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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNET AUILDER DELCARATION
<br />I hcEby {tfrh unJ.r Fnalry (, lErNry rh,r I M crhl,r from rh. C.trr(nrN l-rcna trw fo. rh. L,ll,'wirg r..qJn (Sc( mll 5
<br />tloirs ad ltotr{hn C,&r Atry C y or Cddy *hrh r.qurr r IEnr, k! con{ur. .lrq. 6010(, J.mllh or Elu oy
<br />!etm, Frx t' s Nru&., rlso Equrcr rtE rt{ rrnr ft, ikh Fmr iD iiL r !4ftd n{.m.t rh, h. or ar n lrcnsJ l,q{.dt' lh. tE'viri'ru oi tlx Contr.ltx r L.rnsd l]u (alq'l.r e. C mmRinr eilh Setion 11)(l ol Divknr :l ol llE Bus'Es MJ
<br />Itn.sF,trs Crilc) q thrr h.., rlE tr cr.r{'r rlE.trom.rn F lrc6 nn rlE .lhc.j .rcnri,n &yr,L!mo,S(rrnmll j|ry.n,
<br />.r,pli(onl n, r Fmil subF.ls tlE applrrnr to r crvrl FMhy ol ml m)rc than fiv. hunlrcd dollus (l5m).
<br />_1, .r owrcr o, rlE FoFny, rtr my .mploFs w h w.!.s rs tMr r,L .uFnsdrn,n. *iI Jo rtE krt lrl rh. iturm a k
<br />hr.nlel or oit.r.d Lr sL (Se 7tX4, tluriRs MJ Pi'L$oN Cdi. 1 lE Cdnkkttr\ ti.nr lrr .lEs n.r .pply lo u .wx.
<br />rhr FlFiy rlh tn Ld,rin,6dft4rnwhl - tuh k{t h,lMll o. h.rell or rtmrgh hr ,r h.r oh.rnlry.cs,
<br />nrrvdc'l rhal su.h mln,wnrr N ft)l nr.Bl.n q oficB]ft !lc. lf, h,sw, rlE ttr'!'q or rsnrEftnr r $ti *rho oh Fa
<br />ol LvrykM llE O*Er BoiLr $I hd{ rlE hml.n ol Frllg rhd tE d dF drl d tnu or olrniE rlE F rEl, ftr rlE IrrIrE of
<br />_1. r!owr.r rh. F rrny. rm.r.lulwly conrr&rmg wlrh lf,.nhl.ontrnn n, (rnBt rrr F,Fr (S( ?lx.l. lru\r$
<br />ml lhftasx{ C*lc: Thc Conraur's l -'..nrc lr* J(d a 'tfly (r rh osn.r of lh{rn y *h' hur[r or rm,|r.E hc.d,.,
<br />rtul *tu d,ntrd x tur su.h I'l,F!t *irh r (i)nrnck'( n lirn{'l punqd r)
<br />'na
<br />G'nra.nn r Li.cny h*r
<br />I amcrcnl)l trklcr S.criu , B. & l'.C. l tr rh^ rc6on
<br />ulla5r&t-raufEltArla!
<br />DECIAEAIION
<br />I h.r.t y rruhunJcr Fnrhy{l lf,rjury oR ol!h. nnh*r3 dNll,.lrmr:
<br />-lh.w.,n*
<br />l Bhru. C.nifr.l. ofconst
<br />'o
<br />S.U-lNUr. fG q{rai (snF{qrFn..! Foyrrdnnh,SsrD]nD.rrlI
<br />htior C,rjc, tu lh. Frfomk-'c ol thc hd( tu whrh llE Ffll 6 isrucn
<br />lCh.E In ,rll Mur.'n k,rr6 LTtr{E !ri,r iEUr.Ec, tt r.lurcd b, serFn rnD or rh. blx, cdrc. lir rlE Fftur ol
<br />rh. *od ri,r vtrh lhis r.djt ir tsrqj My *i,rls .rnrEn{lon ins!,e! (uhr !d ,bliry .umh., e:
<br />,,,"tr a?Caf//rr,,,r-r^r^*, GfrA)/
<br />-rrr*,
<br />I (d{yth.r rn rh.IErformLc., rlF u.lk i,tr wh.hrhun rn( tr !$cn. I \h.llfrn.t,Illi,}d
<br />:, r\htfu,m bF! b rh. knl6 $n{f,nqr x,. hw! of Crl'fomu, .nJ .3r( lhi r, I rbull b.toc auhFr ro r lr
<br />utrkcB' .omn! nrrl ion pnvNi'trr of S..xon 1?u, of lhc I ititr C,rl.. I {nall. n)nhv h .oqrly wrrh rln,E nn,vunn\
<br />WARNING: lj.rturc 6 sr. krkch drmrEn..li,n.ot t.[( !r unh*tuI. Bl $dl iubA.-j .n .flphrlr t! rrEiDl Fulrn .!t!
<br />rNtl ljNl un I' orc huolr.J rh'uerl Jollur lsl(x,.tlil), r rdrl [n b rrr ro{ ol6r{xnsr!)n, J,tuBc\ !r Pro*t.J tu rh.
<br />sr(inr 11176,n rl[ ltrhtrcril.. tr .r.( mJ iitr,f,y \ rcc\
<br />' DECI-A'IAT|ON
<br />I h.rcby u(tn utr.lcr FnrhlorFrjury lhlt I rm lB.hrn uklcr l,olNonofCh.pts e (!$mEturry * hSNlon ?0u)) oiDrvNnnJ
<br />dr .lr aBims.Il Pn{Bssn. CcL. .tn my 1...( N r tull n)N .d cn(l.
<br />s9lsrB.lq:loNJ.l8Dl!{inc&alJ
<br />I lltlly rfim unj.r Fn.lry of F.rrr rhd rtR B. ()nidi,n t dtm! .!cny ror tlE Frf(m!.1ttE unt tor *hrh thN Fnu 6
<br />asx.d (Scr.l(l)?, Civ C.)
<br />AIILICAII"DECI.AXAION
<br />I hs.a', rfm rdd Ffix y or Firy oE or rli tou,*r8 delmin.:
<br />rrcmlr!,n P.rmirlArlEnos Norili.orii'n Fcd.r.l R.ruLtioro CTnb 40, Pin6)
<br />_R.q!El ldr.rof l{rfHrir
<br />_l ..n y rnd rlr lclnl EluLrbE Elrnx8 6l.im mrv.l c mr {tl..hL x' rh! FsFr.
<br />_l drry lh.r I hrk E, rhj. rppli.liii !n d.E lh,r dE rtnr nn,@tb, ! colRi. I .tE lri orlely wnh rll Cn, .tn Co!.ty
<br />o,'l'rutu(\ id Sric ljw\ r.l,rrt t' h"lll'n3.!n, ani h.r.$y rrrhrtu n F.{nr!ov.r !,l I
<br />rlxr. mrrtriNJ F,n nv ntr
<br />,\t'l,li.{trr r ar$l SiEsru
<br />o .4//qn<
<br />:"'u),;
<br />Set Backs I
<br />Forms/Steel/Holdowns /-n
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Rool Sheathing
<br />Framinq )f7-"t /z a -'.7fl
<br />ln su lation/ En erg y
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certil
<br />J
<br />FINAL 3.or'tt 14. Crs,vflta| -Zt7
<br />Certiticate ol Occupancy
<br />Notes, Remarks, Etc
<br />/fty'/z'zt --z-Hz
<br />Shear Wall
<br />Ih&:
<br />_l
<br />Drl.:-
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