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SITE.WORK DATE ID/SIG.COMMENTS OWN[R BI]ILDER DEL('ARATION
<br />I hdR{ .Irim undd p.nlhy of Frrury rh, I m .r6nF nbm !h. codturos' Li<e lrq for th. aolloqif,r l@n (se 70:rl 5
<br />aEin* ,fij Pr.l6ion ( od.) Any Cnv o, {bun} *hth r.qurB.IEna r{ co nrucr. rlrs. inFore dstulgl nr rq.tr uy
<br />3rrudur.. Fior ro ils isec., iE i.qun6 lh. {pli.d tu tuch Ff,nn k' 6k ! rign.rl sidmd! rhd h. or sfi. i! li.d!.d l{mMt
<br />ro rlE F!\irioro ol E conrkG r l-k6t d l,* (lqid 9. Coffins wnn SdFn 70l](, of l,lvnhn I of rh. BB$B lnd
<br />Prc fdionr Cod.t or rhrr lE or rh. i! .r.npr lhd.from ed !h. bsir tu lh. .14.n d@ption. Any viobrio. of sdbn r0l I 5 by .ny
<br />4rli.dl lor. pqnn $bjErs rlE E kDr ro ! civilF hyof mr mr.rho li\. h!r&61&'116 (!500t
<br />L B o$ffi otrh. tr.F y. ny mplorc "th s.g6 a rh.n $L comFdion. qill dr $. rul ed ln. tuG i mr
<br />i dld.d &olf6.df d.(Sa'7044. AatrB ed Fnl@b6 ( o& Ih. Cotuoat ljr@ tls rha d {Dly b sos8 of
<br />rn. F$p.dy $ l$ bil& or urFr{6 tlE6( dt *h. d(E Mh uJ& hrn..lf .r hd*lf or rlmuSh hB d lE .m mdoy6-
<br />Fovit d lhrl ach mp.orqEr! e d n.d.d m orsql fn rl lf. lIrEs. tlE hlildn8 c irsusE a nld *ithh w s
<br />.aconq,khtr
<br />'lE
<br />(xG aliE *1U hrvc l,E hr&n oll'ou8 rhr h. or shc did er hrild d nF!!r dE FrFry for rh. F!po* ot
<br />l. a orE orilE FoF!). a.lBn.! codrriu snh fi(.En..drdo6ro ordEl llE r.!l.d (S( 704r. &6'K
<br />ard h!ftsion ( od.r Th.( onr.cror! Lic .I-aw &B n.r rpplyro oo*.nortroFnysho buildr or inpro!6 rh66..
<br />.nd wrh conrd! fs *h Fj.t1i *nh. Cond('lr) ltmt dp(l!dbrh.CodrF(3Liryhl)
<br />I m.r F un& S6!rn
<br />.MBKEAI-IAUIEXIATIA!lliclJSalla!
<br />I h66r amfln u.d6I'.mhr oap6jur- on. ofrh.lolhsd! d<ltrr'ions
<br />I hr\. ,i $ill minrnn . Cd'a.rr. ol ( .nwr ro s.lf'l ruc fo. * o,k6' .onrErds.. N Fovij.d tor iry S.nFn !70o . f rh.
<br />ldnr Code aor lhc pgtollffic o I lh. s! tor*nrhlhcpmn ! isNd.
<br />I h.y. .nd sill nin!8i. "ori6 comp.6.r ro. iBu6n.., a rdtuEd by Sd kJ. ]7m of rh. l,b.r (t'd.. ao. rh. FfomMc. .I
<br />ihc trort lor whth lhi Frn b eld My sdtd o,qEMir. iNrd. dir nn Flty n!f,b.r rc
<br />'*," {o^aucn f,,.l,plrf
<br />,.,.,,...,,,,,,* Ylco nNTg st'?-/J - zotY
<br />!.diryrhd '.rh.Flolrjm.of rh. *ort fM wh(hrh!Fnn 6 asu.d.I:hill mr a,l{,Ly !n! F$n rd) ndE
<br />$ a ro bdom $bjBl lo lh. rtrld'comFstlFn LB.tcdliromir. Md ure rnal if I Jruld b.<oft rut 6l lo llE
<br />{orld s,qElnnn Fovand of SrlFn 1700 of
<br />'h.
<br />trtsr Code I JDll, fontu nfi sndy *nh rho* F!v6io6
<br />WARNINC Fnl@ ro su. 10116' NmF!ri.. .ov6+c s unlAful. tud rh,ll$bjd o anlhrd ro oniml FDhE irl
<br />.ryil fi.6 up ro oF h!,xH rhou.rd doll6 (tlo0,u)o,, in rddnn. ro rh. cd ol.onF@tio.. d.rus6 6 F.\id.d for rh.
<br />sanon 1076 of rlE lrrr ( o&, ini6..r &! dhr* r
<br />o",,-/o-4- /?-
<br />apqrasAlra!
<br />I h6.t y .,Im und6 FqEhy o f paj!ry lhd I m Lca&d u.dn Forilinn of (-haBd 9 ((omn6ci.g wirh sar ion 7U0o) oa Dtr irion r
<br />of rh. BaiB !d PmaBioB Cod., d mt rr.@ a s tull rora d .lTct
<br />r i(.tr\.. r.n\ C- 3 7
<br />n r. /o - l(- @/+
<br />c()NsTtto(_rtoN I trrDlN(i a(;an('t
<br />I hfthy afiim unds Fullyof pfjurl rh.l l!@ n soldrudion tndin8 ud, lor rfi. pqfomNc olth.$orl hr snich li'n p6f,n ir
<br />'!scl (sa 10e7. ctr cl
<br />iiItLICA LDISJaALIO!
<br />I hdlq ,rm uBrd Fnrx v .f Fjw onc or rh. rdhs,ns dcLrrtrnr
<br />lron.l'rioh Pd e^rh<loi Norifi.ll$n lcd6.l Rc*uhn'ns (Tr1.40, P.n6)
<br />R.qur.rt Idrd oaNol'n.atirn
<br />I csliry rhd lh. Lddil rcBul.'ioB qrddin! 6b6bs rdno\rlrE nor imlicablc h lhir rrojdr
<br />I .diia) rhd I h.rr rdd rhi.io. a"d sr.r. lhd lh. atnrc nrfornra'ion ts.ordt I a-{.*lo.omdv snh ill ( iryand Counrr
<br />llhE Cr\..d Courr lo 6rs l'pon rh<
<br />hk ./O-Zb- Lot?
<br />onl'n.nr6 mJ Srar. Ijur rldr€ tl
<br />alxr. D.nr(,n.d pn,polv for i
<br />Applic.nr or As6t SIAnrl
<br />rldi.rr .oGrrudi,n. arl fi6.t4 ad IFru. rqr.ddn 6 o
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsu lation/Ene rgy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Mason ty
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Flood Zone Certif.
<br />/n\r/ar/rt ],].{Wl
<br />Certificate of Occupancy u \J
<br />Notes Remarks, Etc
<br />BUILDING. INSPECTOR RECORD
<br />I
<br />II
<br />I
<br />I
<br />I
<br />Il
<br />I
<br />II
<br />II
<br />I
<br />I
<br />I I
<br />Enqineer Final Report I
<br />FINAL
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