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SITE-WORK DATE lO/SlG. i COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Fioor
<br />Framing
<br />lnsulation/Energy
<br />Drwall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif .
<br />FINAL lt -/7-/,,ett/o j
<br />Certificate of Occupancy
<br />Notes Remarks, Etc.
<br />BUILDING. INSPECTOR RECORD
<br />OWNEN B!ILDEN DELCAR TION
<br />I Esr* ilIm uklo Fulry olFjur,v ihr I m sdpt Eld llE Coir-i6 Ltag Llw for tlE lollof,ing len (Sa 7011.5
<br />Busi.6s a{ Proleioi (-od.): A., Cily or ( ouny whrh r.quG i Fnil |o co(do.l. .llc. inFove &mlnh or Epat hy
<br />smcr(q Fbr b it! ilsl@., dro Equr6 rh.Oltrn (or *h Fnit lo (lc. lrgncd rrnaE lhn lE or dE i lic.nr.d Fmlr
<br />ro rlE ForiioN of {r Cointrd! L..nsl t w ((18!.r ,. ( olhdnt $nh Sq1rn 7000 of Dilit.o I of thc &!ilB Dd
<br />Prcf*i.6 cod.) or tha lE or tE i. qcryt thq!ftob .!d dr t !! for lh. dLscd qaFio.. Aly vioLtion of sdiri ?01 Lt by oy
<br />.pplKm for r Fmil iubj6t! lh. .gplicel ro r c'vil Frlty of ool mr thd nr. hutdrc<l .t UEr ( lJ00).
<br />r..r o"Eolrh.Fr6lr.ody6rlor€wifi q.8€.$d&LcomFErh(*dldorlEsdlni0EtuEird
<br />idaldl orolrdd aor el.(Se 7oart. Buh< ed Prcrsbs Cod. I1Eco ncloa!l,icwLlwd66tui+plybmomdol
<br />rh. F!?6ty $ lr boil& d dvDE rlEElr rd wh. &6,r1hrt h'roll or lwlf or llFuslt hB d hd.m dglote
<br />proviLd rt'n sh i'lFoEr.nr G lDr irrd.d 6o&!d 6. rla l( lb6g.llE hl'ld4 d it4.sdtr it ild winh m r-
<br />ol.orpklio'r rtr O*rd Botk $ill hlw lb. hddr oaF{i8 tl, lt or di {& m buiu or in4.!E 0E FFry for rh. F,Por of
<br />I. s oena orh. FoFry, m dclurtrrly .orinciDs Hrh li.6a.d coffi6 to (BM llE rrj{tl (Se. 7014. I!l!B
<br />dd Profss co&: Tne Co.[.cktri Lic.nr. l-!w Jo6 nol apply b e opnd ofproFry who build! or imptov6 thmn.
<br />sd wlF cotnrEls for e.h F!j.t$ sih . Coftaio(!) lt@l ,ullld ro rlE Codraroit Li.G Lt*)
<br />t m .r.mll rnd6 Serhtr-lr * Pc l(: ihir ra('n
<br />D.l.: _ _ _ Orn6:
<br />wonxFRs' coriPEt{${ii6
<br />DECI-/\TTAflOI\
<br />I sa.by .rm ud6 Flhy .f p6idy oE of dE follo*ry d..Lr.tioNl
<br />I h,!. .d wr ll minr.in ! Cqlra*llc orcongr ro sdf-16@ fsr *ort6- NnFEnion. B Frvd.d fo, by 56l ion 1700 o t lhc
<br />hbor ( o&, aor (h. Ffolruc. oI lh. wort for *hich thc Foil t i,su.i.
<br />- I hlv. i"d vill ru61.i! *0116 omF8d6. trryGq B r.quEd by Salion l70o ollh. Lrbo, Cod., fu tn. F
<br />thc qort for *hach lhn pcnil i3 su.d. My wort6 conF.dion iBum. @i6 ad poli.y numha Ec:
<br />._., _SIIq-!.I_€T -r+r9 Cowr?Aaty _ _
<br />,,,.,*,.o 9td9hJCo l412L o,o,*, -- -\o'ZZ ?b
<br />_l cor'r,$rr mrh.Flolrjle.ol E$o* aorshrchrhBFn( r i$u.4, lhdl &r aployx,Fr.h!,ynffi
<br />$ d ro tE om. subj.( ro rh. wo,t6' .orpd!.rion h{a o f C.lifomi.. sd !36 lhal if Lhould bao6. sbjet lo th.
<br />ro 6 coErelxion FDsbs ol sdion lT0o ot ln. trtor codc l idl. lonhvnh .o'i!ply * ilh
<br />(r'l nnd ut !. ,'n. huftlr.d dousd dolld it100.G)0,.d,ru86 a pro{d.d for lh.
<br />s.dion 1076 of rh. bbor Code ints.tl ud allorn y ! t6
<br />\2 \Z-q
<br />I h@tr Im uBlq FElr! or Frury $r I d l(q6.d undd
<br />oa rh. Bchd rrd Pmf$ioB Cod., dd m, licN ir h tull
<br />n oa(l'ra c ((!trffi itu wnh Sarb. ,00) oI t riiir l
<br />e G?o!
<br />\2. \2.\1
<br />I '."9'* .lrm ur& Fshy of pqury lhi ttd. i . codM rtfty for th. rEtol]M. ot * h.L ,or stth rhi! Fmir .
<br />isdj {sd. 109 7, aiv. c.)
<br />L <ld ! Nm..
<br />lrxra , addd
<br />AIEI.ICABI.IECI.A8AU$i
<br />I tE6) lrm un<la pqdy or Firy o* of ltr follosilg &.htttioa:
<br />Ocnohr. rrntr'Asbdotr Noi6. io. tqk l R.guld ioN (T l.40.Pdl6)
<br />. -R.qud Llid of!*x,ftdir
<br />i lditthd llE fcdsalrsuhln,a Es&drs 6b6r.! ranovale nol.ppli(tbL ro lh6 pml6l
<br />-l cdri lhr I hrrc rdd rh6.p?l
<br />ordinuc6 &d Srdc ha Ebt$e lo
<br />n ir .ord I .g,t to onpl, *irt dl Cnt .nd CounD
<br />autlbpc r(,rcsrartr6 of rin ( nt M.l (-ou.ryro 6rs ulxrr rtE
<br />lbolc m6'ioo.J pmpsly fot
<br />ADplic..l or .\s6r siqn.lu
<br />r.rait( uhr (prln0:C,o{agj{'?,,t91a?-D-Q
<br />\2.tL.,j
<br />.-,-*.(
<br />L-
<br />Subfloor^/envlnsulation I
<br />Roof Sheathinq
<br />Shear Wall
<br />Pool Fence
<br />u
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