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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNER BUII,DER DELCARATIOIi ' . .I hrcby afli"n undd Fah, of Fjury lhal I m .i.mpi fmm th. Contrclo6 l,i.N l,N lor th. follosins rca$n (s( 'r0 r l 5
<br />lnBi.6s trtrd ltotdion Gd.): Any C y or Counly which r.qun6 a p6nn (o sdtud. ahd. ioprovc, &.alish or rqui,-e,\ '
<br />(rucruc- prin k, rr3 i.rue.c, .1$ r.tui6 rh. rpplicd aor luch Ff,nil lo fiI. a sisn.d slal.lmt lhal h. or sh. s li.a...l p.{r,mr '
<br />to th. |,ovrsroN ol rtE Conr.crois l.icnEd la$ (Chafls !. Comnc.cinS $nh s.clion 7000 of Dnion I ol Ih. Runn.sr lnd
<br />Prors$N (i\ic) or rhar h. or sn. k .r.mB rhdcEofr ed rh. b6.t aor rhc olLs.d .xdnplior Anyviolari('noastrio.7orll6'.nr
<br />rrplrra lorrpnnitsohjcrsrh..pplicrnltoacivilpcMh)oanolmolethofiv.hundrcddollm(l5ul)
<br />L * o$rr orrh. F.Flv, or m, cmpkry6 trn[ $rt6 s rh.ir $L compssron, trill& $. uo* &d rrr rdd. i! fri
<br />inlftldorofld.nnrskISE7(ll,l.BusinsodProasio6Cod.TtcConrrsctor'sLi.hw&6no'!DI,l!k'!notrrsot
<br />rh.,nrrH' sh) }Iil& Dr iqm\c rh6o.. ad sho d.a su.h tro,r hnns.lfor h6dao. ttmush his or h6 owndpkJ).6.
<br />p.ovilal lnd Juch imF amBrcml inlddcd or oalqcd aorslc.lt hoq6q, rh. hrrldfl{ or inqrovmr ir$B$nhmorc)s
<br />ofotrph{r rE (nTr B{ik16 rill h.1t rlr 6do ofp inr rh, rE or dr dil d boild or impmt! th. I'oFq for th. FtrF*.f
<br />l. 6 .$ E of rh. F.F.r). m .rcl6iv.ly codrr.lins firh lic.nsj codrldoB o co.nruct 0E pmjd lsd 7tr44, lt6!n6
<br />,d hr6o Codc Ttc Co.rr,(loar Li.c. Lrw do6 mr qDly ro & o{ n6 of FoFn} $ho t ilds or inpiorB liqq,n-
<br />md kho odmds lor .h FnFsf,nt! Codr ro(,li<dE d pG6 ro rlEconkicrors li.e L,*)
<br />l0c(o,fl unds scxon ,B &PC fo.fiir 16.
<br />uoaKEar_coutftsallo!
<br />DEC!JtrAI1O!
<br />I hdd', rmm und6 p.Ghv ol pqur orc orrh.Iollo*[* {t rl[dFm
<br />I h,\. nll *ill mi.rnn . Cdifrd. otCoMt lo Sclf.l6u. for qort6' comFEaF.. a Fviini lor by sdon l?ol) of !h.
<br />Iihor C.<k, for rh. tEforlffi. oldE $.rt fd $hkh rh. Frnn is isu.d
<br />I h!\. !.d sill FlinlM sort6 codrsBnFn 'Nlmc. d ,.qurcd uJt s.ds. -uoo of th. bbor Cci., lor E,qfo,rre..f
<br />lh. uql for f,hEh lhs Fn n isEd My sorl6 @mFEiFn rBue..ril rd polb .mb.t el
<br />Etp6
<br />I .drrry rhll 'n rh. FaolM. of rh. $orl aor $hkh tii Fntr ! bscd. I nEll m' mph) ey Fe. i. mt me6
<br />s 6 ro bdom rubd to th. q!rl6 mmpasnrcn laqs of C.l'tomie {d asE rhd if I slbuld haom $qd t. llE
<br />$$lt6 NmFMhn Fn irnN of Sdion u00 oltlE L.ln Co<k l CdL fonhr nh comlly *nh db* FovtioB
<br />$ARNING lanur.ro sw.{! 5 ..nF$alnn co\@sc a unla\ ful. erl I sobld u aph)6 ro trnBl rEuh6 lnti
<br />cnrl li.6 up rr orc hundr.d rhoend &116 {ll0o.l)Oo}. in ldd'lon ro comFNrion. d.m36 6 i'o\ rl.J ntr rh.
<br />Sar'on 1076 orrh. l.&, ('qj., drdc{ dd rnorrqr! r<
<br />I hdct'r amrm un& pqEll!. oap6ju)
<br />'hd
<br />I d liclel u(lr
<br />ol rh. auffi d{ Ptufs.E Cod.. arl m) lf,G b in tull
<br />oacrr4ra e (offii.s trhh Sdnn 7urrl orrrtrlion I
<br />b
<br />7-Rq3
<br />L
<br />calsrBlJcrlotl,tlDllc-aqEr(r
<br />I hcby a,Irn und6 Fuxy 6l Fjur, thd rhd. i a .odtudrn Lndin8 retr! for lh. Ffortlrec or rl! $dk 6r $hkh rht IEmn 6
<br />Nu.d(Sa l(,)7. Cn a )
<br />AITIIIANLDECIIIAIIO!
<br />I hfttt allm rnda Fnak, of Ftury on. of th. folhq inr da lear pN:
<br />Ddnohrbn Pmirl^.bdbi Noril'icarion F.dral R.8uldiotr (Tnk40. Pd6)
<br />R.q!ta.l lnr6 of Notific.lion
<br />I csl'fy rhlt rh. find.l r.gularioc r.!&ni.* atsros rmoMltu. nor 3pplrcablc lo lhis prcJ.(l
<br />I cgliallhal I h.r.radlhitapplicalDnandstarclh.Ilh€abor. infomau is.or..r Ialrfrr..omtltwnhallairyondCounl)
<br />o'nraN.si s .l itrs r.h'trS r) htriU'n! cof,nn'.rion- md aulh.r;. r.F.frra'nd oafiis Cil, ud Cou.ly_ b flrE ulr,nlh.
<br />ah.v. mdrion.i lroldt
<br />Appll(rnl or Axqt Slttr.:"-F"'"," q' tL-17
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<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 />Engineer Final Report
<br />Flood Zone Certif .
<br />FINAL
<br />Certificate of Occupancy
<br />Noles, Remarks, Etc.
<br />o b ./a/r'Z4-.Zz \l 7 c-z
<br />.L1>
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