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BUILDING- INSPECTOR RECORD SITE-WORK DATE ID/SIG.COMMENTS OWNER AU!LDER DELCARATION I h6.b amm unda Ftulry of pcrllry thd I m.r.mfl ftom lhe Contraclo6 Li.@ Ir* lor rh. ftnhsin! ra)n (s( 70 1 t lluri.6r anl P(f*ion (od.) Any City or County $hich r.!ut6 a Fmil ro codtucl. !1t6, improve donolnh.r lnnn t., srtu.1ur( Fior ro ns isu6.c, slso rcqunG thc applicdt for such Fnnn ro 61. a siSnqj n.ldndl lh3l h. or th. i! lic(s.n lu6ui,l 10 rh. FovtrioB ofrh. Contr.br's Li.a!.d ljw (Chapta 9. Comm.ncin-! silh s.dion TuJo olDivisn'n I of rtu I]*inai tnd P6fsh.s co&)or rhd lE or sh. ir q.rpt rh@&om drhcbds aor th. all.!.d.rmplion Atryri{hrionoIsdon?0ll 5hr.nt aprlicaor for ! p6nir subjEl' th. appli.dr ro . civ il po.hy of nor moE lha. fivc hu.&.n dolls (1500) I. s otr@ of thc FoFtr. or ny dplo,6 whh w.s6 s rhcn FE sdFGaio.. *iU 6 ln. slt lrd E nnd@ i! mr i orrdl or ofidd aor sl. (56 ?014. BBi.B ud ftofdsioB Cod.: Tt. Co rrlor3 LicaE lr* d,.! @l apply ro m ornd of th. FiFry *no tDikl or trnForB EaE nd *,8 dG uh *!n hiffilf or h6*ltor thNulh h! or hd osn mdoy6, p.oyi.H rh{ ru.h inFlEFfi E rcl idqd.d o' otuEd 6r $L ll h.\B6, E bildnu or itrprovqG{ n $H eihin on. }6 oaâ‚¬npkbtr lll Of,E a!il& will h.w t E hrrln oaFornu Oa t or $. {!d ml htitd m uIFDt.lhc FoF, tu tlE,,rp(E of l. s oerr.trh. Ftrpdy. m dchBir.lr.omtuins *ih li.ds.d .onrEloB ro @n!rucl tlt F.l.d (!ia 7Or4, 86ffi an I'rlfsid Co&: Th. Co.rdori Li..N L.s do6 ml !!ely lo u ovnd ol p.op.dt *h. hoildr or hpmr6lhao.. .nd *ho onlki for sEh Foj.rrr vnh ! Codlm.lo(3) ltsa.d FBd io rh. Codrdoir LE.G Lrw) I m.rmB edc Srlon .B &Pc lorrhirren D.r. 0r.6 \I onxELs' aoniiENsarrot DECIAf,AIIA! I h6.b) .mrh ui& pquny of Frury oc of$. follou inB ththdioE: I ha. !n *iU Einttnr ! Cs!rf&r. of Co'gl l! s.lalll.c for $0116' omF@ioG a FDrid.d for lA Sdbn 37lI).f thc l,bor celc fM OE Ffffi. olrlE rnt 6r *tth tlE pqnil it isu.d I h.r. !!d *iU mi' rin sort6' conFldioi illsrlle., a rcqot.d h SelFn 1700 oadE bbor co&. for rlE Ffotrlra. of rlE trorl rm hf,h rh! ffin . ei.d M! {dtd' (ollllEMb. iMG @ hd Flx} tunb., G ,*Wi*t<,.,,,,*"*-4baEy'ffq.rt t *** 3-/-r* I cstit rhd i. rtr Fhrjlr.N of ln. $ort fr shah lhl! Fnn ie is.( I srdl mr 6tplor' , P6en i. &j Dec $ 6 to tEoE $bid b llE *st6'arydBd-tr Lqs of Crlitoma td +R th. if I nDuE t(otu sb<l lo rtE srt6 onpqdsn FltirioB otsdion lT00 of rlE Lrbor Cortc l rlElL fdhrth or.gh * nh lhor Foi3.6 \*ARNINC fiilu( ro cc NrI6 o6pG.bn 0\6+. ir uiLu'tu! s'd lndl rubid 6 6phF r. sinin l Fux6.nd cD'l fu6 up !o oc hur&.d rtbN.d &,116 (t100.0m). in rddnior tlE on of .omFMiotr drnl.s6 ! rovi!.d lor rh. salfn 10?6 of rh.ldu Cdle i.rd ud dbrE) s f6 8- k) -t1 I lE.tD rllm oD.la FEh) of Fjury lh, I @ LcEEd un n of Ch,rs 9 (onrMirs snh s..rion ,ouj) oa Dn ENn 1 of rh. Bdd6 di ProlsF6 Cod., rd my laGE u D hill lora 8r.ITd .**.* -Bon 8-5o -tf /aq1lr.t I hd.t! .rm uidd FElty ol psjury llla lh6. i3 6 oisruclDr ldrdiig +m, for th. pdfolMc ol th. *'ort lor { hkh rh6 Fni 6 isucd (sd. 1097. c,v. c ) tadd s Nu.: AITIICANLDECIdAAIO! I hEltr'rrm u.ds Frhy ol Fjlry on. of fi. fouowin3 &.laral ioNl DsnolirK. Pmil3'Ash6ro! Noiifi.dion F.d.r.l R+ul, ions (Ink 40. Pd6) R.qun.d klrd of Nd'aMirn llny *nh rll ( i& and (irnrr Cily 6d (tunrl h mrd uE n lhc ah\. ndbn.d rNp.ny for iBpdion \t,l,li(rtrr ,'r \[rtrr si[trrru'r t-9c-> /-7 Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Subf loor/VenUl nsulation Roof Sheathing Shear Wall Framinq lnsulation/Enerqy Drywall Ext./lnt. Lath Brown Coat Masonry Pool Fence Handicap Req Deputy Final Report Engineer Final Report Flood Zone Certif FINAL Certificate of Occupancy Notes, Remarks, Etc ^ ^nlq I cdili rhd rh. a.d6al r.*ulllioE Esadins 6b6los rorc\ al uc not .PplRabl. tu rhis pmjdt u Mng I I T-Bar