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BUILDING- INSPECTOR RECORD SITE-WORK DATE ID/SIG.COMMENTS OWNER BTIILDER DELCARATION I h(.by altirm undd ,<nehy of pdruiy rhn I m .rdrr 6om rh. (.onlr&loE LiccN Llv ror fic folb*ing ..Mn (Sd 7011 5 Bunnds dd lrorB(n ( od.) Any cily or county which r.quic ! pqhn lo @onru.l- ah6. inprov.. rkrnolkh oi r.Fn 8ny srrud6.. Fio. b n! iaee., llso Equi6 lh. !.,plicdl tor iuch pnni ro ,!1. i sis..n stdmot lhal h. or sh. is hc4.d Putuer k\ rhc ln)vsn'm.lrh. conlrr.rois Licds.d t ! (Ch.pl6 9. Conm*rg *Ih s.dion 7000 oaDivision 3 otlh. BEinB &d PrcfNio.r (tilc) o. th.r h. or sh. B .rfrfl rhdcfron !.d rh. bca for th. alt.8.d adplion Ary vioLr io. ol S.dion 70i15 by tny radlic! for d p(nn ruh)(( rh. .pplicDr ro r ciril pmlir of nol mor€ lhu lir€ h!n&d doll6 (1500) l. s oM6 oarh. F.Fnr. m my mplorB *ith *'.s6 s lh.n sb NmpaEatn. DiI & dE *dt dd lh. rndr i! mt inr.d.n tr ofid.d tn Ek (S< 70a.4. BBinB dd P,nfsaoB Cod.: Tt. codr..lors Lkav bw &6 rcl lprly lo d otrtd of rh.FoFiy $tr hrilAo, o{r.v6fi66( rd f,lF &!6trhffi niroror ha*lf orltFush hi3 orh6 om mpLyc. p.o\ nln th,l !!.h imDroEErll E ml i{oxLd or olH ft'r st. lt ho{6t lrE hrildn8 or itpltvqEn ii $B snhin oft }a .fcongknn. E (xG B{ild will IEE lh. hdar of pr.virv lllr lE m Jt dit nlt bUiH o. in4.ott {h. FtrFty fo.llE Frpo. ot l, 6 oq .6 of rhc FoFry. @ .rclGi\'cly .ontr.rmg r h li.sB d .oitdoE lo coElrucl lh. proj.d lS( 701.1. BGins .al P$l3rih (lr& Th. Conrklor ! Lir.N. Ltw &'6 not lprly lo D osr6 orFolEry who bui!.L ot impror B th6on. lnd *ho snrEcr3 ror Dch Fojd. unh. Comr&ro(3) li.d!.d pIGd rorh. Co raclois l,iw t u) I m.rofl unds sdion toatrEf,5:(outElsalla! DECIJAAIIg! I hd.tD .mrn lndd Frhy of Fju' oE orlk followur d.(Lrnioa I h.r. rd will tuin.n. Cai6.d. of CoMr lo Sdf-l6@ tu rdtd o,p.Eriotr. B FDvi,.d lbr b, sdrion 1700 of lh. l,tor Code for llE Fflffi orfi. ron tur sllah llE FEn it is!.d I hrv..d u ill n.im.i! uorld cohFerirn i6ueq s '!$ricd bt sdbr l7m of dE L.t r Co&. 6r llE p6a(,lrlM. oa rh. mrl fft ut*h rhir Fin i ed My *'dl6 o,q.laion ill.ll'm 6i n Flty numbs ft:,* ErnpLoVCl S'nufct G/touy'- p.tiyN" * RtUcQ ?&Q?8-L,,ptu /D /O/,/2OlI I .or'ry rha i. rh. pdaolr:lm. olrlE r orl aor $hin rhi! Fnn n i$.{ I i'.ll rcl olploy &y F$n h at n F $ c ro tEr{tr $bal b lh. s*6' of,FEiim LB of C,lifon( ird {G rhd if I slblld t .oft t*<1lollE *o 6 orrFstion pl$rind of S6rFn l7mofrtE L.hr Co&.I Crll. adh{nh ompF *nh $oE FlriDG WARNINC, Fril@ ro sft \ul6 omFdion 6\sr8. L mLutuL d {ull sb,..l & arptoF ro ainir.l FEhE od .nil nn6 up ro oft hu..H tlEusd &116 (tloo.oao). in .d:lnnn ro th. .d or.omFdion. d.fls6 6 Foy'dcd lor thc t tm ( od., mrqd dd,rorElJ UCI}SflL(I)}IAAC.IAA DIIIA&ITAIIhdtt,.rImurd6Fun,ofFjEyi,'rIutcEdur&FDvi.oro!+lsg(onrlj6a.ewnhsctb.,0m)olDivnibl ol rlr auig -d Preksiod Cod.- id oy ltoe i! i tull bc id cltd G A &,1.ztr1-sru )tmat ^ /]-2!'7 12. co,v)d.t&.*- CONSIRUCTION LIJIDI G ACENCY I H', .mni lnl. F.ndJ of FJUry rhi llE it. @rdrudioi ld'dit8 tgtry fot th. Ffolm of rh. ust for trnih rhi pdmn i! '\sud(sd rrD7, atr (') Artu(A[fDrcttSarra! I h6d'yitrTD! J6 porhy.rFjur' oft oflhc follo*'iry <k Lrtlio : r,.nFlnhn PmnlA.hdd NorifEdhn F.d.d R.SuLlioN ( Till. ,l0. P!n6l Rdtun.n tAd of l.*{ifrrim I c6rit rhi rh. ,Gda.l r.fuldioN casdins abdro! rEmr !l e nd 'P,lk.bk b rhis Proi.{ I.dr'ayrhd I h.v. rad rhi lpplk.rhn id!rd.rhd rh..bo\. i.aorn hn n con.cl. I d3E lo onply $nh.ll Cny ud Counly odi..c6 si sr.r. l,*! EldinS ro h ildins codNrrhr !d Hy .ull$rtt r.!r6.riniv6 oaihir Cn, dd Counly lo dlq lpoo ltE .bor. mdrk'nql t,lrF9 lor NFdion A00li..n. or A*nr Si*nrrur. 67E u+/-@--/) -2t1) Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Subf loor/VenUl nsulation Roof Sheathing Shear Wall Framing lnsulation/Energy Drywall Ext./lnt. Lath Brown Coat Masonry Pool Fence T-Bar Handicap Req. Deputy Final Report Engineer Final Report Flood Zone Certif /f\ FINAL 2-221',/v.wtil Certificate of Occu n Notes, Remarks, Etc