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BUILDING- INSPECTOR RECORD SITE.WORK DATE ID/SIG.COMMENTS OTA''T f,R B! IT-DF,I Df,I'ARATION I hdarq lnm und6 Fdty ol rEjur! rhd I @ qnnfl lNm !n. ( ofr-ro6' l.k.M b* f.r rh. followin8 rNn (sc?oll 5 Busind rrd Profdion (-od.) Any Cnr or (ounty *hkh r.!un6 . p6mi' lo $nnrud. !116, inpmvc. d.rnolsh or rqBr uy strudu.. Fhr to ns isuucc. !b. r.{!nB rh. qplral for luch Fflit to 6L ! r'tocd ndffir rhd h. or sh. i! licdr.n tuRurd lo rhr Frrnio6 of tlr Co.tf,lor3 Li.mrd lrs (Ch.$6 9. comdn* $nh sdion 7000 ol l)ririon I of tlE Bulin* dd Pmf*hnr ( dL)or'h{ lEorJE ir d.mt, rlE.tom md rh. tBi! fo. th..lLr.d.rdFFn AnyliolnFnots6lFnT0ll 5btn} !p?lic..l lor r pcmt subdti rh. .lplicui to ! ci\ il D@hy o I frn m.. rhr li\ . hu.dcd dolle! (1t00) l. N own6 of th. pmFny, or ny mplo)6 wilh w.a6 d lh.ir Flâ‚¬ omFnsll io.. will (h lh. rst Erj rrE lu(IB ir n.r i dd.d or ordcd tor slc (s6 7044, Buins ed PEiisri,B ( o& TL Coinrcror'. l-i..@ l* rhâ‚¬ ml +ply to .n os.6 of llE FDFry $ tn trild..r n{mr6 tlE6tr .n $h dG sh Nd nielf n lE*|t.. th.ou3h hi! or lF om dDh!6. Foyi,.d rh,r *h lrrylrlca ft hr dqi.d dotuld f{' rlc lr. lbrnE irE t!'LlnB o. in!..ttffi u $B trih! w \@ of.mpl.e rlEO"E B{ilb f,ill fi.ElEh,ddr ofFrrrq lr LM{Ednml hnld o. irproE ltt FoFtv 5r r F,FEol l. a oun6 of th. Flpal y, m .rcluirrly contr.ciiq with licd.d conrracloE lo conirucl rh. For.Tl (s< ?o!1. 8G'.{ J'd Piolss coi.: Th. contdor's Li.dk l-.w d.6 mr r{?l} io d ow.6 oarrordy sho b{ilds o. inp.ov6 rhson. Dd rto snr,*rr fr tu(h F.j.tli rnh . Co,nr&ro(, ltqE d Fletr ro rlE coedd'3 La.a tr$ I I am.r.n,:, udq S(r(r Drt.: Orr.. lvoRKr:Rs, ('onlPt]NsaTtoit D}IIJIAIIQ! I hq*! imrm und.r F$h' ofrqjlq on..lrh.ldhtrs3 rkhrritB I hlvc dn r rll minr.in r (-d iliclt. o t (-otrEr to S.la-lME fitr $ 0116 comFlâ‚¬mn. 6 rxo\ id.d tu ur\ S<h 1700 of rh. I$.r ( .. nr rh. poloilMN of th. *o f.r *hi.n rh. Ffri ii isu.d. , h.!. .nd sill m.inr.r sort6 conFsrhn rBunftc, s Equn.d by Scl i.n r 700 oa lk ljhn ( o&. for rh. Fn,mtm. of ilE trvl n! $nrh rhi! Fmn . sel My $nl6 ompqdirn rMe cm rd poltr-' runbct G PolicyNumhs I cqiiay lh.r in lh. pqfolmm. of lh. *ort ror *trhlhis Fnn E s.d I rhtll @r dplo] ey p.r$n in tn' mME s ab tt oft stitr ro llE *sr6 smFMb. l,*! orc.hfomq ald +E thd ilI iLuH b.(.ft rub.n lo llE ".rt6' comFsrir. F.vns6 .asdi.n r?00 .lrh. llthr ( od.. I JEll. fodh{ nh onplt $ nh rhor F!!i!KB WARNINC fliluE to ku. *0116 com!.Mn'n cor6.sc ir unhu'tuL and $!ll llhj1tl o otlnld r. simiMl Fu!6 dd ctril lind up ro orc hundr.d th.@nd doll6 (ll00,OO0). iI iddirion to rh. c6r ol.onp.Mrio.. d.ma86 e povid.d lu th. ( (d.. inr-6r Md drrrEljr fG 70 7 DECIJSAIq! I ha.l,y amrm und6 Fnrhy orFjurylhn I d licd!.d und6 Ftrrnio. drch!flcr) (cohng.ins *ilh Sdion 7000) ollr\nion l ol lhc liusins &d PrcfBn'N Cod.. ad my lic.N is in tull lrtr(. d.Ed b 120t1 1 a trl20 calllauq.&!.rlaDM.Ac[Ntr I Ht.rm o,xLr Fuht of Frrurr rn rh@ t. odrudbi Lrdiry.sdy for rlE p6f6tl]e. of rh. rorI ft'r $5ih rhi pdrtri i! i*u.d {se 1m7, Cir C, AITLICAIiLDICTJ8AI,Ia! , hddt nrm und6 porh ) oa Fjo, r. on. ol rh. f.lh* ms &(lad sns D.mlirion Psnits-Ast6lor Nolifir.rior !-.d6rl R.3ulalions (Tirl. 10. Pan6) Rcquir.d l!16 oal'lotifi ( b. I cd'ry lhd rh. f.dd.l rcrulatbN Esrdins abdros 60\rle. d +dohk h rni! Foi< I cd ily r hd I h.v. rad rhir rt rlicllion dd 3.r. rhd lh. .tn\. 'n nimdion is cotrd I aBre lo complr $'ilh all Cily ,nd (-,n'.r) ordin.n.6 and srd. tjss ahtnr b buildint.onsrDdion.hd.tf irhoriz r.rnMr.l'v6 oIlhis (ity dd (-.u.ryt, drd rsnrh. .thy. mdrk,n!n pop.nr. ror inipalion rpp[(rrr or rrdl sturtrr. . PmlrN n.h. ( pnnrt: N tlwlzrtn Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Roof Sheathinq Shear Wall Frami ng lns u lation/Energ y Drywa ll Ext./lnt. Lath lt/asonry Pool Fence T-Bar Handica p Req. Deputy Final Report Engineer Final Report Flood Zone Certif FINAL L1 'l'r t.Ya-,rrlr t! Certificate of Occu pancy Notes Remarks, Etc Subf loor/VenVlnsulation I Brown Coat I