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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
<br />I h6cb, arlun undd ta.lt, of Fj!,y rhd I m Gxmp{ tom lh. CorlreloR La6M Lrw fo. lt lollo$m! lsri (s; ?0l l,t
<br />BrBin6r aBl rroldtun (od.) Any Cny or ( ounly whth r.qutr6 3 Fiir lo on tuc1. .llq. io!rcrc, do.6lirh or qu u,
<br />tuclEe Fior 'o r isume lko rcqut6 rh. lrpl(aln ror luch Fnir lo 6k r sE.cd ltcclEr thr lE or 3lE i! nGsd plll:@
<br />lo llE F!vi!o6 of tE comr-tn'r Li6r.{ b* (lEpld 9. ColMfting wilh S.clhr 7000 ol Diyilbn I of llE BuiB &d
<br />Pmfdio6(od.)orrhdlEornEi.!drFrhq.frm.drh.b..Llorrh..Ls.d.ro{iio.4.,virldionofscl6t701l 5b}s,
<br />ap'llic.nr for . rEin $bq r! rhc !prli(&r ro , r,!il p.Dht o f mt @.. rne fiv. hu.&d &,llJ! 11500)
<br />. -t. N o$d of rh. F.F!r. or my al9lot6 "ih *.e6 6 th.r sk onFudo,. sill (h llt *{ri id, rrE !'ffi4 ! mr
<br />ddrlat M.ilaql tc eL ( Sa ,oaa. turJll* &d liofBhN Codc Th. Co'IIeroi! Lade l^ tt)6 mr .CAly ro a orG of
<br />rh. p(ofd) f,ho hrl&o, mtn!6rlEsc a, *'ho &Erdr!* hllulf or h6-lror rhreugn hs lE omatph)6.
<br />p.oud.d rhd rEt mForlcn! G tui doial d.fidql tor $l.. l[ L$6G. E buildus r !rF!\qGt u !U *l]u @ td
<br />6fc.rplcbtr rlr (xG lrilb $ l h.\r tlE h!d6 orForr\B rhd lE or slE dd mr Uild or o+.ov.0r FoFry fr, rlE FrFx ot
<br />l. DorEofrl* rrFry, m d.lB'v.ly.otudi.! *irh licda.d..ffio6 to..ldrud rlE FrF (Sa 7Ol-4, &!tr6
<br />rdt Prblss Qr.l. Tn! (.onkrorr l-rc6$ l!* &6 mr lpply !o e o8s of propsry who bx,ld! ot mptor6 ihson.
<br />Dd st rcdR1r t( e(h F,rdlr trirh. (!nra1d13) h.G.] pllts@i t th.Coflrdoi! tic@ bs)
<br />l0n.!cm unds s(('n .8 &P( fN ihis r8)n
<br />jIABII!8IL-CAUIEIIAIIaN
<br />DICI.AA6IIA!
<br />I h6.by amm undq p.arhy orFjuryon..alh. aollowinB ddlerlioN:
<br />I havc ed q r lljlllHrtm a Csl,tu irc !f Cdnsr !o sd f lBuc tor *orlss .omposrbn, s Ftrvid.d lor ny Sdlio. 1r 700 ol $c
<br />I$or ( Rlr!*r[. psfome(. olrh. so* for uhrh lh. Fm ! BU.d
<br />|#1*. * *','.,.,. **r* (nmp<rlrk MMq6 (quirrl b, se:lbr 7oo oarlrc L!ho, cod.. ror rhc pgfolr@.. of
<br />rh. *ork f{ trhi.h rh" p.mnr s s\u.J NIy tr
<br />,-,- '.'l ( -,nf,a, 1c f1 -_ j
<br />Poltr\ Nu'nlE
<br />orrd comFsioi i.6}(*.n:-n'. I u
<br />o\ dd polky runbE d.
<br />\
<br />, l.dr'i ihri'n rh. Flolrr@c orrh. *o.l for shrh rh6 pdmir s su.d. l dd! mr ophy My Fr$n in rny .sF
<br />raroba.m$bj.<toiEr.6o'nFldirnh$!ofc.lifomarnd.sGtbdrllCDuldb..om$brdto'lE
<br />f,.rr6 onFMls. tRrlirhE otsdrn 1700oarlE Ubor Code I sh.r[ amh* nh onpl! *hh rt r Fo\itEB\+ RNINC FliluE re q{. *nrkd clmp.Mk'n ord.a. ir uhwtul. ,'d shlll bj.{l & qlrploF l. aimid FurE.d
<br />oll in6 up k, or h(iLl rhour.,rl .lolls (tlm.ooo), in !.Birion lo lh. cor of onpquxoi. d!oB6 a Fovilai for th.
<br />scdFn .1076 ofrh. lrlbr cr!.
<br />^'. L'6't-C 0nL Va LO
<br />Dt( l_lR\ I l()\
<br />I hct, dlsnuids Do.llrotF)u,y lhd I m [cd!.d odn Fosioi ofcl',rta 9 (.o ndcin8 with Sclir 70@] of Dlv Bht I
<br />of rh. BciI6 sJ P$f6tioN(!d.. lri Eylc.e i! rn tull forc {d cfi6l
<br />c-?1 q4
<br />'.) -^^
<br />I hs.tr lllm undd pcn.!, of Fjury rhil rhs. i! . coi!(fu.lion L{dog a!6cy aor ihc pdfomR. of thc rul tu *h'ch lhn lEni ir
<br />is!.d tsd. ros7, cir. a.)
<br />AITII(AtrLIIECIASAIIOX
<br />I hodylnmuid.r Frhy orFjuD dE olrh.folro$i,B d..l- io6:
<br />D.frolrFn P6nny^ltElo! Norrli(dre. !'.dqrl R.suhlhB (Tnl. ,10, Pa!6)
<br />Rat!nal ldrdof Ndrff,dM
<br />rcAuLrh6 rtrdrx atEros rmral d. d q?lEabL b rhs rol.{i
<br />lh. !bo\. raor.'tion n.ontr I rrrd kr omplt * h lll ( ilv.fll Couoty
<br />n. !n kcby adtrDr qr6aldn 6 of rhis Ci !, ed ( ouD
<br />'o
<br />6rd qnn
<br />'lE
<br />l-
<br />qrq,tz--
<br />V6.-o uc :-,\rr/l_
<br />t t6 rV
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loorA,/enUl nsulation
<br />Roof Sheathing 4-/o')o ;W/ot
<br />Shear Wall
<br />Framing
<br />ln su lation/Energ y
<br />Drpvall
<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 a--t -20 Drl.t ta-t
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc.
<br />\d-.,
<br />\1,.,".
<br />rz rark_ lc
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