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BUILDING- INSPECTOR RECORD <br />SITE.WORK DATE ID/SIG.COMMENTS OWNER BIJII,DER DETARATIOII <br />I hq.bt rfiLm un& Frly of Fjury lhn I d qdfl tlm E Co.r,..r6 l-ic.nE t!* aor th. aolhwins ltei (st7011.5 <br />B6i.s ,rd arcfBion Co&) 4., ( nt or Cord, whth r.qlnd . Ftn ro .odM. .na. mFovc ddmLt[ or EF! dv <br />nrucr@ Firro !r! isusq.lo EqriE lh. +plt6l lor 3uh pa ro 6L.3i8n dtlda'El lhd lEor th. k lica8 d Fm&r <br />b lh. FoviiioB of lh. Contldor ! Li@nEd trw (Chrpl6 9, Comdcins silh setion 7000 of Divilion ] of th. Buins Dd <br />Prel6ioB Cod.) o. rhd lE q JE ir adF llE 6!n ,!d lL bca lor rlE dL8.d .rd.FDn. Any iohrbn ol S..lior ?0.r I 5 t v &v <br />rp?licer for . Fnn $bj*L ll! .prl'.Dr lo. or n FEt! of mr mE lie lit. hundEd rl,lla (tJ00) <br />-1, <br />s osn oath. FrFny. or ry mplor6 vnh sre6 d $d sk q'mFtsalion. *ill do tlE *ort !d llE dtule b Nr <br />i .rj.l dofiod ltr sl. (Sc 70a4. BuiKod ftladhE Codc Tltco r.cld,lj.wtls&BDl,Ppl,rorowof <br />rrE FoFty $lE hil6 or !ry!6 dEoL d wlh dc sh h,t hilrlr or lE*rl or rl@u8:h tir q tE ow aipblq <br />povidcd thar .uch mFnldEs c ml .rorLd o, olrdd tur $l l( how, E hiild'.g o spro\uEn L iU *rnin oB ta <br />of conpldio( llEGtrr ttuil& wi[ l[wln hi&r ofptrving lhi h. or Jt did rct hildor iryrorc thc F$Fry tut lb. Fit Eof <br />-1. <br />so$Eof rh.Fopdry, @.r.luiv.ty.o dos Enh licc!.d co rrcromldrucl llE FoFl (sa. 704'1. &!ir <br />ud Pt!tusim cod.: Th. ( o.k.(orr l-ic@.I-.w do6 not $ply lo u ovod ofproFny who b{ild! or idprovd ihd(n. <br />.nd who odrss lor rEh Fojdr *nh! Codrsro(i) lao!.d PUlrEr nrlh.cont.doar L!@ L.s) <br />-l <br />e crdpr w<k Serion-, B. & P C aorrh6,@r <br />D.l. or.d <br />wotrxf ,ts. coitpi\s non <br />IECIJAAUA! <br />I h6.by amrn utrtt r pqrhyoarrjuryo..ofth. following ddhralioE: <br />-l <br />ha. rn {'ll rinr.in. Cslifrdc of C6l9r to s.lfitur.lor wr6r omF.rrion. s FlviLd for by Salio. l?m of fi. <br />#;;lor rh. Ffffic of th. sod tor utrh rh. Fii it isdl <br />! .onFMlion i6llMc.. s r.quiEd b, s*lion 17(a otthc liboi Cod.. lor lhc Flotu. ol <br />i! isEl M) udl m in3l]lin. .ri6 rn poli, rudbn ic <br />)1-t- t4'9--o/ <br />-! <br />.driry (hd in Lh. Ffornuc. olllE f,ork lot whi.h rhB Fmn i! i3u.{ I dEll nor dpnry .ny pdsn io ey m{nd <br />$ d ro b.com. iubjct to rh. world' mmpqsdion b$ of C.lirom,r. &d .B@ th.l if I nFft bdo@ .!bi{l 10 lh. <br />I'ort6' NnFalt6nF.virioBof Sdion l70Ootlh. L.bor ('od.. I <br />dploF ro dmiorl Fdi: rn <br />n n. dorsd 6 p@idoj for llEc\:'l nn6 up tu on. hun&.d thoukd dolla (ll <br />Sdtron :1076 ofrh. t br(deinrrerl2 <br />I h€.t , s,Im un& FEhv o f Flury rhd I ffi Forirbd of(tFa e (omtrEcinJ wnh Sdion 7000) of Div6ioi l <br />of dE BullB rnd Prof6bB Co<L, nd sy lrcoE b h full fore rn dTEl <br />,,r,h <br />-(1 <br />callla!.Igrqx.LEdulcicEEl} <br />I lEtt,, 5rm utds Full, of Fjury rhr tha. ir. otdruclioi ld'di!{i *fty for rlr pqforlte. ol rn m* 6r dlah rh6 Fmr ir <br />iso.n (Sd lt09r, Civ. C.) <br />AllllcauLDlclJlAllo! <br />I hdd,y rtrm !816 Frh, ot Fjury oE of $. followinB d.cled ioN <br />D.ooh'on Pmir!-Arbdor Nolific.l ion F.d6.l R.ruhbn. (Tnl. 40, Pd6) <br />_Rcqun.d ldE of t{di6.iion <br />-l <br />cdiry lhd th. f.&rlcgular$ro r+ddins ctEtos roovalsc not.irplic.blc b lhis pmj.d <br />_l .diry $! I h6. raj rh! rpplE i.n idnn o NmpD snh .I C,ry .,i (tlnry <br />.nl:o 6 and Srd. ta. EldilB ro rhn Cny rd Counryto and <br />'4on 'lEain\. Erron.d p(,Fdv Inr <br />.\ppli.rnt or ,\r.ni Signrru /o - "Y -6 <br />Set Backs <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />Subf loorA/enUlnsulation <br />Roof Sheathing tt /t /lt4 Qnor>-/6v <br />Shear Wall <br />Framing <br />lnsulation/Enerqy <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 />FINAL //.//5,//tr a'nH,4d) <br />Certificate of Occupancy <br />Notes, Remarks, Etc <br />3 <br />Forms/Sleel/Holdowns