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BUILDING. INSPECTOR RECORD SITE-WORK DATE tD/srG.COMMENTS O\INEN BUILDEN DII,('AR TION I hsdry ailim un&r paahr ol Flury rhd I m .r.mB f(m tn ConridoB Licc. l,\ aor th. t(nk's 'ns rd,n (ss 70l l 5 It$ind! and Pmt<ioi Cod.): ny ( iry or County which r.9ot6 a txflnn ro .oniru.!. dh6. impnr., i|nolish or rcpdn dv nodue rrior to ilr isom., .4. Bq!n6 in. +pli.dt aor such Fnn to ,iL ! sis,Etl nd.lml $d lE or rh€ is li.a$d puMd r. rhc Fovai.B of tlt ConrBroir l.'cda.d litr ((tuFd 9. (-omfl.ftins $ith Sdhn 7(xn of Diririm ! of rh. uuri.6 .nd ftorRi.N Co&).r rh.r lEor slE ir.\mt{ 6a.6ohrnd rh. b6c r.{ th. rlkscd q@Fn. An.v \ iohlFn ors.clnn Torl J b:nr tprlEd for a ndmlrubjEls llE lprhcul to s cn rl p6!lr! of mr m.r. rhM fi\. hu.dr.n doll6 { l5m I l. a omd of lh. FoFdy. or my .nploy€ $ ith wr*d a th.n sb comFa€lion. *ill & tlE $ orl .,ri th. inEt@ u nor inrod.d or.F6.d for r!. {Sc 7(!rt. BuitB md Pr.fdira C(l. Th. ( odrd6r'! l.'.le lr$ do6 Bn !prl} io e o\F nI lh.Frdy r th tlrll or in4..6 tlE@ in * b &E ix.tr Nd h,ruta or fidslf or tlmuSh his or nq oq n .q,hr6. ForiLd rbd .(h iEFaldEit c bl -roid.d or olk frr rL l( rhq6d, th. hiLltrR o. np.otffi s $ld \$ihi. om \d .fsrplaiE 0E ()*E ttuildd $dl tuE rlE hrdd! ofFow* thi h. or rn dil ml hiild or iqmv. dF FoFr) for tl! poqlrs or L ao*cotrh. I'oIEry. d.rclBtrdyco rdh3 snh lka$.d.odrdo6 ro..dtud rh. Fo,.d (S( 70l,l, tldffi,d hntuir (-o& l h. Codr-torr l-tar t $ &'6 ml rppl! l. uotrGorroparruho hil& o mro\6 thd@o..nd who sd*r. tor 3uch F!F. *nh i Co No(r) lided For!]d hrlEcotudo.! Lkffi lr$l I dn.r.mpr uido setrn It &P( n!rhnr.an Drr. o*n6: $ otaxtsrsiaoitpr\sATi6N DECL II II(IN I hd.t' aflim undd F.!hv olFluD on. otlh. hllN'ns d(ldll'otrs lhav. a {illnrinllinaa.nific.r.olCoBd n) scll ltuuc ror \ orkd' conpqsalnr. s pmvid.d tu b} s<hon r7(xrolrhc litnr Co&.lor rh. rEfor111m. orrh. *ult 16r shrfi lh. Fnil ir ns!.d I naE ilxl $ ill minr.h rorl6 c.nFMion iM[r.- a rqun.d Lt Srrnn ]7(r.f th. l,hor (n&. ,or rh. FtomNc of th. $orl lor shafi rhi! rErn i is).d Mr worl6' onF,Ernrn rB,rEc.unrun F)lq rumtE ,. lcdrryltur r rh. Frolrruc.of rh.nork lor $hkhrhisFni 'r ii.utl.l3h,llmr mnkr! iny F$n !n m! 6e.6 e &i!o b€com. st Ri ro rh.*orln .onFErion hwr orcalifomtr. od r*relhal if Irtuuld b..omc bd roth. wortas' comFds.rnr p{.visioN o I Sal ion 1700 ol rh. lrhn Cod., I iqll, fodh${h comt ly * nh tho* !no\ istr)* WAiNINC trlurc lo suc uorl6 codFsalion co\d8. is unL$ful. ard 3MllrubFr D dph)d r. $inrin"lFuhi6 Md .N!l nnd up ro oc hud(d ilruqd &,116 (t1(x),u)0), in athi,. ro rh. con of (.mFMrion. d,nut6 B Fo\d.d nr !h. sdrhn i076 ol rrE lrE{ co&. Drqd dd dlorrx! 3 ,6 Appllunll Lt( aNsr.r, ( oNl'lt (ll)8 DISASAIIAd I ffi, arm u.dd Fdv of Frury rhr I m liclsl uidd Fvilion of Chlptq 9 toIl]Mins wirh khn 7l)001 of l)n Bir I oa E BGiiB r.d Pref6bd Co&. tld Er lt@ it in tull f.R rn dlct CONSTTUCTION LENI'I'TG AGEN('I' I heh,aranundd F6l'y of pqJury lhd th6c ir a co$rncl ion ld in! rttry for lh. p6fommc. ol rn so* forwhichrhirffit is isu.d(s6 1097, ( i! C ). drru(bNLDl;g,AMIlQN l,EE trdu(ld paahy ofpsjuy oE ollh. folloaing d(lfdio.s I)@,l rn P6mil!- rhclo! Ndiiic.'$. F.d6.l R+uldFm(Tnk{0. Pd6) R.qurql I .lld o r Notfical$n I ..nily rhar rh. f.{ldal r.*ulali{N Esadins 6tE*'s rmo{l e. nor Eplkabk ro rhit prold I (di&$d I h,r. E*l lhir 4fliibi id nal. tnd rh. lborc infomdin 8.ffi I d*c ro smgl! $ ( h oll ( n' ad ( oui) ordiME6 rd sr!t. I r$: Eldiis ro tlild'ns .on ruclna ,ri hdo ldlhrn. t.F.dc n 6 o, rhG cn! rnd (-.unD ro 6t6 urnn rlE .tEv. ddrnrn d pFp.n, tor iNp..ituo ^pprl..ir or ^Porr stsn.rure >-y' t'c,ntre "trc tpriart: * /tc Q i.) rr-57 Z//r7 Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Subfloor/VenUl nsulation Roof Sheathin Shear Wall Framing Drywall Ext./lnt Lath Brown Coat Mason Pool Fence T-Bar De u Final Re rt En ineer Final Re rt Flood Zone Certif. FINAL (-27- />Jal. (o -D Certificate of Occu nc Notes, Remarks, Etc. I lns u latio n/Energ y i I I Handicap Req.