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BUILOING. INSPECTOR RECORD
<br />SITE-WORK DATE COMMENTS OWNER'IJILDER DELCARATION
<br />I h6.by amrd !.dd l,.oh, ofp6jury rhd I e smF fi!6 th. ( ontru.loro' Lrc.nr hw tor rh. rollowra r@n (Sd.7of] 51
<br />aBin4 &d Profdhn aod.)i Ary City or Cody wl'ih r.qun6 r Fni 'o
<br />@Ilrruci. .!6. itrtFolc &,blirh ot E .r Dy
<br />lor.tE Fu lo tu i!.lre. rbo r.quic rlt edier lor st Fmi 'o
<br />6L . .t..d drdEr d'r h. or dr a liued lir'fu
<br />ro rlE Flrilios of r Conrr*ld r Lrc.it d L.e (Cl'.F6 9. Coffiitrs wnh S<io. 70(lo oa Diriri,r ] of E &!iB ad
<br />Prcf*nrd Cod.) or thll lE or 3hc s qcnB rhq.tom ed dr bc6 tor ttE dl.gcd q@Fion. Any tiolllion of Sd ion 701 1.5 by .ny
<br />rrplicd lor . pdnir subjcl3 lh. applicot ro ! civil Fuhy of nor morc ltur 6v. hun&.d dolle (3500).
<br />_1. s 0$6 ofrh. FFrt. or E, dnpL,)6 *nh *.g6 s fi.ir bl. omFaiDn. sill do dr *d !d l,t inaiE k ml
<br />ida'&l or ofisld lo rl. (Sa 7ort. oltilE ed PhrgioN Co<b TIE coddd t Li.e L.v &d mt 99lr lo e o*G o,
<br />rn pmFly *ho $il&or uDrov6tlEon, sn wh dE ru.iw nnelfo, hdltor ltruBn h'.6r ha oM.nphyG,
<br />Foviit d rhd $.h ihFor€El! e mt htftLd d ordld fi,r sl. lt h.wM.llE tlilnu or uII'mrEEl n $B *irhin on. tat
<br />ofolPlc.tr dE Oqs tl,!a *iI hAr dE h,d(n ol FnaB dr lE m dE dn d hild $ itr+.ot! 0E FlFry nrr d. F,p.s ol
<br />_1, sown6of rh. Fnpqry, m.r.l6iv.l, conrEring sith licm.d co.t..toE ro ol!ru( trE l'.j6r (s<. ?o44, uEins
<br />&d Eohtr aod. Th. coitldoa ! l-ic.dc Lrw &'6 nol lpply ro o omd o aproFiy who huildr or inpmvE lhqon.
<br />.nd trh. sdffia Dch F!ir! *ith r CorrElo(t) ltoE d FBurr rotlrcco r.dd r Lkaerr*)
<br />_l m .r.nfl undd Sd*",2-l'lq
<br />DES SAIP!
<br />I hd.tr rllm un(k !d3lt, olFjurt 6n. of $. lolLsnle d<h.!sB:
<br />I h!r. {n rill mint.in r Califrll. of Consr ro s.lf'l6ur. ttr *u l6J onlP.nslion, s FrviLd aor by Sction 3700 o f lh.
<br />l.b Code aor rh. FlolrMa of
<br />'h.
<br />\.rt fs *ntt rh. FDn ir isud
<br />-l hlrc .nd * itl n.inr.'n *dl6 ..nFB.rion i6!r!ft.. 6 r.quir.it t, ser io. i70o olrlE lrtN Co& for lh. pqfdlj@. of
<br />th. sort t). *hich lha pan i! isal My mi(dr omF8dion ierlN cric !d polk, nuDbd a.:
<br />Policy NuBba:-Erpn6
<br />-l.difyrhlr
<br />inlhe p6iomuc.of fi. worl lor shi.hrhi! Fnn ir isu€d.I .U not 6nphy lny F&n o My mnnd
<br />s a lo b.om ruB lo lh. wlt6 onFEcion Ltrr of Cdifodq !d rsft rhr ill .nouE b.com suuFl to lrE
<br />*uI6' .lmpdEarion FltiioB orSdi'n 1700 orrh. khr Co<h. Lrll, fdbwnh omplr {nh rhx ForBioE
<br />IiARI\IN(; l.a'luE t, s. u. so.L6 .ompaMi.n .o\d!.ir rnhrtul. dd !h!ll slbjrn d drkrld io <mnl pdtrhH,xl
<br />c'v,l fidd trt h on. hundrcJ rhoo$nd Jollffi (llOtr.(rx)|. in additn)n d.nEld a lrorid.n for th.
<br />sdtio.10?6 !f rh. ljMr ( G]c inr66r Md lnorn y r 16
<br />DECIjIAIIII!
<br />I h@by rllm und6 p.ulry o a pajury thd I o licasl undd Fovttun ol chq,ls 9 (comd inB silh s.dbn 70(U) oa Divnn'n l
<br />of th. tlulB atd PDleioB C.<L, dd mt ltaE ! ( tull loc al.lId.
<br />LicceNunbdl
<br />colilallllalJ.Ellac.Ac[ll:r
<br />I h6€by.num und6 p.nrltyolp.rjuryrhd rha. n !.onrtu.lion h.din! aSacy tu th.Flomuc. oflh. wo tu $hithlhi! Fmh i!
<br />isu.d (sd l097.cn c )
<br />t,..dd ! Adtts: _
<br />atPr rc{lllDE(a ^rur!(lNIhd*,lrmun&rF.I,of F {rr om ol rlE folb* iry dELrd bro
<br />D.nohion PmieAibaroi Notifi.aiion F.d6d R.suldioB (Till€10, Pr16)
<br />R.q!n.n ldrd of Nouftr ion
<br />-l
<br />cd rry rhi tlE l.&r!l ..sultd66 Gsadi.s dt .ro! @r.l &. .d t?li<.bL 'o
<br />rnn pmi.a1
<br />-l
<br />cdily rhar I hav.6d rhi! rpplic.l[n !d stsr. rhd ihl.hL. inlunMnn s con.d I olre lo s,nnly $'irh dl ('i I md aounty
<br />,rJjle6 &rj srirc b*r r.bnB ro hl,ldh!.odrrgnn rlhdd,q,llnMrcp6d'ldtr6oIrhncn)&d('ounDioarcuP.nlttil:-::il.:"T*JrU.il',2, ..,. 2-:1'th
<br />pmi*n,o.,pr,r,r lll4-k J4,t a317, n7
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />Subf loor/VenVlnsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framing
<br />ln sulation/E nerg y
<br />D rylva ll
<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 />F|NAL 1L{//f F/A/E
<br />Certificate' df Occupancy
<br />Notes , Remarks, Etc.t- h^l -,, A n
<br />L
<br />s e
<br />tD/srG.
<br />UFER Ground
<br />SLAB Floor
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