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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE tD/srG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subfl oorA/enUl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />IID
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Pool Fence
<br />T-Bar
<br />Handicap Requirements
<br />Deputy Final Report
<br />En ineer Final Report
<br />FINAL
<br />Certificate of Occu an
<br />Notes, Remarks, Etc.
<br />Oha-Blild.r Deln ti@
<br />I hcby .flifr uid6 p.ndty of Fjury rh.i Ln qqnF forn lt. CdlErddr' Licorc lr* tr d. follNint B6 G6 703 L5 Baind
<br />ed Preaei@ Cod.): Aly Cit, r Cohty rlti.h Gquid r pmn 1o .lfficr, .lrcr, ihp.ovc, d.mllh or Eprir &, loldurc, Fi loia
<br />iMc., n- Eqlid dE rpdi6l f6tud Fnn Io fl.. ii8n d irrffit tnx h. d !h. ir li6.!d paer to rt. FDndoB of rh.
<br />C6r*1d'r U.aB.d te (Ch$t6 q co.ffiinB wirh s..ri6 ,000 olDiliih ! 6rdc Buins 6d lrcrsid Codc) d th.i n. d
<br />tll. n amr{ lnfrfEn ad tl! h6i. f6 ln. .ll.8r{ dd9iid .Any viol.l]d of S.al6 703 L5 b, ey +pltal la. Fmn bj.c! rh.
<br />llllicor ro I civjl p6dry of n.r ne $& firc h6d.d doll.n (lro0).
<br />I, B Md of lh. FDFty, r trrr 6,!ploys *ilh ,.sq s $.ir ol. drDadiorl' *ill do rn. rdk Dd lnc rirucre ir nor iDrdd.d
<br />d olIGrd fd ..1. ( 54.70(. BEi.6 md Prefdid Codc TIE Csr.&td'r Licdc Ld dod nci irfly to { ownd of rh. PllFry
<br />who boildr or inprov6 thd6, bd who 6c ru.h *ort him.lf d h*lf ( fiNBh hir d hr oM mp,oyc6, prcvid.d rhrt $.h
<br />irrprorcndl, e nor inr6d.d d olfdld fd d.. lt, h*.!B, dr. buildin8 d inprovdmr n toB wirhii oic y@ ol coftpldioD, rhc
<br />Orna.Blildd wi nN. lhc bordd ol prcvi.a lnnr nc d rh. nor blild or ihp@rc f,0!c purpor. of rl.).
<br />_I, ! own6 of fi. pmFfiy, m Gclulv.9 mkdinS win t€N.d 6turd ro .@rtscr O. Fojet ( S... 7044, Bu!i.6 sd
<br />Prcfaid Codq Th. Conlr*ld! Licas. Lr{ &d not lpply to e omd of prcp.ty *to buil.b o inpFB rhdd . ed who
<br />.06!.6 for tuct ploj.ca wnh . Codh..ro.(, lic.u.d pt6@i io rh. C@rr&rd! Licoe L!w.).
<br />_I m ddnpt und Sftlid .4. A !.C- fG tih rao
<br />WORICERS COMIENSATION DECLAR TION
<br />I n6.W.mm undd Fidry ofFju.,6.ofrt toll@ins.,el6ri6'
<br />_I h.E od *illtuiinh r Cdri6or. of Cd6r ro Sdf-nlw td rstd'ffiFsrrior', a Flvi&d f6 b, S.crio r70o of lh.
<br />bb.r Cod., for tlE Frfo.ree ofih. ro.k fdrUci fi. pd,nir ir itru.d
<br />(Thir rcri6 ncd nol b. @mpl.r.d if rh. pdil ir ftr On. huftLld dollo {l100) d 16,
<br />Jtnn^**r^s otrh6*dt 16
<br />64r* tubj*r b
<br />'ho
<br />wdtd ' 6npdr.ti6 hE
<br />*hi.l thir pmn is itr!.4 I rh.ll hot
<br />of Cdif6i4 dd lsre rtr if I
<br />compd id provki@ of ,?00 of 0E trbd Cod., I 3hdl, fonllvnh+//-o
<br />WAININGT F.iluE to G@ *dd' conFrstio @va8. it 'nployr ro diniirl r.i.lti6 .id civil
<br />fi!.3 l4 io 6. lun(M lldred <lolln (t t 0o,000),in .<ldni6 lo O. dr of
<br />lnc lrbd CodG, intGt lrd df,.rr f6.
<br />d!m86 a Fovid.d fd $. Scdim 1075 oa
<br />LICENSf D CONTRA(:TORS DECLARATION
<br />I tdby .mfr und6 panlry of Fj!r/ rhr I m li6cd md.r psvirio. ot qlprr 9
<br />$. Auindr xd Prcfdd@ Cod., ntd "ry lido ir ln full ada &d .ficr
<br />,ilh S*$o ?0oO) ofDiYiim
<br />/t-/(-o
<br />I hd.t, .fiin und.r p6diy of pGjury $.r rhfr ir r .Nkucrid lddins l8a.y fd $. Frftu. of rh. ,qt f6 which $i! p.mit it
<br />isu.d (Scc. 30rr, CiY. c.).
<br />ed co6ry ro 6c, lpoi 0'.
<br />.!oE n Dtoncd pr.p.rr, for i,rp.ctid purpo.d.
<br />.ppliebl. ro $n Fojet.
<br />@1-of,
<br />I
<br />ffi
<br />Masonry
<br />Flood Zone Certificate EXPIKT ,u
<br />l'tu - |UIJ
<br />ira R-J1 ,qn
<br />_I h.E od sillmjnuin ?dta' c@!d!ni@ iffide, B Eqdr.d ty Sccrioi 3700 of d. L!b.r C.nc, td lhc pdffnlie of ln.
<br />wdi td which d)it Fnir i, in!c( My *dtd' .6FB.d6 iMc. nid &d poli.y nudbc E:
<br />AIIUCA Ti.UECI,AMIIOX
<br />D6bliti6 Pnit -A.tdt6 No.ifcd6 Fc<k l Rcrul.ri@ Gid. a0! Par 6)
<br />_ R.qdtd Land ofNodlicdid
<br />IfI+
<br />I
<br />f-I--
<br />i------r----
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