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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNER BUILDER DET-CARATION
<br />I h6.by ofim und6 pquhy of Fjury thn I m doF tnE lh. ConrtuoB Lice trw for l& follovi4 ,!&, (56.7011 5
<br />ltu'ns r,'d Prcf6ion Co<lt Any Ciry or (.!ry whth rqui6 . Fni lo onrrud. .na. ulpr$G (bellh o. Ep.n xy
<br />{tocr6., F.r ro ir. iw., .L EqliE tlE ?plkd fo. *h Fnn lo 6L.3isi.d !..,ld ihr lt o, dE it lk.d.d FB.n
<br />ro th. Fovirnrtu of r,. Conlcloar Laar.d ld (Cluflc a. Co,M*lng wnh Salion 7000 of DvBro I or rh. Asic! !d
<br />P&asiotu Cod.) or thli h. or !h. i!.xdpr ihc.from ed rtc l8i! for rh. dl.s.d qoFio.. Any viol.iion of SdiJn 7011.5 by uy
<br />lp0licer for ! Ftrir subjdlr rhc .pplicdl lo . civil p.6! y of not mr. rhs liv. h!.dr.d &,116 (1500)
<br />l. s @c of$c !.oFry. or my dpbta snh $.A6 s $.n bb omFEi6'l. $il & dE $sf nd tlE iiEE ii d
<br />i.rdrLd or olta.d aG slc (Sa 104.1, BuitB xd PEfsiod Co&: TIE co.ranols LE.M Ls &6 ml .r?ly h M o*E ot
<br />rh. rmpdrr ek) t!il& or i,nr$v6 l,6En. ud {ho dG luch Frt hiru.lf or h*ltor rhtuush hi. or h6 om mplor.4
<br />provid.d thlr tuch inFb\EmB ft mi i crll or otu tu et. lf. h6q, tlE bildru d itsovdGr ! Fld *itui oi. )d
<br />olotrpldbtr rlE (nE elitia will hlE dE h,&r olFolrr thr It d ltE dd @l tnild or mFw {E FlFry for tlE Frrot ol
<br />_ L d osd olrh. popqly. u .rcldiv.ly onr.ding wrh lica$d .onrr!.loa to codru.1 rlE Fojdl (56 7044, Bu'nB
<br />a,rl n Esin ( od.: Th. Conruroar Lico!. Lw do6 mr tp9ly lo u o*nd ol Fopdl, w[o buildr or inprerd lh66n.
<br />ed $ho conrrrlt for sh rmrarlrith. G'rdclo(.) l.cB.d Fj,![, h rlE Co ddrLtoEl.wl.
<br />I m crort und( S(rx,n
<br />E!BXESI-(! fftS/tllq!
<br />DICIJf,AIIO!
<br />I hq.b] smm un.tq Fn x, ofpdrur) oft of rh. followi,t dElndas
<br />-
<br />I hlvc &d vill mi ain ! C Gn ifEdr. of ( ongI lo S.lf-,nruE tor srld @mp@!a io.. G Folidcd for br sErion 1700 of th.
<br />ljtu Co<t tn rhc Ff(xfu. .trh. \ o* aor rikh ln. Fnn b isu.d
<br />I h.* rnl $ill Mi tin wrl6 comFMnn ils.tr.. 6 t.quncd t y sEthn 1700 of rlE Llbot Cot!., tor rfi. Ffffi. of
<br />lhc erk aor uhkh dn Fhi ir ia$.d" My worl6 conpqErion 8ule. c&io a.d Flt, tlmlE E.l,,,,'4t*E a.*tYa*tzrcn O
<br />1.,,r(\\Ln,r(r- il f q77r'- t/r/zoo
<br />I cdi! th.l h lhc psloo!.cc oflh. *ork aor vhich lhi! rEnil i! isu.n. I rh,ll mr mploy uy Fs$n in ey ,run6
<br />s s to hroE rubj.tr lo tlr r!*6'@nFdion Lsof ( dilomia ed.srlhd if I tlsuld bdom tut <i ro tlE
<br />*!rld' @E{6qrrn Fov6io6 of sdio. l7m.l E l,h!r (-odc I Cdl. ronnsnh 6nply snh $or FvaioB
<br />WAIININC F.il!r. ro sG {ort6 onpssnren ordg.
<br />.,vil lif,6 u, lo on. hun&d lthrGlrd dollu {1100,000), 6
<br />S{ri.n 1076 of lh. t{bor Code inr6.n ed iuonrr's fd
<br />I hftby arm undd Fnakyofpdjtrryrhd I dn I (con,mci.8 wilh Sdtbn 7000) ofl)ivision I
<br />.a rhc Buoa ed PofdiN Co&, a,i my li..e
<br />B
<br />,.,". tz{ty'g
<br />I hcr.by amrn utuld F.ah, .l 16!r, thd rhd. is .ror lhc t6lomM. ofth.*ork for *hichrhis !6hil t
<br />in!.d(sc.109?, cir. c )
<br />Lodd s Ard.6
<br />-AITUCATLDISJAAIIA!
<br />I hdt6y nlm !n& D.trdr v or Fiury oE of rhc followin3 ddlr,.|iotu
<br />I)cnohior PmtreAlt€ros Norin.dion [.dd.l R.SukmN (l'nk 40, P.n6]
<br />Rr1lutr.(i I.rr.r f lN.rili.r(rr
<br />I .6tify rhn rh. tu ral ..suLri,N Esrd'ns lt!.iror rn)!.1 d. mr @lklbk to th! rrtrJ.cl
<br />/Ct,"' n t,I hav. rc.d rh6,pt'li.diondrls.r.l61166 complt *nh rll Ctryand ( ooniy
<br />.r.l.iss Ebrn'r b huildi.s iv6 ofrhis Ciryud (outt ro 6t6 upon tlE
<br />.b\. lMtion d pNlEly lor 6p.dFn
<br />",," .rZ-/f7
<br />^pplr..nl
<br />o.AEdtskn.lur
<br />l'$mlle nome lprlnl): lL
<br />Set Backs t-
<br />Forms/Steel/Holdowns !l 'j'
<br />Erection Pads
<br />SLAB Floor
<br />Subf loor/VenUl nsulation
<br />Roof Sheathing
<br />Shear Wall tl
<br />Framino rL +lq D'ton tru *6'
<br />ln su lation/Energ y I
<br />Drryall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enaineer Final Report
<br />Flood Zone Certif.
<br />I
<br />FINAL t zlql p *n,,la
<br />Certificate of Occupancy tt tl
<br />Notes, Remarks, Etc.
<br />UFER Ground
<br />_u ,c7
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