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BUILDING- INSPECTOR RECORD
<br />COMMEI{TSSITE.WORK DATE ID/SIG.OWNDR BUII,DF,R DEI-CARATION
<br />I hcrc$y .tuh utut.r ,.nalry ('' pcrjuly rhar I m.rcnlJ)r linn rh. Conhcl,m l,i.n\c ll* lnr rhc l,nbqiry rc.n,n (Se 70ll 5
<br />8urtr.\s rd PiolcssDn Colc): Any C y or County *hEh tcquns a pcmir t) cunnrucr, alr.. impovc. d.nnrEh .r nn!tr dy
<br />rsurnr, rho rcqutrcr ll* apnli.ant,or sucht rmir h lilc a (i8Nd sr.l.mnt rhar hcor sh. n [.en*,.j rursuanr 'h rhc nnrvrons of th. C.ntracttr\ l,ictnscJ tiw (ahErcr 9, Commcn(in3 *irh S.critr 7m0 of Drvision I of rh. Btrrims rnd
<br />Prrc$ionscl c)orihrrhc.rth. N c\cnr lhcrcirum inl lhc $!ns l,rrh.,lkC.d cx.mflr'n. Any v!'lf,ts'nors..lNn ?0115 hvrnv
<br />appl'unr tur r p(rhn \uhjcch rhc rppliranr b a c*,l Fn.hy ot ton nuc rhatr iivc hu*lrcd dours (t500)
<br />Lisowner.lrhc0nl[xny.ormycmPbycesNirhwasc\rlrhcr{'lc.!,n'lrn\Jrr{rtrrll,l rh.!nrlJxlrh.r{tururci\nor
<br />mrc,rlctlorollcrcJk*..L(Sr..7044,Businc$anJPnn$v,,n\a,dclh.t,{r,trsl-trcn{LduJnc(nrril,lyL,rnown.rol
<br />rh. F,IEny wk) hu J\ or in{ov6 rlf,Nnr, df,t !lr) df,s su.h u)rl hm\clf or h.flcli.r rhnn'8h his or hs own .nrpl.yccs.
<br />O ovrlc r lur su.h iNp!)k'Enh m kn inrdr.l-l .r oltcrcJ lttr s,h lr. k,wc!cr, r1r luLtm3 .r mqx)vc'rm is $rl q h'n .nc vcr
<br />dl .o phrDn. rlrc OwFr Buillcr w l h!!. rh h&lctr ol Phvll! rld hc or sltr Jr] rn hu l (x h{'nlvc rhc P!,rcny tu ft. !n4i}t ol
<br />l. !\owncrolrh.!.,r!.ny. dnc\clunvcly..nr.rcrn! wrh h..nsc!i rotrrfi8 n) .onnrud rhc Pn'rccr (Scc 7044,lltrnncs
<br />r'rl t\r,.s*rCoJ.'Ih.Conllrntr'!L'ccni.LlwJocs.ordpnlyl.anowncr.lFoa.nywhoh!rldsorrmProvcsrh.rco,r,
<br />,nl wh. (onn r(r\ lnr \u.h roi(B wfh ! Conrn.t,(\) l'.cnscJ lJu^umr b rh. Cd.rri.nr's I rcn\c ljq )
<br />I urcx.nrrrun,lcr Sc.ron- .lr & PC ntrrhA rcr\{r
<br />tt(rRl(0I{s c()l\tPF:NsA 11(J\
<br />u;!]lr!!drsr
<br />,rnrlrr_ 'n Brl'ry.n. ol rM l,,ll,)$tr,! J.rlxrxr!$\i
<br />,I. aJrl w l tuinrxr d Ccn rltlrc ol Con\cnr L) S.lf In\urc ld workcF .onr.nsdon. a\ Ft,vidcd for bySccrion.1700 ofrhc
<br />rtltr C,rlc, f{tr rhc lIdnrmrc.,,l lhc Botk rd whi.h rhc pclmir is i\\u.J.
