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BUILDING. INSPECTOR RECORD <br />SITE.WORK COMMENTS OWNER BUILDER DELCAR TloN <br />I nd.by ,lfm undd Fn.lrt of Frury rhd I m .rmF &.n rh. Co ,xloE l r@ lr$ lo, rlt lolk'$in8 lts. (sd r0ll 5 <br />86in6s dd Proadion Codc) Any Ciry or Coudy whrh r.qutB r p<mir lo .odod, ah6. improv.. &nolirh or rq{n dy <br />xru.1@. F;r ro i! i!sim.. .ka Equr6 th. +pli.si ao. $.h Fmn tu 6L r s[.€d irtur lhn li or lrr a n ded pursd <br />!o rhc FovisioN of tlE ( onlEctor's l-!cos.d b\! (Cnry( s. Com6.ms r h Sdrio. ?000 of Di!L!io. I ol lh. Bu,r6i dd <br />Pofdndnr Co&) or rhd h. or rh. ir .rmd rn cfr.m r"d rlE t .b for lh. .lks.d .rdplion. A.y v hhlion oasdlio. 70i I 5 t y any <br />.Fpli(d for aFmn subdr tlE 4?lk..l io.orrlF t)ofml mElhd 6\. hu.&.d &llas(r50o) <br />t. s olE of rl! FrIrdly, o. 6y nngloyG r'in $rs6 6 rhci. $k comFsdhn. $iI & tlE uqt td dE rndG i! ht <br />'nrodcl n ofi6.d f6r eL {Se 704,1. Blrils o.l EolshN Co& Tlr (trnr.clois Li.c t* tl'€ d Fh h e ouF or <br />!h. pmtEty who tlilt or impmv6 thd6n, ed * th dc rRh ElI hiB.lf or h*lf or lnFugh hii or hd om .oPlott6. <br />prorilai lhd ru(h inp.orffi e d nqd.d or otuld tff tl. lt ho@. tlE boildiB ltF&ttE i rld vihin 6m 6 <br />ofs!9hi.tr r(xc Rildd uil lE!.fi.hddr ofFrsrB ! lEm CE dil mr tlitic !rs!E dr FiFry frrill tltpo*of <br />l. 6 o$E nf rhc !ron6ly. n cr.lctr.ly colr.&ln* snh lic6B.d codr&!.R '. slfrd rE proF (S( 7Ot1, BUtr6 <br />6,11 Pn)t3ion Co& -I h. comr..ror'3 l-i..n* l-r* do6 mr rpply ro e oun6 o f propqiy sho buildr or ihprov6 lh6on. <br />sd $ho (odrrl] td lwn p..F(! r'ith. Conrno(!) laoel F4un ro th. ( o rdd'iLtct,f,) <br />lor cr.mpl urddSdion <br />jtof,{tt8(oMPiNsArlo! <br />OECIJIAI]A! <br />I lEcbr lmm uda Fdry of Fjury o( of rh. t!\llo*Ds ',..hr!rFB: <br />. I h!r. rd s'U dnlr'n ! cdrifr.tc of colq! ro sdr.lEe for emls orpdsdnr d Flridd lor qL sdi.n 1700 of rlE <br />ljtn Codc tm lh. Ffm of lh. *orl tor rt,ch lh. Fin i isu.d <br />I hr..n<l *'ill tuinr.'n *0116' .onqEsioi ilMci c Gqlt d bt ki,n !7m oldE t b.r Co&. for lt FfM. of <br />rh. N.t h{ f,hth rhi! Fdn i! iq.d My *ort6' 6nl,.r!iion rM. .ris rd polt, nmb.r a <br />c--'N6rL/u"r'l L(r( <br />', <br />^* "**-; wD7<- 6z pu-, :, 4 b 17 V <br />_l c.nift !h!r <br />'n thc Ff6,l1e. of lh. wort t. whkh !h! Fmn ir isu.4l shlll nol6gloyey Fe. in yne.6 <br />r Btob..omsbidrorh.w 6 $dp.tEdion Lsr otcditodi.. .nd lsE rhd ial lhuld bdom $bjcl lo tlE <br />st*d' or4aurion Foviio6 olserm 1700.lrh. t E, code I tdL fdhqnh otrph *'nh rhr F!\iii,6 <br />WARNIN(; Farlu.. ro sE \nnk6 (ompcosnn co\mBc n ddoF ro aiminrl FEhE ..d <br />ion, &naaB 6 prorid.d t r rh.civil fin6 up n' on€ hu.d.d lhrurnd.lollc <br />scrhn 10?6 0l rh( Lrhn co<!. nl6.r uxr <br />I h6.ny.rm und6 p@hv of Fjury lhd I e licd!.d lnda FovBior of( luptd'r (commo.i.8 *rh S.(lion 7000) rfOivsi.n ! <br />ol lh. t!$inB md nn.6si,B C.d.. nd my lr.E i! ii flll lorc !d cfidl <br />,_*,.*_ ,tr <br />-,.r+lTTlt?^}{,--,L/ ' <br />,67# P <br />loltlalJclloN.LllDrNc.dcEd(aIndiryrfmu.&rFdt!ofIEurythtllErbrord.tb.l.n!{.sdyrorrrEFfreofrlEr.rttutrtrrhltuFnn. <br />ilrucd (S<. 1097. civ ( ) <br />knd6i Nm. <br />APPLI('ANT DECLAITA ION <br />I hdd1v llfm un&r p6nhy of Fjury oE of th. aollorinB d.rl,.l ions: <br />l).nolitnn PEInr Arbdd Norin.rtin t.d6,l R.ruh!6tu(Tnka0, Pd6) <br />R<rruirsl lard of Noriftdnn <br />I co1'ryrhll rn.Id(al Esuht.d r.!*dinN dhGror rdovale. hor apr,licablc ro <br />'hi! <br />projd <br />I coi,t) thri I hr\ . ,.!d rhir .rplraiio. lld drt. thd rh. &o\. infotuhn t coEd I .gre lo anpl) r (h lll CiU md Counrt <br />odrnrncF a.d Slal. La$s Ghlin8 rurh.n,. Bpr.sbrivd frhis Cny Dd ( ou.rylo dr6 ursnrh. <br />.th\. Mrirn d FoF!! tor <br />Alpli.rnr or7ti.nrSiqnrhire <br />e^t.*". ,Oa^rl' / <br />,..lefuilD <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />Subf loor/VenVl nsulation <br />Roof Sheathinq <br />Shear Wall <br />Framing l-16-lc k.\414 <br />lnsulation/Energy <br />Drpvall l-t6 -tg.Y-p/ril <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 />/^\ <br />FINAL t-tq-w v.w.1t) <br />Certificate of Occu anc <br />Notes, Remarks, Etc. <br />I DATE I ID/SIG. <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />-,.. ^1"u2//7