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BUILDING. INSPECTOR RECORD
<br />SITE.WORK OWNIiR BUILDER DEI.(NRATION
<br />I lF.l, ifinm und.r ltmlry ot pcrlor, rh,i I m.rrn{, hn rlI (i'ntek'.' l-f,.hc llw fttr rh. ft'llrwul ovr (!a 70!l 5
<br />Btr\oc$ xd Prol.rir'n c(rkJ Any Cn, or Counry whxh rcqu,.s r Irlfu t, onqrucl. .lta, rvox, &mnrh or FF! nny
<br />(n'cl@. Frtr b fi riun., .kD rqucs rh. rJ'pllar tu skh Fnul t{! ih. rtxn {nr.m.l rhar lr or \h. 6 h$n{J lujwd
<br />r, rh. In,vtrNn\ ol rh. ci,nks.(tri l-..neJ Le t( hrflcr 9. (i,hnktur! wxh S.rnon 7uxl.l Orvnn. I ol rh. Bunms rftl
<br />Prn.{rrns CixL) nr rh.! lr,f, (tr !.r.mfl rhd.hon srrl rh. hrns I'n rh. rlLS.'1.\ctrq.n AnytirLrrr.olSdrrrn r0ll5 hylny
<br />q'rlrrnt tu r Fm,l ruhFh rhc !pnl,.!rr n, { r'v' I FMlry ol ftn m)rt rhln livt hlnlttl dollB ( 35(t}).
<br />l. .r .wBr ol rh. Iit'F(y. ,tr my .n!'blN! *trh *!8.\ {\ rln u w'L .rn{r'n\.r x t u l d! r,E utt rnl rll {ndrft 6 t{
<br />ir.n].l or oficftJ nr qk ( S\. 7(E4. A{nft$ MJ h n $!)ir Cd. Th. Codr{ntr'\ l-id( tjw rtE\ ft'l 4'dy n' :n o*kr ol
<br />rh. I,r{sy *h, lirlk o nrn'K\ rh+Er. rd *hd &8uhsld hrorli..h.rcll orlln'u3hhr or ld own cflnloyecs,
<br />pruvrl.d r h{r nrh mll('{fr dr e hl hlcBlc, or on RJ hf, qk ll. h,$c\q, rlE h,llD3 or ur{h,rnrnr tr $U *ihr .F Fr
<br />ol $mpkr,n. rlE OwBr Btrrlkr *,ll t w itr hrLh ol FosnS th{ hc or \hc Jrl fl hu d or bImE rh. F{qty tin rh nnlr,t or
<br />-1,
<br />:r , '*Nr , 'f ! h. JnlJ'cn y, .trr .\clu!rc ly !.rrrsrr3 $ h lEcncJ t$n rano^ !.' o'n{nkr ! h. Pn,r.t r S.( ?04,1. Bu\tu$
<br />a t\n$h(i!crth.Co,nrrrtr'\l.ilcnrb*Jr\n.r'1,(o!n(rn(olroll{nyBlllhu'hlrormpnntrrh.t.r,
<br />,d *h, rorrtuFk, <kh rn,F F vih . ci)ntr&rd(r) lf,cnEd IrF@r h rh. (onr{d'r tr..rIr!,
<br />I.n.rcnd undcr S.d0n-
<br />]tg8trE8E(A!.lllNSArO!lrEgJ3trua!