<br />-l
<br />hn\t dd wrll Nlhlain *orkcr\ ronf.ns.Lon rn{n
<br />r tr\u.tl Mt workd\ q)
<br />,,.,., SL/- tr-41
<br />rtrec. is rcqurc,l hyScrLdn rTu)ol thc trhor CoJ.. nt rhc ll.rinmutur o,
<br />mFnr(n)n inurn..fffidd lolry numh.r rc:
<br />?o3o 1.3i--.,n *, //- /- zo10
<br />, "'rr inrh. frf,trmrkc.l lhcwork n, wh'rhrhtrtcflnn s is{rcd.l shrllnor cngh'y rny !.n n in rnymdicr
<br />, -.oB....m. subjccr trr rhc u,rr.n comp(n..!on kwsofcllilbmir. anl apto.lhal l lh.ull hcoR {hJ.ct loltr
<br />woltcs, comFn\.1i()n pn)vFion\ ot Scerion 1?00 dI thc L.htr C{rlc- I \hf,ll turlhwrh conll]ly w irh rtu,{ pn,vl\i]ns
<br />WARNINC [r'lur" n' a.h snrkcr !',mncn rl,n ytrctu!. i\ unlrwtul. and \hrll subJccr o cmpLycr lo sinmi Fmlrrs aid
<br />.trrr xncs up h, ,,n. hnnJrcJ rh,'uq ,lqll,r (!lrOJxOr. in r,ld idr k' lhc cod ol.omr.n:nr'on, dm3cs a\ Piovrl&l tar rlr
<br />S..ton ll)76 ol ih.l-rlirci{c, i crc( rnJ. ormy { f.c\
<br /><ozo
<br />I UCENSEIII9NIEdCI9E
<br />IIECIASAIIO!
<br />I herciya(lim unlcr FnahyorFrjury lhdr , am lEcnrrl \Q'ls nn'vtru, orChaflcre lcomEncins wnh sccr6.7000) orDivr$oi l
<br />or rh. Rtr{m(\r'rl Pnn.str,ni CoJ..,rl nrvli.cns F r lill lorucelcln(r
<br />cJ9 3Yf 2-6r
<br />o,r" A^1 13, 2ot-o coirhcr.
<br />glal'rxleurL!l!!]!!!-1!il]rL
<br />Ih.r.hyrlrtr'nun'lrrFtrrlrt',1F_rlryrl,.(rhcr/ri. Nn.l(,nhn,tt$rlcncylnrrhcpcrli,rnBn(. I rhc w.rk lnrrhrhrht\F n n
<br />r\nk\l (Scc .!097, Civ. (.).
<br />txnl.rs A.ldr.(s: _
<br />AIIIICANLDECLIaAII9B
<br />I Mry alim trn'lcr p.naliy oi Pctjury onc of rhc n'llo*ins 'lehrar('n\
<br />D.nxnnnn PermillAsh.stx Notli(.Lrn Ftdcral Regulirons I l rr1. 41). Pad6)
<br />Rcquirc,.l Lcxcr ol Notarcdiir
<br />I.cnifyrlui rhc lcJrrrlrcIllit$tr! rclrknn! r\hno\(nnivala't iot rtd(ihlc hrh,\In)J.cr
<br />l.cn yrhrilhracBidrhr\lnplHr(rr {Icd[rrlrth)vcrrl,rn]rrontrro'rccr Ia!t(lo.rmply* hallC van(lCountv
<br />.nlmursMdSrr(ct ws rclrring b hu,U 'n! .onslrucron. dn lrrchy rurhtruc rctr.\cihxrcs,r rh$ C t rftl C.unlv to cnrcr uIir rtr
<br />t v. nrtrrk!\al pr+*n! l(tr \f,.rr!l
<br />Appliunl or AElnl siAn$l'rft a 1L
<br />s^,/J , 2oto
<br />Sel Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />SLrbf loor/VenVl nsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framino
<br />lnsu lation/Enerqy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Ivlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif
<br />FINAL /-22- 2D DeH/o,
<br />Certilicate of Occupancy
<br />Notes, Remarks, Etc
<br />D.r.
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