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BUILDING. INSPECTOR RECORD SITE-WORK DATE ID/SIG.COMMENTS OWNER Bt]ILDEA DIT-C RATloN I hdcb,v .mrn undq pollry or Frlury lhrr I m .rcnfl 6om th. (-onlradoB l,icG l.w itr th. follo$in3 r..$n (sN 7011 5 li$ns rfil Ptufdion (-od.l An) Ciry or Coul! qhi.h r.qurB ! Fma !o.odrud..lt6. inForc. d.nn ish or rFn u'_ t' th. polsrN .f tlE Conrrloas I rar.d ljn' {('tsfl( 9. Conmd.inS *nh sdrnrr Tlxxr .t Dri.iln r ol rh. trutinRr lrd . Prolsiofls Cod.)orlhlr hcorrh.n.r.nfl thd.fr.nind rh.bei! for th. allcr.!.rmplion 4., violarb. o I Sdion 7(rl I 5 hyiny .rrr'.er for . Fnn 3ubr(k th. spplic.nr lo ! ci il F.llly o f rcl hor. ln . fi\ t humL.n dollr! ( 1500) Ldo*mofrh.FoDdy.ornydrloydsirhs.rr6s$.n5komFMi)n.snl&llErsi&ddEnMEiimr i ax,.d ororcr.d for slc (s<.7044,8Ni.s od ProfdioB Cod. rh.Conl,icloai Li..e l,* <to6nol {,?lylo uotr6of lh. FtrFr, wh6 t!il& d ir{,oE tE6( .nd who rh6 sch wd hiErlf or hGlaor lhmugh fiir or 16 os'n drh}.6, Fori!.d th.i ruch ioF$\Ed!Emr itdr&l d odi.d lif, -l. llt $t€. lrr tlildls trlrF\sd n$B*ihinoR\6 .fo'rpkihtlEo*GBo'Esunlh.r!.hd@olthrnEddlEMJrdidB{h,iEo.nrp.or.r!.FoF!turlEF,BEof l, s osna ol rh. Flpsiy, m .r.lNiv.ly conlr.ciins wnh licak! cofllr*tor k\ coihd rlE F jd lS( 7lr.l4. BBinBr el PDisis con Tt. Conrrxroar l-ico* l-.s (hd hr ,p9ly k\ orE ofrrop.n]. s'lN hulds or inprord ihdsn. lnd uho olnn rt ad.u.h FFr$nh. c.ffionr lt.Grl lilBosr lorh.(iddoar l.k@ f.{),i DlicldS4llQ! I hdtliv rfinn rndd p6ally illrEiur! on orlh. foll('w'or ddl@rn,ns I h,\. id srll mi.rs. ('difrd.or(.lFr b s.la-llw lor trnrld'NmFdh.. * F\ i&d tu, h,! I€ii,.lr{Dolrh. L.lu co<le ld rh. Ffolr@.. ofrh. ${rt for $ hi.h 'h. pdnn i! isu.d l hav. dd * ill naimain worl6 comFns.l ion iNumncc. 6 r.qurcd by sdtun !7(x) .l rh. l-ttnr Cod.. nr lh. pqfomd.. of rh. uorl lor$hkhrnnFrni n isE Mysort6 q'nFE Fn,Bu,et.mE sd Dolt) nombs e I cdibthd rn th. FfoIMm. orlh. \ ort roruhxl rhEFnn r e.d.l sll.llml4plo) tn) IEen m tn) mdF $ 6ro tEcoo. ru!,..r ro rhc rorld cnmFMion lN. of crlifomi!. nd aar lhar irI slblld lt otr st <r lo tlE wor!6 co6r.neti6ntmvnnrBofSdim l?0O ollh.l{bor Code l dEll. fonh*irh..nplr *irh rtoF pmvnionr. WARNINC liilu.lo <m work6' .omFBdirn .dro,*. i! unh$tu1. !.d 3hrll rubj.rl b dplotd !o riminal Fui6 d c^il nn6 up ro oE hun&.d ttF@nd doud (lloo.uxr), ir .ddni.n ro rlE cod or conp.Nl &n+d tr Fo\d.n trthc L.tor ( qle inrd.s dd on y'i 16 I - tt1 1-r I hd.by alrm un(b F.al', .l Fjury rh! l6licsEd ur&r F.\6i,n ofCh,F6 c (.omnFcin8 $hn Sel[n 7firo)oaI of rhc tlusirBr snd Pofa:n)ns Cod.. trd y licms. ic in full lnc. Md cft{l cqrsrBu(Iroll.llDjlclcfB(} l h6riy.mrm !nd6 p.oalr) of Fjury ihd rhc. is..$nntu(io. k*!i.g 6!fty lor tlE pqfotuc nrrh. " [ tu qhth'hii Fnn a hsu.d{s( 1r})7, civ c ) lcnd6's ND( APPLI( NT DE('I ARATION I nddl! lfm undd ,cnalry o f FrlD oE or rlE aolh$ in8 &(lrd i.nr O.mlhion P<m s-Asb6lor Nolificlion l.ddtr R.ruht Ftu lT nb ,r0, Pd6) Rcquir.d ld!6 of Nolifi cdnn I c6r '[ rhd r h. f.dnll Gstrldioa krrd'ne ahdktr r.mr r] ,. .or apd(.hk l. lha lh)j.< lcdiry rha! I hrv. (ad ihh.mlicalnr dnl st0rcrharlh..tn\c inftn]dnrn is.ondl l aFah.ompltwirh.ll( ilyand(in,nit o,dinarc6 od sr6rc lr\a dd in8 r. boildint conrodh[ axl h6.bv lul h.ri,. r.rtula! n 6 of rhn ( irr" d(i{nlvlodh trF,nrh. .lrr. mrirn.n f'oFdt aor ldsFdion rrrlicinl or \!01 stnrrtrrr N Ht-\a"U bl It It] Set Backs (t -l Forms/Steel/Holdowns b n\\ ( Erection Pads UFER Ground SLAB Floor Subfloor/VenUl nsulation Roof Sheathing /t/ Shear Wall I Framinq 1 l)l)-tr<\(n lnsulation/Energy l Drywall Ext./lnt. Lath Brown Coat Masonry Pool Fence T-Bar Handicap Req Deputy Final Report Enqineer Final Report Flood Zone Certif . I FINAL IL Wrr tvt Certificate of Occupancy ,,_ r- / Notes, Remarks, Etc r'." i- I I I I I I