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BUILDING- INSPECTOR RECORD <br />SITE-WORK DATE COMMENTS OWNER BUI.I}EX DALTAX TIOI{ <br />I h6.ty llfm uald FDl, oa poJ@y thi I m dal$ frDm rlE Colf*l6 UclE Lls to, lhc followog .C&. (S+,701Li <br />t\!in* atl Prof<io. Conc) tuy Cny or Couly *hih r.qun6 . Ffi lo corBltu.t dta, inFlE, dcmlth or lF.n ay <br />irudR. prior to rt! L!suc.. .Lo r.qut6 th. &91@r for 3tch p6on ro fiL . ii8Ed n..Et llli b or tE a lkoE d Flt !r <br />b $. p.ovsioN of dE CotrMo.s Uc6i.d Llw (Ch!pr6 9, Coffius tr nh Scrion ?000 of Divilion I of <br />'lE <br />AGiB od <br />PmfdioE Co&) or rtd L o. nE it do9r rhdrtroE !d tlE b..ir hr rll dkr.d sdrFion Aly rhLlb. ots.dion 701 I 5 by &t <br />lppl'cer lor. Fnn $blxr rh. .r?lkrn to . ovilFdt, of ml mE rhr fivc huidEd {hU,6 (1500) <br />L ! ow of th. FoFty. or my mDlo)6 wnh was6 a rlEr &1. comF6dirn, *iI {b rlE m* lrd dE nndr ir E <br />ordr&l o, olfd.d fo, srl. {sc.7044, BBi.d ed Prof6ioN Co&: TIE Codr(d r tj.o& t& dG ,Br 4pl, lo - orE of <br />tlE poFB who hili.! 6 lrsoE Eq !d wlE d6 nrn Nd hirello.lEslf or rtrcud! hit mlE ow atploy6, <br />Fovit d th.r .uch imFDlEiEa E d irdrll orofld.d tur sl Il tsM, ilE tuildirB o. !,p.!vaEi ir $ld winin om )d <br />ofcoEplibE 0E Owna BoiEa wiu h.G lh. hldn orFo'nls du h. or lhc did mr t ild or i,4..r. lh. FrFr, aor dE FrFr of <br />-1. <br />B o*E olrtE FDFry, @ ddGi*ly coflreri.B wirh lkaB d codrrroBlo oi*ucl rh. FDicl (sc. 7044. IrrEu6 <br />.!d Eoks Cot!.:'rh. Co trroar Licdc kv doa nol !9plyro downaoaFopdly*ho huildror improv6th6dn. <br />ed rho .o.rdr aor locn F jd! wnh ! ConMoi.) ltdE d FrM to rh. Codarq. Ltoe L!*) <br />I m crdF uxl6 Sdion <br />woRxEns'co Pr\sarloN <br />DICIJIAIIa! <br />I hd.by .lTm un.ld Fdry oi Fjury oE ofth. followin3 d.cl@l Ed <br />I hrw !d sitl mhr.in . CdiaEd. olcoM to Sclf-lM fd vqtd moqa..io!. B Fbrid.d lor by Ssriotr l?00 ol$. <br />rrD6 Cod., f6 {E Ffol]re. oldE NlI f riih lh. FEn it isEd <br />I hlvc ed will nainlain wort6 coindBilior iNlfuc., a r.quird by salio. l70O of rk lrbor Cod., for llE Ffotlrld. of <br />th. wri ,or *hich rhi! F6, i! &!d My worr6 @nvaaaion iGiJle. .sid !n poky .unbq r.: <br />I cdiry rh4 ir rlE Ffolrmc olllE wor* for *tich ltis Fiil n su.( I dull nor aIlloy ry ps$n in ey f,und <br />e a <br />'o <br />tdom $bi-r lo th. woAd coDr.Narn law! of Cllitohl. ed .3r thn if I rlnulC haod st*tl lo llt <br />stt6'(nposrionpo6io6ofsdio.lT00oflh.rtt-co<L.liEll.fqlhwnnomplyvntthodForilio6 <br />WAR]\ING: F.ibF b s@ wl6' onpdlnion oE s. it uLwtuL ntd rlull sbixt e olpklF to sibin.l Frri.! ud <br />citil fb6 up ro oE hu&.t rholgd dolbt (i1m,000). in rddnhn ro rh. con of coo!.Ndion. dm!86 E providrd for llE <br />Sdrion 10?6 ofrlE Llb.r Code id6.d.rd dorE s 16 <br />lr0lld!t_ <br />TJCEIIED.COtsIAACI9f, <br />ar4laSAlro! <br />I heby .rm undd !.tuIy ot pgjury rhll I o liGs.d uod. Fodrhn olctlFa 9 (@ffiins *nh SelDt 7000) of Diltb. l <br />of rh.lluind d PnfdioE Cod.. dd Ey ltc& a in tull to,€ rn cr6r <br />Lic.N.Nunbs: <br />qQriral(Jlq!-LtlDAc El(lt <br />I bdlty.rlim oi& Fdr, of Fjlry E lhqc ir. od.u<lior la'dins.s4y tor th. Ffollffi. of rh. wo* for sti(h lhis pshil ! <br />,sqi (Sc 1097. Civ C) <br />AITUI]AITLIECIJSAIIO! <br />I ha!4.trm unds p6tly of pdjury oB of lh. lollowir8 d..lalrioB: <br />DgFliriro P@ne^lbdo! Notilic.rion !-.datl R.8uldios GnE 40. P.n6) <br />R.qun.d lnrs olNodfidir <br />I cdiD lhd rh. lcdsal r+uhlioN ,csudin! 6b6tos r6(v!l &c nor .pplicdbL b rh6 poid. <br />- I csiify $n t h.t. @d rhis .rplrnio. .ld ra. thd tlE lholqrfodion u.qrd. I isrc ro @md, *nh rI Cny Dd Couly <br />nlE !6 ..d Sltr. Lff drr.g ro b(ildiru @rEtuiotr rn ha*r &lhori4 rqerdivd of tr Ciy rd C.ury to alq upon tlE <br />aloE MIbn d Fopdly lo, ir.Dcli6. purFs. <br />Al,plicsnr or/\8rrl SiAn u.( <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />Subf loor/VenUl nsulation A( .t./9 <br />Roof Sheathina ,.4{dl urdtL W6 <br />Shear Wall I <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 />Enqineer Final Report <br />Flood Zone Certif. <br />I <br />I I <br />7a-Et t\w1u, <br />Certificate of Occupancy <br />Notes, Remarks, Etc <br />ID/SIG. <br />li &PC forihnr6n <br />I <br />FINAL