|
BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE OTr1lf-R BUTLDET DEI]CARATION
<br />I ha*y !r,r uods Fu!) 6l Fjurr lb, I fr aanF 6om th. Codtu@' Ll(.M Ir$ lor rlE folhsit}3 rd,n {sc 701 I t
<br />BGir* r,!d Prof@tr c!l.) Aly Cny or Coudy *nrt r.qun6 t Fmi ro odrud. !16, i,s.o\c daDlith ot .q.t D,
<br />llodue Fn. lo ilr iBll4c .L r.qrG rli ipd*rd lor Mh pahil lo 6k . t'3t'.d rlqrEt illr b. or dE i licq!.d F .{d
<br />ro rhc FDrkios ol ,E aof,nrk r Li6r.d lrw ((-n!rrd 9. Colllj'4ing wn,r S6lion 7)00 of Divition I oa rlE Bui6 &d
<br />Proa*iof,r Cod.) o. rh.l h. o, 3h. 6 catrpr thq.fon &d th. t-ir for th. dkg.d dfrFion. Ary rioldion oasdbn 701 , 5 by oy
<br />lppltdl for ! dnir !!bj6lr rh. 6F?licsl to a civil p@lty oI nol ma rne fiv. hundr.d &llB {t500).
<br />-1.
<br />6 ow of ih. FDFI,. G ny dPlo'6 wio *i36 B lnd sL onFlrion. sill 6 UE *oil ai llE itude i mr
<br />idad.d or oEacd for sL (56 7014. BGilB ud PlDt-hB Co&: Th. Codr..ld'r Ltag L.* &6 ml +9ly lo D o$c of
<br />rh. ElDary wlb t{ilt o i,ry!6 dE@,! rn vls &6 rt mrl hinr.lf o. h6*lf or lteur} hit r lE om dphy6.
<br />FoliLd rh, sh itrFEd! E ml ndd.d qolLld it.l tl lbM. fi. hliBir ot uqeq6 itsld*rhhmlc
<br />ofonprnir lt. O*G &iild. wil h.E dE h,rb' olFlvi,B drr lE d aE d! 'd hrld n i,+oE dE FDFIy &. 0t FrF* of
<br />-1,
<br />d otr s of E FoFly, h dcluivcly 6,nr8los snh licd.d cotudm lo odnEl llt F.itl (Sd 7or4, BEir
<br />!d Eokih Cod. Tn. conkdoa! Li.tr Lre &'6 mr .rfrly lo u own6 of ProFn y sho blilt ! or inpruvd rtaon.
<br />a.d sho .o.hdstuiucnp,ljcclswilhaConr@.ro(.) licdE rrptrRuer rorhc(tnrru.ntr 3
<br />l5
<br />DICI'IAIIA!
<br />I h6.t y .,Im unds Fun, of Fj- r.. oE 6lrh. folhslB dcld.ioE:
<br />-l
<br />hd. !n will uuniin . Cdificc. of CoMt lo S.lf-lnse tor slnt ampdllim, s FoviH [ot by Scrion 17m of rlE
<br />L.hor Code aor rh. Ftufr1e. of th. ert for f,'hich
<br />'h. Fhn i! isu.d.
<br />-l hd. ed will f,airt.in work.r' cooFNtion iEur.ft.. s r.quicd by Sfttio. 1700 of lh. L.bo. Cod.. lor $c pafolru.. oa
<br />th. uort fo, *hich $s p@nit i isr.d. My wdto onlaEnioi insl@.. @iq an Flt, numb6 @:
<br />Pol(v N@b6
<br />-F(pG
<br />l.dit rhr in rh. Faolr]l4. otllr *o* tor sh(h rhB pa6n is ie.4l nrll ml ophy uy Fen i. my nsE
<br />$ clo t6om. rubJ€r r. th. mrta mmFsion Lwrof Crlifomi& &'d t*c th, if I rh.uld baom rub..l to llE
<br />sort6 onpqlrr'o. poltioN ot Sdrioi l?C'o of th. llt{r Cdc I s[r]|. fodh*ith onpty w'lh llne proviliom
<br />\t]lRNlNC l;.ilurc k' su. sork6 conp4\llnr ful. ad rhlll uhld M mploF lo ainirol Fuhi6 dd
<br />!.\rl nn6 Lp h, onc hunL!.d rho@d doll6 rtl0u,Lr04,,
<br />Sdirn 1076 of rh. l,trrr (ida dr.d ..d .nomv't
<br />,.,., .l0l,2.Llr8-I-
<br />L[.(l.t&\tlo:
<br />I hclty rm u.dd F|h, of F)uy lhr I o li@E d ulxla Fovitbi olol4ra 9 (on:jrEils \ irh Sdbt 7(m) of Divirbn l
<br />ot rhc BBil6 id Plnfa-bB Co&. d hy lia* i i! tuU loc !d.fl6r
<br />COIIIAULIIOUJ.EdDIIG.AGEUCI
<br />I horby dTm uD& pdd, of Fiury thr dEr i! . o'dMion ladilg .stry fo. tlE FlM. olllE *s* fot rtih rhi Fni ii
<br />s&d (Sa 1097. Cir. C )
<br />AITIICAII.DESAAAIIO!
<br />I h.!t,rfEnundd p6.hyolFj!ryorcof lh.follou'ins &.1!4lio :
<br />rr.!tuliri'. Pdnr.A.b6rm Noiificari.n Fcda.l R.8uLlmN (Tnb {0, Pd6)
<br />R.quiEd ltri6 of l{x'lr.im
<br />I cdiry rh, tlr a.d..d ,cs,ltdir6 Es&d,ns stsrd rm\.1 ic mr 4plr.bk lo rh" pr.jt{
<br />-l
<br />cd ify thar I b.-c r6d rhB appl(dio. &!d rtk lhar lh. shrv. infoma'on is coBl I !o complyvnh all (''rra.d (bumt
<br />frhis Cnysd Counry r...ra ulon rlEf'(lnrnc.\ nn Slirc l.i\s
<br />'.hr'nN
<br />() bui
<br />abo\cmdlion.i pnrp<ny nn inrp.<
<br />.\ppli.rnl or As6l sh6rlur(8.ln]2r'll{
<br />Set Backs
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUl nsulation
<br />Roof Sheathinq D]I -,-K\\-Fur'-9'
<br />)
<br />Shear Wall lt U I'
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<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 \It n/>
<br />Certificate of Occupancy \)\
<br />Notes, Remarks, Etc
<br />ID/SIG.COMMENTS
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />Brown Coat
<br />l-..dcas AddrN _
<br />I
|