orrlr $.,t lu *hrhrr* tth tr tr\rd <br />Sf , *,. ", * ',, .,*,t *',Asi . 'nllcnidrn 'nidrtrnc.. <br />11 Fqulrcd by seri'. -1?(r0 or rh. titxn csh. !u rrr rEkrtuft. or.\ rh. rflt k, *hrhrhn rmr r r{hj Mv f,irtn! tun{xn{hn,nruffic rMEr.nj F,lr) nurnbq ( <br />,/.""", <crE- ---_(.",;Ias5aB - - -*--Dglaat <br />_l cc.rify rhrr io rhc lorDrenc. of rhc worl( ror *h.h rhh pcirni n n\u.d. I sl'all.oi.rploy in, Fa). in !.y nurr <br />$ d k, belm subFr ro rlE w*6' .ompctrslrion la*s of Crlrromi!, r.d !8N rh'i ir I ih,uld bc<om subFl to lrt <br />rorlEr' on{ENrbn Fmvti,N oa Sdln. 1700 of rlr lrDr C.dc. I rlh|l rodhrnh Nn, y *nh <br />'hos <br />pn,vtrions <br />WAnNIN(;: liilurc lo B-E wo,kcr'cotr{Eoslion @r.hs. Lr unL*tul td 'lEll iubFl o cq,hFr ro silml IEdtF lrd <br />,*; <i frizj**:',S*jffie.r.;; <br />Pn edq r' h' <br />Drcr {&rTIoN <br />I hcEby ! nm undcr Fmlry ol rErjurr rhd I n'n liatrrJ uflLr l'n$i,n ol Chrp'd e lNmnEr rn8 *ilt iE(r bn 7cu oa D'rti,. .r <br />f rhc Blsi*s and Pmlu$ion{ ct'dc- lrd ny liccnr is h fuu ror. dr] .flLrr <br />,z,iftn\.c,a( c3ca\,.'.4EIA- <br />I h.Eby lmnn uid.. F@lry of Friury !h.l IIEE ir l on{ rio. Edi.r !E!E} <br />irs!.d (SN. JC)7, Civ C ). <br />L.ftlcrr Nrft. <br />- <br />lxnd.l( Adlrc\\ <br />I lmtD rlinn u*lrr Ftrrlry ul !(r <br />AItUci rxull)grr&|]IOr <br />rhc hn[]wtr'tdNlrrrri(x* <br />l).m,1'rn,, I'rnntrr \haxx Nor Ll R.!ul.i(nr\ r lll..1lr. l\r(ir <br />/_;'osr I r8N k, !i'q y *nh rll Cnt lnd C.u t <br />i)nl'fu,kr\ rxl Srrrr I J$\ rrL c\ ol rhirCirynnd cox ryk,cnr€uIDnrh <br />rhnc mnl i,tun ,'f,,rEny nt <br />/,\Dli.nnl ". ,\lletrl Sian.trn w {\u B.,u^,/v'Y- <br />,^,,ATILL <br />u9lryl <br />I <br />I <br />I <br />I <br />I <br />I