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BUILDING- INSPECTOR RECORD <br />SITE.WORK DATE ID/SIG.COMMENTS OWNER B!ILDER DI'LCARATION <br />I h6cty lrun uds Fuxy of Fjury rhi I m .ratrF fiDm rlE ( od...rd' Li.dr lr* fo, llE folowq r.en lli6 r0ll.5 <br />&!ins dd frolBb. Cod.): Any Cny or Couny shrh cquic r Fmr ro mdN, .Ia, mForq &hlah or trt t ny <br />siruduc. Fbr ro it! i:tuffi.. ito EqunB rhc lpplior for .Gh FDn !o frL i li8f,.d ]ldmdl lhll h. or *E i lka!.d Fel,r <br />to rlE FosioN of dE Co.u.dn't l,i@nxn Uw (ClEd6 9, Commftios *ilh Stlion 7000 of Divi,bn I oflhc Buin4 ed <br />Pr.f6iiB Co&) or rnn lE d.lE 6 d6Er th6.6on d rh. b6ii for 0!. .l4cn aar!.hn tutvhLrbnols.(bn70ll5byDy <br />ap?li.ul for r FEn subiaB th. rpplicor ro . .i{il p.ulry of @r ffiE the fiv. huidlrd {hlls! (!5&l <br />_1.s o* orrh.FFry. d my6rplo)6 *irh*!a6 a ttEir $h onFsriotr $ill<b 'lE$nl -ddE rnrr@ i rcl <br />insrLd oroFs.d fs nL (S! 70fi. Bdi6 od Pill<bB cod. TIE CodGrd'r LtoE bs <rE id +plt to a orE oa <br />rfi. pri,Fry wh' hi!& or !p.!v6 rrEs( d who d.€ Mh sit him$lf or h.*lf or l,mlsfi hir or hn om mdotlq <br />psvid.<l rhn luch imFiroE iemr i,'roi.d$otrord forsl.lL ho*6q, rlE tlildirB or imFoEE L!sld*in4oE'd <br />oforpLr4 rh. O*E tlu'Bn rill 16! $. hr&i ofFuiig dr lE or nE dn d hild tr itFlE ln. FIFD br dE F,pd oa <br />-1, <br />s osE of rh. Fot'6ry, @. l6iv.l, conlrdi.S snh li(.B.d corrdoclo @I,ruci rlE FoF<r isd 7041, BGiIB <br />ad PtDkno Cd& TIE ( otu cror't Li..u L.* &s Nl .pply lo d o$na orFoF!! s h. boild! o. ihprcvd lhdon. <br />ud sh. o'I,r$ tor !u.h Foir! *nh . Codtuo(3) lE.rE d pnM lo lhc codrrdd'3 Lic@ k*) <br />-l <br />m .rfri un&r 5{l <br />/e 1,2:S-Q! <br />u!.1.!.!B.lr.lu: <br />I hqar! .md un&r pdnhr olFJuD.I oE oailr lolloq iqr rk l&.rF6 <br />-l <br />h!v. -d will @inl'in . Csrific.r. ot CoMl to Sdl-l6ur. fn mlda onlFMlion, 6 Forid6l for hr S.niot l7O0 ol th. <br />LtEr cod.. i rh.FIo'lie. of rlr sat for stth llE Fni i is<d <br />I hdrc and will maiouin woi(ri cotrrp.N.rion isu!n.c, s ..rlun.d by S<t hn 3700 orlh. lru Gd.. lot rh. Ffomucc ol <br />th. norl tor which rhis Fni i (aal Myrdl6! comFuion inuffi.ceis d E,hcy nunbd e! <br />-l.diryrhd <br />in rlE Ffolrrlft.oalfic worl f( shah lhtr pqD'l <br />'tr <br />4u.( I nullnor mplo) &, F{n itdy nmod <br />s u !o tqom rubel lo lh. srl6 omptun'n bs nf ( .lifomL ud !€r thtt n Lru[l b<om. tubicio rtE <br />solla emFE rior F!vai,6 of sdio.l7mof E hnr Codc I 3lEll. forlh* nh @ody *hh rlbr ForirhB <br />WARI\ING: l-.ilur. io sw *uld oBFurion ormsc i! uL*tuL ad tull stF 4 dph)r lo frni..l Frhit !d <br />civil nn6 up r(' on. hurLtr.n lhousnd do <br />Sdn n rc76 of rhc tlh, ( o{c inrsd !d 'l <br />i. odd ion ro rhc.or oa comFsrriof,. d846 a Fv'!.d for th. <br />I tFctr lrm und6 FDlrr.f FJu-_ rh, I m lk6a.d Fldrbn of Ch.{,rs I (onnE6g trnh Sdbn dJo) ot DillDn l <br />of !h. Bui.d &d Pmf6io6 Codc. dd my lic.N n D tull hrc. ri.ifdr <br />c!)llIalCllllIuEUllxG.AGEA(} <br />I hq.!r llfm undd p.n rof Fjury thd th6.ir.otrdrudion Ldins ostr] turh.Ffolli1tr.of th.w{k for*tihrhnFnn i! <br />is.d (sd 1097, civ c., <br />Lindd'r Nmc <br />- <br />APPI I('ANTNF('I ANAT(IN <br />I hoiry !6im uid6 Fn.hy o f Fjury orc of $. aollo$ in8 d..hmt ioc <br />Dcml'tF, PonnAet'd6r Ndin.dio. F.d.r.l R.*!hbni (Tnt &, Ptn6) <br />Rcquir.d L!rd oaNolifi carion <br />-l <br />cdiry rhr rlt ftdarl .cguhrioN Egrdj,C dtd.s lgft\d n nol 49liobl lo rh! FF <br />-l <br />cdi0 thd I h6. @d th! rrdk.li,n -d r1. thd tlt .bov. irfodrtio. i! cotr.<r I lgrc lo omPly wnh .! Cil, &d Co6ly <br />odi..sg xd $a. L,E Bliir io buildila cotudior .n hdtby irhoria eFErnns of lhL Cil! -d Cou,n, lo cnc 4on dE <br />atnv. mnloncn propdy tor <br />/\ppli(rnr or.\.nrs13nrru n /e - 22 -2o17 <br />Alhr'4 /luyat4 <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />Subf loor/VenUlnsulation <br />Roof Sheathing <br />Shear Wall <br />Framing <br />lns u lation/Enerq y <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 0Dr1ltl.1 fuai.rsx '?)) <br />Certificate of Occupancy I U\ <br />Notes, Remarks, Etc <br />o.,.. /- - 22 -