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BUILDING. INSPECTOR RECORD SITE-WORK DATE ID/SIG.O* NER BUIIl)I:R DII.('ARATION I lECt, lrrn !.&r FEn! of Frron rhd I m .rd,, nom rh< ( odr&1.6' Lkffi Irs for rh. folloN inr rc&'n tr( 70:l l J BBm6r !, ProfsFn Cod.) ny ( ny or aoudr shkh iqutr6 . Fni io conrM. ah6. impro\e ddmlnh or rcrhr My srtudd., Fk,lo 'lr i$ueq als' r.rtutrNlh. applicur tor such txmn to filc 3 sisned slrlddt lhd h.or shc ! I'cord pudarn lo lh. trollnrN ofrh. (ontrkror3 l,icakl l,w (ci.pr6r). ( (mm.n ins *ih sc.rir'n 7(In oa Division 1 .fthr lr$inN and Prefsn'n! (nd.)orlhal hcorshc ir.rcmDl lhq.fton Md rh. b8n nn th..llcscd.r@ nn An,violalionofsdi,n70rl5 byon, aptli.d tr !,6n'i subj..rs lhc !t rlicrnr ro ! c'rilF,ahr ofnor mor. rhs lirr hundr.d doll6 (1500) l. 6 o$E of 'h. FFd!. or m! mthr6 rnh *1116 B rh.' 5h comFlri.n. {illrh rlE ust ,n rlE rdm 6 nn ilndn d or ofisdl ftr eL (Sc.7O&. BsilB ed Pmfai.B ( oa. IlE coffioa] ti.E |ir &E ml l,9ly l. o orF of rh. FoFty tr h. hili q inFt€ rlEFtr id * ho {tE sn ss* hib$lr or holll or lfimush hn m fi6 o*n opkD F, prtyi&rj rhll !u(h inFolaEn! e d nod.d orolH tor sk r( tn*as. rlE hirdine "lD.nffi i! $ld silhin.rc )6 orcor@kira llr ow BuildE $ill h!\r ltE htr&r of FlvtrB rhi h. nr ih. dit m' hild or itr ..r. fi. FlFq ft,. llE r{qm of l. a o*c ofrh. I'opsry, d cl.lurivcly co.ltuin8 $ (h li.mr.d $.lrado6 lo er'nrui rh. Fl)itl (SE. 7orr. DuhRr rn lltkin co.l Th.conr8i.r! l.'.oc li* d6mr imly to osroof FoF r$hr b!il&or imp.o!6rh.on, md rh. odrds for s(h Forns s(h. ('offio(r) lr.Gd p{BM ro 'h. ( odr- il-tdEL.r) I m.rdd unds S6rhn Dil.: O'tr.r !aati};&r:(I)uftNs .rl(,l!Dro.dxl]rar I h6.h\ aflinn unds Isr.hr ofp.r)uL- onc olrh. nnh\ ing ddlnrornB I h.Ed*ill inr.b r Cqritr& or( onh io s.lfi@ (, sdtd' .omFldrn. d FfuiLn for b S<ion rT(l) oarh. L.hr C.d4 f( rh. Ffolllrc ol ilE s$t rrr stih rlE Fnd . e,.d I hlrcud snln.'nlain world .omrru'ion iBurrrcc. a ktm.d b) SdKn 1700 ol'h.lrhor Co&. nn fi. p(fomm. of rh. *o* for qhich lhn pc, n Bu.d My eork6 @mFMion iNurw. cnir arj policy.umbq m: I rd'ry rh.l 'n rh. Ff6ll1re. of rh. trrrl ft{ *hth rhn Fnn n su.d. I 5rrll ,rsn h) !.} p6sn i...r m F $ 6 lo h..om sq.d lo tlE mrt6 onVtuion Irs ofcrlf.lu drl +R rh, il I Jruld t .om $h..! to ',r$0116' conFslion FlvirioE olsdu 1700 of lh. l,ll. ('dle I ilEll. fnhsnh .omply *nh rhs For ilioB WARNI|{C: }-!ilur. ro Gu. *0116 comF@io. colais. n unhwtuL dd .h.ll runja! M ophr}q ro dihin.l Ftrlrs dd cril lin6 !p to on€ ntrndEd lhousnd dolls (1100.000). in &Oikrn !o th. cost otrom!.Mlion. d!roscs B pmvidcd lor lhc scrnrn 1076 ol thc l,bor Cod€. intosr Md rofty s lG.o1 ob.t-) DICIjIAIIq! I --,r*.lfm lndn FuhyolFiuD rhn I o licds.d u&r rmrEp. or(18fl8 9lcomtu,rs *nh S€rnn 7{xxr).rl,rniJn r of rh. Bdirs dd PrcfdnrB Co&. dl my lte t in tull forc. rd.,IEl . c-39 l-i.dr. Nudts:6ssngb o7.06.l) ca!lla!.llJ.[l!..l!dDl!9rcll(I I ha.by lmrn un<rF Fuly or psjury thr( rhsc i a Nldrud$n Lrdhg rACy for lh. p.rtoMc of thc lort in trhKhrh. Fni B nsu.d(sc l(n7. civ. c ). AtllJ(Atrt DticlrSar.lQ! I hatb! .Irm u.d6 Fr!h, of pdjury oE .l rlE lollol ds &.l[!t iont Damlnbn Pmn!-Atb.3os N6r'n.!l'o. r.dsll RcsuldioN tTnt l0. Pd6) Rdtur.d l.cit6 of N.rfi cdio. I .c!if, rhd rh. fcdral EgdldioB Es.dins abdos rturvil {. mr .prltabl. ro rhn I)Nj(l _l cslri lhd I tht Ed thi! 4plic.rirn.n rd. rh, fi..b.\. 'nlo6dr. is cmd I iar6 b mnrD! tr nh !I Cny Modin.m6 .nd srd. L$ s rdiuu 'o tultlhr confulro !,1 hs.t^ ,uibtu.ofrhs( d! r.d Counrv 'o drd upon rlk .bo\. .mrrn d rnrFq for in p<rp. Itrti6 \pplkn r rirrr \irmrrt { f'cnriftr dn'c rrrn f 8L4k tfgCTity' o1. o 6. t7 Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Subfloor/VenVlnsulation / Roof Sheathing t? .lr1 -il i4\1 <,d Shear Wall Fram in s ln s u la tio n/Energ y Drywall Ext./lnt. Lath Brown Coat Mason ty Pool Fence T-Bar tlandicap Req Engineer Final Report Flood Zone Certif FINAL ) 1lY \\.d11 Certificate of Occu pancy I Notes, Remarks , EtC, COMMENTS I I I I Deputy Final Report I at