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BUILDING. INSPECTOR RECORD <br />SITE-WORK DATE ID/SIG.COMMENTS OWNl:R BUILDER DETI'ARATloN <br />Ihs.t\lrtrnurdFully,rfFju.yrhdIm.r.nF&!nrh.(onlr&loul.t.El.qtulh.rolL*i,slaJn(Sd?0rI5 <br />a$'n6r dn Enl<b. cd., A.r" cny .. Coudt shkh ratun6 ! Fnn lo codruct. .ts. idFolq &tmlih or redr m! <br />shdu.. Ftu ir r isu c.. il$ r.qrr6 rh. qdad for such FEr lo ,iL ! 18..d srddmr $, h. or rh. k licoEd ruNUn <br />rd rh. Fovi.ioN otrh. cont..knt Li.. .d ljw ((-hrUd 9, (on,D.ncin! $ h s.clion 7ur0 oaDivhio.I olrhc 8sin6s .nd <br />PmfdioN Co&) orrhll lE or slE 6 crmpt lhdcfrom o.d th. bcln lor th. alkr.n.ranpr'oi Ant lioldiooofsal[n 70:l I 5 bym] <br />@plicet tu ! p.n r subjclr th. tppliclnl lo t o\ il Fuh, of Nr mE lhd ft. hoftlral &lla (15001 <br />I, 6 oun- of rh. ,,oFny, or nr, .mploF6 s h e0sd s rh.ir e,l. comp.root Fn. { ill d.r rh. uoilxl rh. 3tfld u. E nol <br />iddrldi or 0lT6.r! lM $L (S( 7o4.r. BuioN ed t'rol6irN C,rL l h. c.nkki..s Licru lj*' do6 ndr !ppl) h d o*fr ol <br />rh. FlId, slr)h l3 m i,r'aFE rlE6r rn ub dE un s!* fimklror lr'*lf or rhtuah his or lE otrr od(')6, <br />Fovddl rh such mF.\tu! !. m( ddrtal or olT.d ror $k rl l$tr6a, rlE hilrqg or inqu\tld B $tl\ ihi. oE ]6 <br />ofcomDlcl krn. lhc Gvn6 Builds wnl hlvc lh. hda or I'urrs rhi hc or lhc dd nor build or nqm\r lhc Flr,oly fot lh. FnF,* or <br />L E oue of rh. rroFry. m .rckn.lt codrd ins $ h liccrkd codrdoG lo codrucl rL pmF (sa 7or-r. BG!6 <br />a [\.Eshn cod. I h. Contrcktr 5 Licosc l-aq' doB nor apply k, M ownd ol p.opdy $ fio blilds ot mpmvd rhdq'n. <br />and trho conl'rtl for such Fojdr *nh, contad.( s) lt6Et{ ouRwl to rnc ( ontrxroi. Li.@ Ir*) <br />Io.ropl u s sdi,. <br />Drt. (hner: <br />laariE85:grufi:lsalro!uigllarar <br />I hr.b).m.m undd ,..alrr .f Fjlrr onc .a <br />'hc <br />lolL\l.t8 d(lsrlotr\ <br />I h.\. !d sill <br />'E6lain a Cdrf{.r. of Cdnsr h s.lal@.1o. $1trlc onF6dion. N rrolil.d aor by s<ton uoo of !h. <br />t hr ( ode td rlE Ffffi. of lh. urnl ror n'irh rh. FEn ir *!a! <br />, hav. and srll mr'nrai6 $0116 co,np.Barbn insurrnc.. s r.qtrrcd by Ssr it)n 3700 of rh. lrt$ (ixl., for rh. pdLmanc. .l <br />rh. *uk for whrh lhb pdmn ir Kd My trorlsi (omp.$dion nrurN. luF t*l F1l(t numb.r . <br />I catiry rh.r <br />'n <br />rlE Ffotrl@C ottlr *.rr for $h(h rhar Fm n M.d, I J l mr dFhy u! pqen m dl nmF <br />s B ro hcoDc aulrd lo rlE $$ 6'onFgnion l.e! ofcdifomn. ind ts6 lhlr ifl th.uld beom. sqd ro lh. <br />trort@'conFsrio.provirirEofS.dionlT00ohficltborCodc,l!6ll.fonhsnhcomplrwilhlhoeriotisioB <br />wAlNlNC: F.il,e ro $@ $rkd .omladion $r.6r. i! sL*tuL .,rl ddlsubrn d o,lphln ro dmml FEni! ed <br />cnrl nnd up ro oc hund!, rhounld dollB (tlm. xrl i. xldnion to lh. cd orconF6.rior <l,,ue6 a Fo\d.d for rlE <br />s(1on 1076 ofrh.t h.r cod.. inrqtg ud drorEy rf6 <br />ulrMqcqllaAcrua <br />u,lclAf,alla! <br />I tdby amm!nd6 psEltyolFJuryrh6t I m l,coE d u.dd Fnvirion of( hapt6 0 (conmdc,ns with Sdln.7qx)) ofDilkkt l <br />of rh. Irsind dd ar.fd$B ( odc, sd Fy IEN 6 r rull to,c. !n .ftdl <br />(a!flaucrl(lNrt;lllldc]cl;Ncl <br />I hsrby .ftm un& FElly o t F)ury lhd rhd. ! t .odtud.n Lnduu .eftt f.t rh. Ff.,lrl8. ol rh. rlrk for { hih $n IEni s <br />is.d (tia loe?. (-iv C ) <br />AIITICANLIIICI.A8AIIg! <br />t hdlby.JIm unds pdrlry of pdJury on. olrlE folbwin* d(lmri,nr: <br />l).mki,n P.mn$&bd$ Nonfic.lioa F.dal R.subl{G(Tnl.40, Pd6) <br />R.qur.d t!16 of Nolifrcdi'n <br />I c6 rE $d rlE t dqrl Esuld ioB G*&dins atdor romr al r. m{ <pl(!bL b rh6 l,sl.d <br />Icc1'lyth l na.rodrhis r ,lr.rion 'nl $ar.rhd rh.ibv. inn{in ion irrotrd.l r*ran'(omplyrv hall( ir}.6d('oonr) <br />od,mnc6 md Sr.rc,iws r.brins u hrildins .oNrtud ion. dnd hdcby durlnniz. rq,Mtaln6 orrhE Cily$! ( ounry kr drd uF)n rh. <br />r. nHlon d pop.nt for iBlErnro prrp(c <br />Yppli.rnl or asml slsn.lure \ <br />"p"-r,--..rpa"r, -f#;'N+{ N6 uzEN X" ot/ra,4e <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />SLAB Floor <br />Subf loor/VenUlnsulation <br />Roof Sheathino <br />Shear Wall <br />Framing <br />lns u lation/Energ 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 />/'t\ <br />FINAL Lf-l7.lk v-L.il1 <br />Certificate of Occupancy l_/ <br />Notes, Remarks, Etc <br />U FER Ground <br />I <br />I <br />I <br />I <br />I <br />I <br />I I <br />I <br />I <br />I