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BUILDING. INSPECTOR RECORD <br />SITE-WORK DATE to/srG.COMMENTS <br />Set Backs <br />Erection Pads <br />SLAB Floor <br />Subfloor/VenUl nsulation <br />trttur,rxcRoof Sheathinq ub/ l*/ fi^r- <br />Shear Wall <br />Framing <br />lnsulalion/Energy <br />Drywall <br />Ext./lnt. Lath <br />Brown Coat <br />Masonry <br />Pool Fence <br />Handicap Req <br />Deputy Final Report <br />Engineer Final Report <br />FINAL (/a /84 ryttutu-l0a,/ <br />Certificate of Occupancy <br />Notes, Remarks, Elc. <br />OWNET BUILDEX DELCARATTON <br />I hd.by.ltm und6 Fdy ol Fiuiy th! I d .rmF liln rlE Cqfi.crm- Licru tre for th. followds lajn (Sa 7011.5 <br />BBin6s dd Prot*io. CdL) 4., Cny or Cou y which r.qun6 a pann to cotrnrucl. dts. idrtovc. ddnolnh or EFn uv <br />rrucru.. Fi,. to ir. istra .lo E+i6 th. +plE{n tor kh tE n ro 6L r lrst d nddGtr rhr h. or Jr it lkdcd Fr&d <br />ro rlE F virioN of [r Co.lr&lori Li@.!.d t w (Cn!fl6 9, Comftrg vhh Sdion 7000 of Dirnbn ! of lh. &silB Dd <br />PmfBioN Cod.) or rh.r lE or ,lE i! d@P thdtfi.m .d rh. b.!ir tor llE dlkscd qoBiotr A.y vioLts. olsdion 701 L5 bv av <br />rrr,icsd for . Fni ebFr rlE .pplicul lo r civil po.ly of @r mE rhr livc hu.dt d & 16 { Itm} <br />l. s o*G otrlE FoFrr. or ny drplot6 wilfi *ss6 B lh.n eL omFsdiotr *iI rb llt wt d'd l,E inrle i rcl <br />itian d dollatd atr rL (Sa 70,1,t. BuiBed hllisaoB Co<r. Tt Curocld'r Lio& t& ddd ml.p9lv to d o$c ol <br />rh. p,lFiy vno bil(lor inlF!6 EEn. sld who &E sh wli hirelf or h*lf or lhrsh hn or hd oM cnPlo)6. <br />Fold.d $d Mh msusld G mr -rarLd otu av rl l( ho*t6. tlE hr'ldq or trFotqcr ! ,ld wihi. m Je <br />otoqld!.\UEOvGBoil&*dlIEEth.hl(liofFortUlilEd{E{Mtslhrldmir9rot0EFDFyfor.Frpo*ol <br />-1. <br />s o*c olrh. FrFy. m.(tulivcly.onrrros $nh li.dldl codi116lo @dtud rlE FFr tsa 7o'l'{- &&6 <br />Md P,Dfrsbn Codc: Th. co.krciol! Li.d. L.w do6 nol lpply lo o oMd ofpror.ny who build! or idpmv6 $6of,. <br />..r! $'ho oddr for Mh Fq.di wnh i Codrtro{r, l.dldt PUBu,r lolrE co adoa!Lk@L.s) <br />l!08aE8g.C0llfEssarla!IIEq.dMIIA! <br />I ha.n:_ .rm undd F!h, olpgjury oE oath. n lh{ n'8 d.(la.rioB: <br />-l <br />h& !d rill mituh. a.tiftd. of Colel lo S.lf-llM fo. wld.' 6hFdiol\ - Flvij.d fq b, S<rio. !700 ollL <br />Itbo Coda f, th. Ffoffi ot $. sqt 6, *tt[ ih. Fsn it islcd. <br />,l h.tc .nd yill id.i, wmld o-FB.tbn iM.. B ..qut.d by SElbn l7m of lli bbor Cod., tu tlE Faqrje. of <br />th. wl fd shah lni pqEi ir i$.d My qdid' orqddi{ i!j'lm. Mlt nd lolty n@bq G: <br />-l <br />d cr@pt uo&r Serion-, B &PC aorrhk r6on <br />Policy Nunb.r:-ErdB <br />- <br />Apolitut: <br />- <br />Lic6. CLs <br />-Ltc6. <br />Nushd <br />L.ndd'r Nm. <br />l..trJei1^,ld6r <br />- <br />-l <br />cdrt lhat i. thc Flolfua of th. ro,t for *hth lhii Ff,n it i$u.d, I slEll mt dplo, ey Fsn 'n <br />rt nmE <br />s sro banm lubidl lo llE wd6'comDadion hB of Cdilomi.. d 4G thi if I rh.!H taoh. suqd to dE <br />*ort6 oE adion p.o6iod ofsdtnn !?@ olrlE t h, Co&. I ClrL fodh$nh ondy Ynh lho- FovilioN <br />I*ARNINCT lrluc to su. wort6' NmpqE tio. orfts. s onLwtul. md lhdl subjdl d dploF lo ainiol Frii. ud <br />civil fin6 up to oc hunlt.d lh.!,nd &,ll&! (tl(lo.OrJo), in addniod to lh. co3l of conFMiion. dd..3d 6 F vidld <br />"r <br />rh' <br />s.(io.1076olrlrt Er (6de i'nad &d.ndr.y'r f€ <br />UC!!!IDIAdI!ACIqA <br />D!C!AAAIIq! <br />I hehv rrm u.dd DsElly otp.rjury rh, I e li.ss.d uds Fovlio" of (ltrFd e {coffiils *nh s.<r hn 7000) ol Divition ll <br />of rh.Iq! B !i fttrf6t'B Cod.. sd my ltdg ii i. tull lorc rn.,r.n <br />colilallgra!.rEd[llrilcllcr <br />I lErby .llm lnja Frly of Fjury Or lhft ! r odMb. bn&s lsdy fd ilE Ffffi of dE wl 6r st*h fin Fmi i <br />irlu.d (s( 1097.civ. c ) <br />AITIII]AtrIDECI,A8AIIAd <br />I h.*r .trm und6 poll y oapajury om of lb. followins &h,!lioc: <br />Damln.f, Paanetuhdor tlorili.rion F.da.l R.EULrhN (TnL40. P.n6) <br />R.quiEd rn16 of Nori6.dir <br />I cdr 'fy lhn rh. Lddd r.ruLl ioB rqdrtins sb6ror Enolal e. not arphsabL ro rhi! Fnid <br />-l <br />cdifo rhd I h.w rsd rh! rpplk io.rdnd.thndE.t r. infotrlrn. i!cffi.I lsta lo ot'pl, snh.[ Cnv Dd Cout, <br />odituc6 Dd Srd. l,wr cldrls lo nriuing codruclioc rd t@by Nrhoriz. r.F6a'ldivs of this City .nd Counlv lo dl6 ulbn $. <br />.bor. rEnio..d FoFry r iq.(lion FrDdd <br />,\ppli.rnl or Agenl sigtr.tur. <br />Forms/Steel/Holdowns <br />UFER Ground <br />T-Bar <br />Flood Zone Certif. <br />f-------T------