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BUILDING- INSPECTOR RECORD <br />SITE.WORK DATE ID/SIG.COMMENTS O\T'N}:R BIIII,I}EN DEI,('ARATION <br />I h@try 6mm undd r.f,dty oa p6ju.,! rhd I en .rcmll 6on th. Cornrelod l-i.m. l rw for lh. lolkNiry r6si ( sd 70 r l 5 <br />lhsins .d Proash. (irL) An' ( irr o, Cou'rr. shEh r.q!6 . Fsn ro .oBrud. rtls. iE rov., rlmolirh ot Ep.n u\ <br />irumft. Iru h ns inu&.. ,lo rlqun6 $. tflikm! for 3u.h Fmn ro 6t t !€n d !166r lh, lE or stE ii licd!.d pleei <br />h rh. F$Lr$s of th. (-ontuto.s l-!c6sd l,$ (Ch.rl6 q. ( onmdins \hh Sdin. 7r{x) of DtrLFo :r oI lh. Burin6r a.d <br />Prof*ions (td.) orlhd n. or shc ts rrcmpl rhd.fion @d lh. bdir lor rhc n[8.d.tmptiotr Any viohlFi ols..'ion 70]l 5 bf.ny <br />,{rhcer f.r ! Fuil tubr(t th. 441i...r io . .'vrl pauht of nor mrc tto lir. hur}.d &Ud ( l50ol <br />l. s .$rdof rh.IrorEly. d mydrrlo!6 *irh u.s6 s rh@ sk 6mFdFr. sill dr llEld rd UEtur i! mr <br />rrd{,Gd orolls.d for dl.{se.704.1, Bui.d md Prol6ionr (-od. ftc Conlricloa3 l,i(te Llw do6 nol +ply lo u o*ir or <br />rh. p.otm, who hit& m itqm!6lhde !d vlr, <tE *h xr* him.ll ot h.*lt or llmurh his .r hd o$n dploy6. <br />rtuviLd rh, $ch ihForffi e Ln indrd.l c olH frr sL lf.lB*nd. r,E tliBnt M itsdaEr it $ld *ihh k <br />'aofcurphn rlEol*r ttiBs rin h.rt tlE h(b! olF.r!* rhr E JEdildtrdtri"qD\tln.F,td!6.lllFFEot <br />l, s o* nd ofrh. I'.rdr, m .1.luiv.ly cornrdins s'nh licdr.d co. Er.6 !o 6dtud tlt Foj.<l (S( ?04,1. &,rs <br />.d Pntse Co& It. Conrrror! l.r.@ lrv d.- mi .Cf l, ro d o$nd orFoFly tr ho brir& oi mrm\6 'h66n.dd uh. .o'nret fd sh F.ids $nh ! Conr-o(, ltdsal p{Eu,n l. llt Co'rab'r Lk.r t!*) <br />I e.r.mfl undd sdrion <br />lr.t. o'rd <br />lvoRl(f, Rs' ( of, lPENsArmN <br />DESJ.BdII{!! <br />I hsq\ lmm u.dn Frhr olp6juD_ on. oath. folhsiry ddlMilion! <br />I hrr. !n *'ill di.td. cdria..r. or( o@n ro s.lf-leE 6. qnt6' onFBinr. 6 F.riLd aor by S€hn 17(x, orrhc <br />l,btr Co&, f.r lh. FfollM. otlh. *o.t fs *tah rh. Fn( n isu€d <br />I har. .nd sill mlinuin * oitd .omFMion iNurR.. G rc{lircd b, S.cl ion l70o nf rh. t bor Gd.. for lhc Ftbrr1@. .f <br />rh. *ut for uhah rh! Fmn ir isd My sortd omp.dhn 'Mc c.tG &i lrlr)_ numb.r r. <br />,""'- 'Ao<o <br />,,,*,^-.* -/Tr6f llLip3')01-tJ 'zot/ <br />I.dri! rhlr <br />'n <br />rh. Ff.l11ltr. orrlr uort lm shich lnir p.rsi! 'r isu.d I !t.llmi mpLt u} tEM. it ey nuk <br />$ s ro b..omc subJet to rh. {0*6' conpnBa'oi lr$i of Cdifomi( md r{R lh.l if I 3h.uld h..omc !ti<t lo th. <br />woltd.ohntEslionpmvBiodorS.dion:r70oofrh.trhorC.&,Ish.ll.fonhs'ilhcomplywithllhrF.liiioN <br />WARNII\G lilu. ro s@ *vld otrrFErhn .ovsD*. . unlru tuI, !i lnnl 3ut'td d orphF ro .mml Frhi6 Md <br />cril n.6 uD r. oR hun&cd thoud &'llc Itl0O.000). 'n.ddn6. b ih. td of .omFNrion. d&!s6 a F.\il.d f.r 'h.Sdion 11076.fri. titv (-.dq inr6.i ed rrroB \ fc <br />I h*rr amrm und6 Flhyof p<jury lhn I d li.d!.d undd Fovirion ol(-htpla q (conn6.i.s *'nh s.d.n 70Oo) nf l)ivisio. r <br />6f rh. BGin* tl PmfdhBcod., dxl my liceE i! in tullfo,c.&ld.lIdr <br />,'-*"a,^. 'C3? <br />',,". o?-15-zotZ <br />CONSIRU(TION I DNDING A(:rNCI <br />I hdtly !flirm lndd Fhh, of Fjury thrt lhqc n ! $nslrucl ion lddins ardcy ltr rh. pdfomdc. ol lhc sor! for whi.h rhis pdftil n <br />i!u.d lS( lll)97. Civ ( ) <br />AITUCANLDTOSf,AIIO! <br />I hd+.Itu ui(kp6!htof Fiury omof ih. folL*rB rklj.tnns <br />D.nolirion Pmit-Arbcsror Norific io. F.darl R.ru hriod (Tnt. 40. Pd6) <br />R.qut.d lnl6 of f(,'fraFn <br />-l .qlify rhn $. f.dd.l r.Bullt ioB rqrdins sl6or rm\ rl r. ml E plrrbL ro rhir F.l.( <br />$,,^t,,nn, ^*,^,n!.pplicrnrn <br />en nar. rhn rhc !bov. inaoMio. i cordr I lBrE k,.ohply *irh cntmd('ounry <br />ndmm6 .rd Srd. L&! Elrins ro biui.s cois!.r b.r &'d lFrtr, ruthorn. qrsrins ol rhn Cny .d ( ounit <br />'o <br />el6 uFr lL <br />.tn\. nhrnncd FoFn) f dEpchn FrD.s _ J , <br />App,h. o,^rd,sh..,uE *-.q.r'4'-,# -,.'m-15-U1{ <br />Pmh.ri.rp.rno: * fu,ao l"m{o/ <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />Subf loor/VenVlnsulation <br />Roof Sheathinq <br />Shear Wall <br />Framing <br />ln s u lation/E nerg y <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 Certif <br />-6\ <br />FINAL toh+/t z Nl{-1s <br />Certificate of Occupancy <br />Notes, Remarks, Etc <br />-+ <br />,,,,,. t0Q-15'zol ? <br />,r.B.Nujrr - 4/977<,-**,1 Cllcx <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I