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BUILDING. INSPECTOR RECORD
<br />SITE.WOBK DATE ID/SIG.COMMENTS
<br />Formsi Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/Vent/lnsulation
<br />Rool Sheathing +-tu-71 Nlt44',
<br />Shear Wall tt 7.4
<br />Framing \-z'zt
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar (
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certil
<br />9-21"-z)
<br />Certilicate ol Occu nc
<br />Notes, Remarks, Elc
<br />I
<br />OWNFI AUILDIIR DEL(ANATON
<br />I trrcby rnim uais Fndry o, IE.llry lhd I m .rcnpi fism rll Gdrd6 lid* he fitr rlr folL,ua3 Etn (9.7(rl I 5
<br />Aurinc$ rd PmL\!o. C.ri.) An, Cir, or Count, shah,qutcs. Fnnil to dtn(n.1..is. itq,nt, &mlth or EFn try
<br />\r 1ure. prtu ro ns nruffic. rl\o rcquirs rhc appltor for ruch F mit ro ul. r sigEl nalcnEnl lhat lE or slE is lkcnEn punusl
<br />ro rlE rrethFns of llE ConrLld r Ltn-d La* (Chrrr.r 9. CoIlftMinS wilh Sdrion ?(In of Divli,n I of rlE AuiiE$ ud
<br />Pn,fcsbn\ ( dL ) d ihl lr or {r n .r.ri Mn,m .rn rlE h.ra lor tlr rlL8r{ crdll,liI Ary ei,bi,n ofs.dit. 7011 5 by ry
<br />rpplicanr rin I pcmir lrhFri rh. spplkrnr b a civrl Ftulry or nor mE rhr fiv. hudlr.n dolle! ls5iro
<br />_1. L oqB orrlE FUFny, d ny.nPl'Fn q t e.36 rs llEr sb rnn{ENrrn. *illltl dr krt rn rffiR6mr
<br />hrqrln or or.r.d tor slc (Sd 7l),1t. BxriB{ 'nd PrDf6sio6 co{hr TIE (tdHd r Li.nE t w &.! ml .Pl ly h e o*E ol
<br />rh. Fop.ny *rs hrild! or r{nB rlrrtr !d pho drEr sh utrI hirucll or n Mlf nr llwu8h hn d &r own ctQlu}td,
<br />I'mvilol rlur \kh in{IDmdr G d idddcd rrdrlddl for r]. lt bw. rtE triuiie d inFomil ir rld eiho c rr
<br />ormnphta th. O*E au dr r hE rrE hrd.n orFflnU th.lr d rlr dn d hlru q irD.nE dE I'trFi, it,ItE lx4*of
<br />l. !r oq ffi orOE Flrny, m.r.h.iwlr $ rdh8 with l*!.rn co.lrEr6 loln<tulrlt FoFi (sd 7(x4, Buim<
<br />td ft'ftirn Cd. 'rh. c.nr-r,rt LK.n* l:e tk8 mr {tly to !. orN of p.oFny *l$ l ild. or iapmkt tlEron,
<br />rnd who conhch ror such Foids qnh ' C.nn&.ro(s) li(nrd ,urud lo thc O,ntEdolr liusc b*)
<br />_l.m.rm,r u.& Scrion
<br />llaxf,!85:clJMtrLtarlo!
<br />DIj(;IJISIII}d
<br />I ltruhy rllimundci lrnalry.fF.jury on.olrlE lol[]*iag da'lnrarionr
<br />_l h:r .d will Ei ri,. Cdirrr. of Ci'tr{nr k, s.lr law 6d eort6 onrEMion, B Ftrvildj rc b, Sdlni l7(D nl r,.
<br />L.tor Gxj.. fq th. Fno'll@t ot rlE hrt f{r rii.h rlE lEmir h ilgrd
<br />f'*l,i rnd eill 'Brd.in sor!.r' mmrEnsdion imuflr.. s. EquiEd hy SNiin 17(r) of rlr lrbo. ct .. rtr rh. Frl{)fu! of
<br />h rhs rEmnr 6 r$.d lly *(r' cotrFtrdnn insuEre cria .d Inli'y nn*E e
<br />o-a\
<br />r in rh. Frr{trmtuc or rh. eort,or wh.hrhi\ Itlmi h ir\ucd. I +.ll frn.rr?l{'y rny Fr!,n in oy 'EnM$ s ro lEdm ul'Fl b rlE e(tqi orrEN.rion L*! ofc.Ifomn. lrl *N rd ifl rlul, tf,.oE qlbFl li, rh.
<br />srt6! contEern.lft\tnN orsdr,n.17(tr.trrE t hor Cu.L.I tEll. forlh*uh dlIl{rl, *irh lho.,bvnis
<br />WAt{NlN(; Fuilur. n, scuE *orkcs c1'r{Enelion covcBsc ir unhetul, and stull .ubj..r d dDI,loFr ro aihirl Fmllis dtrd
<br />ro.m hu nal rk,uuJ dn[rr rSllx](rr) in ad'l ion b rh..oi nf $qEn€ron. diE8.s 8 Fovidcd tnr llt
<br />(:
<br />,n :l{,76 0l rlE lrhn cod., 'nrrE{ .d atr(,ty'\<lr5- ).t tr)
<br />DL(L\&UI1r!
<br />I h.Ebyalnrm utncr Fnollyol Frjury rhal I rd lidEd u.dd,n,virion otchtl)l6 9lconmEu8 *nh SalionToGr) otDivkn,i l
<br />or rlE Buiift1. .d Prof.$hr( Cod.. !n my lt.nE n D rnll ror .rri .rldl
<br />f --Re t)
<br />*t/-)5^ 2r I t ryP ,D/ o.
<br />s)aslxuqll!]lLEDldlill;rdq
<br />I t Eby .rfm uEL. FBlly o, Frlur, rhr lhdt n . oorfrb. ltdi8 .!!ry fd llE Ff()l]lm of rli ctt for .trh ihn F.nt t
<br />ns.d (S( l(})7. Civ C.).
<br />l.ndcls Ad&.s\:
<br />-
<br />AIILICANI.D}:CIISAIION
<br />I hEr*t, .trm undd F.dx, ol IEflry oft ol tlE forh*in8 &cLrdrhni:
<br />D.nhlnio Pfimi'!ArlE(or Nrlinr.rhtr t'cGnl Rcsu lol k n\ (_tnh 40, P,n6r
<br />RcC! 'hrt tdrd .r Mrifrdih
<br />ldcn'rrrhxr rl[ liJ.Blr.! hrtr)n\ n'Irnl'tr! r\If,{o\rcnrtrrln'r tr"r ipfl[:6L r, rhirpr,]rr
<br />rh! I hdrc Ead rhil amlaar mn ir|l {!t.rh.r rh. ah& mnxmrrh 's.ondr t.Eet,$rply* hallCny.ftlCounr}
<br />nJ Srarc la*lElrinA k,t{ildinS.on{ r*,tr *rl hd.hysuth'ru.r.prc{crrlli'!\oi rhisCirytrnd Counry k, .nrd xllr rl!
<br />,\t,pli(dl or ,\E.nl Si*n.r
<br />rQa Drr Ar
<br />()9^LS'al
<br />Jlrtt!&ll
<br />Rev 08'07 2015
<br />Set Backs
<br />I
<br />I N]0-t()FINAL
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