<br />I li r.br rlltrh trr,l.r tinrlry.l tr4urv ofr ol rh. nnl'*o! .]dL!iri,n\
<br />_l havc rrl *,ll nrrnrln r (td 'l;rr. ol (,,nrni t, S.ll-ln\uic rin w rk.6 .onqxnrlr'n. rr F,vrlctl htrhtSc.ti'n lr'lx)iarlE
<br />lrtrtr(iiL. ntrilt I'.l,lIru .nl rh. *o* l,n whrh rh. Ir.rnur s rrucJ
<br />I hr* r lxj prll ro'nr.m *ork!.r comfin!,r ir h\urrB.. $ rcqnmtl hv S(r tr'n i?lxl or rh. lrtrtr (ixia. |.r rh. I
<br />:
<br />O lrEslJBAIlqs
<br />I lEEhy.ltum un jcr $ulryor o.rtry rh, I m h..<d u .r F'hlrrn Dl ChlF.r I (d'nmh-.ot *ih S&1$. ru)O) olDiYrnn l
<br />dl rh. Butm$ rd Pnncsri'nrC,iL. lhl my lrens. tr u iul turr sil.ll.cl
<br />l-mn(C'\\: B
<br />0c
<br />aqL6 >€
<br />,r.,'4h8/t\*-6
<br />(-()NSTLU( TX)ti l,F\DlN(i A(;UNCt',
<br />I li.hh,3rlttu uJri.r |rnrkvol trrJury !hr rh.r.6. on{nr.['n tfrtuF r!.h_y l rh.Ir,l,mLr.I'ltltr\rttl(xthrhrhtrlr]mn!
<br />r1{'r(lr\c. l(r)1 (tr ( )
<br />AITLIIANIIIEII.AAAIIA!
<br />I hdrt'y .]lim undc. Fn.h, ol pcrrury .ft ol ihc iolk wrnf d.rb'rr Inr
<br />D.mr ('n P.rnnk-A(h.(dr M{ uri,n F.n rrl Rc3uLri'n\(I L.i{. Pd6)
<br />__R.quo..l trx!r dl I'J!l i&h
<br />l.cnrrlrtur I lr l.JcrJ (gubroni tlrJof.{x{n\ r.m,t!ldc fri rpdxr$b h rhs Pnlrd
<br />Z-rr",u"rr,,*.-r,r'nrtflhrr[ndrl{ir!rhr hc!li'\dnl'nfrrlntr.(r..rIarrehoilPly*nh.llC,,nl(i,ury
<br />orJEE.r rfti Sr.r.ljh nlaros r' hurl(lrnS (o.{ru.rk,r.n hcr.l'y rurhrr. r.tft*nr.r 'v.1 ol rh6 (,ly lnl (i,u yn,..r$uPnrh.
<br />, itr. nrnrr,r,l|n.txdv r.tr 'nrF.( n r t'trrF\(\
<br />Al|pli(.nr.r'1rcnlSirqluF /7/s/A
<br />Set Backs
<br />Forms/Sleel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Boof Sheathing
<br />Shear Wall
<br />Framinq
<br />I nsu lation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handica p Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />FINAL F,".r
<br />Certif icate of Occupancy -fr^:r,o k oLt'oq \/tA/z
<br />Notes, Remarks, Etc
<br />DATE iID/SIG., COMMENTS
<br />_-l..nnlrhrr orhc l.rromu,u ol rh. *ork ktr wh(hrhtrFrn( 6 r'!il.I lhrll n cmd,y,nyFrv,n 'n
<br />lnymank.
<br />q, Jrrrh.oft nrhFlr (i'(f, woltcn' uon{xn\$ Nr Lp{ol(.lrtnns. tBl !3R rhi I sh,lll t*om {hi..i tuih.
<br />* *cr\ onltr n\.ron F,v(r'nr oi s<.ti'n .!?($ .1 r lr l ihtr (irl.. I rh.ll. ftd h*[ h compl! vnh rh){ Ih)!Ni,n!
<br />IVARNIN(|: F{lun t) (uk rort.6 linllf,n\ari'n (Ndrfc '\ unLwlul arl rlBll .uhilr r sr{'l'yo r,6m.lliMlrr 3nd
<br />.trrl hn.r ut r'.n htnl'rJ rhoullRl,lolhc l!lrl).{xxr, m rdllon I' rlI .o{ nl uhF dron, Jam8.! as nn,vul.,l r(, rr.
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<br />Sublloor/Venulnsulation I I
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