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BUILDING. INSPECTOR RECORD SITE-WORK DATE tD/stG.COMMENTS O\t NT:R BTJII-DER DDI.('ARATION I ha.t, .rm !i& F. yof Fjury rhd I b.roF ton rh. (-o.rd(m LK@kn lorlltdhri.!r6n(sdr01l5 Bnsinds dnd Profsn,n (od.) Any Cily or Couiny shi.h ..qun6 d p6nn to co nruc1, !hs. iFtrova &tnolish rr lFâ‚¬n M, slrucluc FiJ.lo irs rsuftq arro .cqun6 ln. {pl.ul L. su.h Fmn ro nh r s(dd srr@r thd lE or slE i licdE d Flru'l t h rh. IrotkioN of rlE Cortdtr ! Lra*d ljr (ChE ( 9, (infrtrinr s(h SdhI 7fir) of D'rilno 1 .ifi. t}!nd.nd Pmt *rn'B Cod.) or lh{r h. or 3tE i! dmfl rhd.fr.ft dth.hsieforlfiGdll.rcd.rdplon Anyvioldio.o{Sdion70!l5hy.ny rmlt,flaorrFnnlutdsrh.tpli.mrb!o!ilFMh!ofmru'Ethali\.hu.dtd&llrr(t500) L N o{F ollh. FolEny. or my mploy6 sirh *rs6 tri rh.it $lc comtElsdion. qilld) ll! troL ,'d lh. sul@ is Nl "rd'dd tr ofl6.d tu $k lsd 7ol,t. 86dB Md Pr.asFB Cod. 1n Codrlcr.rr I rce lr$ dG mr Tt t ro d 016 oI rh. pNrEN sh turl& or rsol6lhsoq ad *ln &E sh r.* h'm.lr or h*ll or lholsh hB or hE o$n mplo)6, provid.n rhd ! ch inFortl1dr E mr hrad.d M ofsd nr st lt tF*Bo, 'h. hrrlinx d ihFovmar t $kl silhin M. \s of.or?krbtr llE O$M B{iEa trnl h5\r rtE hrr,.n of Fo\inS th,lE,tr slk dil d tr l m aFtrt tlE tmFt} fin lt: FrFeof L d otrc of rlE FnFr!, m d.lu!tr.|y o rrllB u'lh licâ‚¬&d codrdod ro Fffi.l rlE rojcl ISE 7ou. BUtrB rri ftot ir ( od.: IIE Conlr&1or t Lic@ br &E .or lr'plt ro & own. of proFny q h{, bliltLr o. imPrel6 lb66n. .nd who.. d3lor locfi pr.j.ris*irfi ! Conrrrd.(r) lic.nsql pu6@l h rh. c.nt doir !,ic.M lrw) I m.1mrn !nJ6 Sdnrn ]la&$f,r-gDltENsaro! ltEcL6SAIp! I h(cbl. lmm und6 F!h) ol prjury ot of rlE folld$in8 .L.Lt rr.B I hiu. and will mai.hin a Cdnfic c oa ( .n$r ro S.lfi.surc f.r ( orkds comp<trral rcn, a F$vtd.rl lit bl S(hon l7(ro of lh. tr&tr (iic ln th. Fl(ruc oa llE f,orl for tr hih lh. Fnn i! sudl lharconds'ill marri,n *0116 .omn ffarion rNUh.... s tcq{r.d bys(lFn 17(nof'h.l-tboi(i'd.. forlhcpqromflnc.or thc rrrl tuufi{hrhnFn 6 Ls.d Mr" trortB' omFrcion 'nrurmc c!ri6 trt Flt} numlEr m l6irylhd o rh. Ffolrlle. oflh. rorl for shth rhi Fhi B &k{ I3h.ll not oploy uy Frn in..r" nME ar 6kr tEmft rubj.rr ro rh. yrld ftmFr6rrsn tNsofc.Lrom( ad +r$n,ll lrhutd t .oft sttd ro tlE worl6' smrosl rotr pmvaiN of Sdion I700 .f rh. Lh.r ( odc, I !h!ll. fontNilh .o$i'lt sirh rhos lmvisn'N \TARNINC l.i'ltrr. r. <ure (or16 rn sL@s. b unLuful. $d shlll $bj.{ e 6pL,E i6 oinin.l Fuhic sJ .nil find up h oE huftlr.d co, of comp.Exo.- dnm+6 B Fo\ ld.d for rh( sNritrr liij6., rhr I xrn' (.Je. dc'.:( 0 (0 1 DECrilAIlQ! I hd.by .rm unLr Futy of Frr' r- rhr I o l&,E d undd Fbr irfn of (n{{6 9 (coffi,ns { nh sdion 7000) of D^ Bbn l of rhc aBina od Pr{fBioB ( orL. ud hy licâ‚¬R n in finl forc. nd .fd ,'/z- q 7iliTn I H,y dtm undd Fnlhy o f Fjury $r rh6 b . codi!.ibn LndilB .sdy ror lh. F{die. ot ti. Mrt 6r qtkh lh! Fna . isu.d (Se. 1097. Cir C ). AfIIIqNLDECI.ASAIA! I hd*^' .fd unl6 Fdty of Fjuy or .l lh. f.ll.lin8 d(lii hnt rrimliion Pdnn!tutdG Norrlicrion ljcb.l R.suhrbtu (Tirl. {0. Pd6) R.!!nrd Lnrd oaNdifEdir l.d1'lvrl'xrrhel.,l.'rr.rrtrLirk,s'rrnr(ltrrri\lrs.s'cfr\ilr,.roirl't,'.rhlcn,rh,st)r,Nr E(oftd lisrc r, m!,nl\ nihill{ J.nd(d'nrlrire irtr6 flhtC r_snd(iuir!roorc trB)nrlt ,,t.,t,^hb trllul | ) I .d 'i! rhd I lE .r(d rhE qplk.rFn rd r.i. r hd tlE 'rnr. 'rlotu h. dtr ca qd sbr.r.u Eld rns r. buldmr.wtrud nn. dd hE.br .u'hor /. rt!,c ".rK\f pdr ro. "6+ap!@r<--l rppncrnr or a/ailtsnrrum"-'--"5( k N7''7e" Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Subf loor/VenVlnsulation Roof Sheathing Shear Wall Framing tl"517 ks24 t(,. lnsulation/Energy Drywall tz-7-t7 I Ext./lnt. Lath Brown Coat Masonry Pool Fence T-Bar lz-7-l-7 !r4l Handicap Req Deputy Final Report Engineer Final Report Flood Zone Certif FINAL l-t6-t( Certificate of Occupancy Notes, Remarks, Etc I l" t-/ I //\\')ry