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BUILDING. INSPECTOR RECORD SITE.WORK DATE ID/SIG.COMMENTS OWNf, R BUII-I}ER DfITAT TION I hfthy lmm und6 p.n,Iy.f pajury rhd I m .r.'nfl iinn lh. (i racro*' Li.ffi tr$ for rh. a.llo$m8 rdsin (.cL 70ll 5 trurindr i PNa6io. Co:!.) Anl ( iry.r ('o!fl! *hth rdtuim . Fmn ro codod, .l'a. imForc &tmlnh or qnn \ irumrq Fdro il! isuffi., lko r.q'rtr6 rh. eplic ' for ruch Fmi' r. fil..ri8n d.rarmr rh.r &or rh. a h.ftd rrNld ro rhc FnririoN ofrh. ( onlkror s l-ic.ns.d llw {cn |16 e, conm.ncinil *nh s.flioD 7({n of Dirision I otlh. Busin.s a.d PmtsxlE Co3.l or lh.l lE or sh.6 c!6nl'1lh6.trom !.d rhc tGn fo h. alk*.d 66nFrn A.l vrl'lrnofsdi)n 701I 5hlmr rplli.onr aor r pdf,n s'bjds rh. rprlicanr ro ! .i!il pddlry of not mE rhd n!. hunJrcn dollns (15(l(J) l.do{ffiolrh.rr{Jt!n),ormr"m0lotGtrnhs.rr6airh.n$k.omFl$ri.n.$!lld,rn $dt!tih.rMK6mr inrdd.d or olt6.{ for sk (Sc ,044, Burins lnd Pr.f6sioN ('od.: I n. Conr6.loi3 l.icce Ii{ &6 nor ,pply lo .n o$ nd oa rh.F.rtny \ lrr txildr $ !rS.016 rlxtaE !d tr tb dB $.n rdt hrmslf or hclf .r rhmuSh hit or h.' ost mph!6. I,.v'ii.d rh.r ruch 'nFrffit e ftn d.iLd oroffdd tr $k It h,s6d, rh. burldrnS or mFol.E n$kEhhrnonc\tr ol.omFki.tr $. ()$E BuikL e ill hdr llE hr.lar of FovinS lht tE .. rh. dij en hit or irr(rc th. F.Flv t\r trE tiiFt oi l. sotrE oarh. rrnF!). m .rclun.ly colir!.1ira *irh lrcosd.od6do6 ro s.rtu.l rlE tfrjd (sft 7on, BBi6 lrn Prnks ('.d.: Th. corkrrorr l.i..N l-.$ &6 mr qrlt 16 e o$.s.fFop.dt $k) brrldi or inpror6 rh6@n- lnd who conr6.rs for 3uch rrerccrr sirh ! ( oorEcro(s) licdEd puBur ro rh. Contictoi! l-i.4* t *) I m.\mpr un'i< Sclron l).r. ()ind l\oRxriRs ('ot\t ft.NaA l loN [E(!r&].110! l h.r.h) rll'rnr tr. ( p.mh) ol F:tu^ on. ofr hL ldloNn! d6l!, ionr Iha!.lrluillroi.rrhrC.n'a(.rcnlcolFrloSdf-lNEldtrorlo.ohr.(dr(E rfrriii.n f.i h, Sdi.. \7(x) orfi. hbor ctrdc for 'h. pqfolffi. orrh. *!* for trnrh rh. Fnn b isu.d Iha\..ndtr'llmarts'nrorld.ohnoer'o.,Nur!Nc-sr.qutr.Jh)S{t$nri(x,ofrh.Iltbr(i|d..nvih.tEfone.ot rh. sorl for s h'(n lhn rFni n rsEd. Mt suli6' conrpc6dion nsuru.€ G,rin ald Fli.y numlE .: I c.nrfylhd in rh. pdfomBnr. oar h. *orl f whi(hrhttdmn is irsu.n.l $alln.r mplot any pss! i. iny mainfr v' alo tE$m. rutlal lo rrE l.116 mmrEEiion Ltr: ofcrlrfomn. &l4G (bd ir I rlbuld it om. tut tr r. rlE uoft* conF<lsIor rovi.iod oI sd6n 1700 orrh. I lbor (i'dc. I {sll. fonh$irh .omplr $ hilbx,!mv(ioB WARNINC F ilur. h EU. *odd (onFnsrhn m!6+. ir unhtr ful. sd shsll rubFt o dpk'y6 kr ffiBl FEhE md cnrl n.d up b.rc huD]r.d rh.u$nd doll6 (tl ). 'n.ddnm. r. fi..6 oacomFNlion. dlrEsd e rro\d.d f.r rh. /7 -Jo{ {Lll4vF9 I ffiy.mm u,.Lr lEn.lty or psjury rld I m lilEEl undd Fo\i.ion 0r(1.86I (Lomm-ins rvirh S<lpn 7001)) olDn 'r'on:rol rh. Bdn< md Phl6i6N (-od., .nd mr liLe n i. tull llr( drl.iIftt ',))'*r1$ 111,r /oot{17JH 1utFr1tfr I hqlby .mm u'xla Frlly ol FJU,y ll'n lhs. i a @tdruclion lddins .efty for rlE Ffollre. .lrlE $t.l iir snih lhi Fni ! nsu.d (Sa. 1097. Civ C ). AttI,llAdLDECIdSAIIg! I hr6y .IIm ur(k p6.lry of FrJuI. oG .l rh. rolbs llls d.(l(.r ioni' D.molhhn Pmtu-ArtBtos Norifirdion t_.dsrl R.aul.'io lTnh{, P.n6) R.qun.d llllaof Noriftd{o I .d ify rhd rh. f.nd.l r.suld ioB r.3dJinl ab6k8 rm\ .l a. id' .prlkahl. kr lhie pioj.{ N.otrc( I ^are ro comnly Nirh all(-irt ind ( otrnr) Jo{€4]41/F< "'l',,r'^'trr,; Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Subf loor/VenUl nsulation Roof Sheathing b/t/ n //h.$'( Shear Wall Framing lnsulation/Energy D rywall Ext./lnt. Lath Brown Coat Masonry Pool Fence T-Bar Handicap Req. Deputy Final Report Engineer Final Report Flood Zone Certif FINAL b /or/tl 5.hr LV4U {.6 II Set Backs I I I I Certificate of Occupancri Notes, Remarks, Etc. /1