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BUILDING- INSPECTOR RECORD <br />OWNI]R BI-IILDEI DEII'ARANON <br />I hd.lt r(Im uida FGt, of p<jury thd I m .rdpl fr!ft $. contildo Lrc..! t w lo. th. followiB IEjn (S€.r031.5 <br />B6ind sd Profdio. Codc): Any Ciry or Cou y *hich r.qun6 . Fnn lo snntuc1. tlrE inpruve ddnolish or Eptr Dy <br />strucr@, FFr 16 nr i''lffe &o r.quiE llE s?li.! for Mh Fn lo 6k ! 3!8nai rrcMl lnr h. or th. i! lictdd !c$.n <br />ro llE Fuiioc oa tli Co rd.r LEnEd Llw (CtSa 9, Comchs *nh sarhn 7000 of lrvirior I oa lh. aur6 6d <br />Protdnrc Co<t ) d ttd lE - slE ir qmpr thsdroh ud th. bdi! fo. rh. liLe.d crdFbn. Any r nLrsn ol Sdih 701 I t ht &v <br />.ppli..ni for . Fhir rubJ6l3 lh. ,p?licm o a civil pcuhy of mr mr. th& fivc hun&.d douc (tsdl) <br />-1,s <br />o{@ ofrh. Fopqly, or ny mrlo,6 wnh $.s6 B Et $LonFBiior r &, tlEhrl xll Ern)dEiDl <br />iddLd G oFard fd eL {56.70r.l, BuiB ed rrof6ioN Cod.: l L Colrn.rd'r li6g ta &,6 mt +tl} lo , o{G oa <br />rh. FDFi) *tb hriLl d iqlc r,Eu rd u ho dE str *vt huell or hd-lf o. rhDush hi3 d lE om c,4lor6. <br />Fovid.d rh.r uh iEFolqid. e mr iddld.d dordd 6r sL. lf. non6E rt hritlins or nrP.nttld it sld*lrlE oE rd <br />ofonpldioG tfi. (\rs Builds wi[ h!v. tE htr&r ofFUaE th, tE o. nE dij Dl build or in{rtE lh. Flpcty for th. F!F* ol <br />-1. <br />s orE of lh. FDFr), D .r(lun.l, coddi.t rnh lka!.d co'irEl6 to @dM tlE Foid (Sa '704.1, &.llB <br />rd Prlkbo Cod. Tn ( onhcr6rr l,i.@ Lr* dG hl .p?lr ro o ownd orFoFl, sho b!'k! or inpbvd rh6on. <br />sd sho @l'ls'$ tor !u.n Foj.{! wirh r cbDtkonr lk6s.d FBun lo dE Co, r.dd r Licd& k*). <br />I un c\.nrpl unds S(r <br />Drr. ()r.6: <br />\\ otuir Rs' cotuPfNsA ftol <br />rrll(ta8dll9l! <br />I hocby smnn ud6 poulry oapdjury om Dl$. follosinr delmrions <br />-l <br />nt!..n qill tuinr.in. cdiaE{. olcoMr b s.lf-lM lm srtm MF.rrion. 6 Fovid.d for by scrsn 1700 of lh. <br />Lltor Codc lor rlr Ftnrl&. of tlr edt ft, *,t*h tlE Fnn ir Bu.d <br />*illmai lin *ork.6' cooF@riod iNuhn(.. s r.qunal hr S6lior lTtOorlh. t bor (i'ti., lor lhc pdft.ruc. oa <br />Mywo d! .omlddion iEurec. crir 6,ld rblicy mmha r. <br />L <br />(, <br />I (.rlifr rhal in rh. rqforfucc of rh. "orl for *hth rhis Fnil t sNcd. I 3h!ll frn any r<srtr rfl dymdE <br />F B lo basft eqet lo dE sort6 oE .6dion Ltr! of Colifomi^ !d tsE rtr il I ihuld h..oe $t*rn to llE <br />*!nd orqo!.tb. Fsrirbc olsdi'n 1700 of llE L.bor Co& I ilrll fdn*nh odply tr ilh lho* rerc66. <br />WARNING F.ilur. h su€ sorr6 comFadsn c.\cg.rlbJsl D dpkrrs ro sinin l Fut6 tnd <br />cilil fin.s up lo oE hundr.d lhouod doll6 (lr)r),o(ir). <br />'n <br />add{ri' n) |o'iFnerFn. dond*6 d p(r'J.tl for rh. <br />Lq <br />UKLIIJI]] <br />unda p.Exy of Fjory lhar I 8 li.6E6.l unda prcvsM of chaprd 9 lco rn'6cins silh sc.1Dn 7000) of l)ivision l <br />of thc UuilB atrd tn't $oa co!., .ri Er lic.N G in rull lorc. d.nd <br />cl}0rlv .'{i 1 8 <br />0 \( <br />co satl]crloll I F{nrn(:lctrlat' <br />I hatby .lfrB ui& F!h] of Fjutt lhr tha. L . mdtudirtr ladirs .stry for tlE Ffm. of tlE wt ft,. *lrth th! Fmit il <br />i$u.d (sc .]09?, civ. c.). <br />AIIII(AILDECIdEAIION <br />I lEd, dtm uidd Fnalr, of pdjury on. ot lhc tolkrwins ddl,r.tio.3 <br />Dsml'rio! Pdni^stBlor Nori6c.l ion F.ds.l Rc8uLl ioN (Tnlc .l0. Pd6) <br />R.quftd kr6 o, l*ri6.ibn <br />I cdily rhar rh. 11".16.1 r.Buhn,N Grardinr 6h6l$ Emov,l tr. n r dollic.blc lo lhL Dturd <br />I cdr! rh, I ha. rad lhE infomrion i! cor(r I {E io omgly *,'l1 .ll Cit, od ( ounly <br />od'Mtr6.d sd.ti$sEhllg ldhrroc r.lr6arJtr6 6lr <br />rbo\. Mrnftd FoFdt lor <br />Aplli(rtrt or Bql sltnrl <br />ID/SIG.COMMENTSSITE-WORK DATE <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />Subf loor/VenVlnsulation <br />Roof Sheathing <br />Shear Wall <br />Framing <br />lnsulation/Energy <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 />FIood Zone Certif <br />FINAL lzt/tq -Mlr,Certificate of Occupancy <br />Notes, Remarks, Etc <br />'I t(r w(J 0ll <br />;:i;l;l IY <br />I <br />--------T------I