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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE I COMMENTS
<br />Forms/Steel/Holdowns
<br />Ereclion Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathinq
<br />Framing
<br />lnsulationi Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Reporl
<br />Engineer Final Report
<br />N
<br />FINAL N
<br />Certiticate of Occu nc
<br />Notes, Remarks, Etc
<br />OWNER BUILDEN DELCARATION
<br />I h.Ehy .iI(n !.d.r p.MIy of Friury rhr I m .!cng fnrm rlE (i'lllrNnn Liat U* fin rh. firltrwr3 E.$n (S.. ?0J I 5
<br />Bunncs ad l\da$u c(iL): Any C y or Cornry *h!n Equrt\ I rrd io L!.nru.t, .ltq. htmE. tlnnsh or qrn m/
<br />(tuim. lrxrb . !rud.. rlq, r.{u6 rtE 1r *rr l tr ruh Jtmr tu nl. r .l3En {rl.Ed rhn lEor dt 6litN.r! lUnud
<br />b rh. Frv,sirnt oI r& Conrrrctrk l-'r.n{J tr* (Ch!pr.r 9, CohmturnS unh Seron 7fi,0 ol Divtrr,n .l ot rh. Bun*$ MJ
<br />Pnn (i'n. CuL) d th.t lE tr llE s .(ng{ th.rtlnh .rn llE hrs nn rlE iLs.J .kn{ibn Any vsLL orsalin70ll5by.ny
<br />atllrcanr lna Fm rutjek rhc rrphcor kr!dvno.nllryofnor d'rrhr liv. huBlrcdd.ll(s (sim).
<br />_1. r. dwn.rofrh. ptuFdy. or nycmploF.\ wirh wrt$.r rh.tr rn. uompcnrorn,n. * l.lt, rL frtt uJ rlE rfrrm ii nn
<br />d.ddl tr ofl(Gl frr * ( Sd.?o,l:l. 6u1iE( .rtl frof.($n! (irL: Tk (i,nrurdr'i lr.n< L.u .Ix( n* :{r,1, ro i oqnr oI
<br />rh.ln,Fny eh' tnnlk o n{hr€s rltB}n, ul wh) 'lri tud, H,lt h'mscll or h.Fclfnr rhD!3h hs qh.roecrll,br..r.
<br />pn'vrLJ rh:i ruh r{h,Fftdr e n{ n.r al o..r.ral td {h Il.hrEE.rtrl[ u! or unpmwftd n$U *ihhln J.s
<br />o, c.nl0Ll nn. rrE Owmr Bultlj *nl h.E t,r tunjo or ,n'vuE rh.r lF ,, \h. Jd n t orinlnrErh.FtElylnlhFrF):of
<br />-1.
<br />a! o*rr or E FoFdy, n.(clu{v.I, codrdn! rih lL.ncd ndr.nx ri, qriei rlE rrrj.li (sr 7044, alrtrs
<br />.LlftDf6imCu&lhc(i'nln.ttrrl-r.nt.lj*,lern.ppl,('rown.roittotdyPhrburldrorrmPmv.trlxr6..
<br />rnd *lx, $dh-( rd luch Ih,FcB wlh . Ci, Elrono lkn€d !u unr ro rlr Conruktri lr.n{ Lw).
<br />_l rn.knfl unl.r S(..rn)n .lt &PC brrhisuw,n
<br />woRKFqs conlPFl\isaTloN
<br />DECIdXAIION
<br />I h.rhy r,lrm unLr Fmlr, of FiJ{,y or ol rlE nnk'pd3 l\Ll:l.rr)n\
<br />-
<br />I hr\. J,rl *,ll m
<br />'nram
<br />r C.n 'lid. ol Cnnrnr t' Scll-l nru,. ttr sorti^ lrnr.nqr r)n. r\ nmyrlcJ l,tr b, Sd x'n r7U) ol rh.
<br />hhtrOic.,'trrh. !.nomuftcol rhc *o* ntrwhf,h rhc p.mi E r\u.J
<br />_l hrvc rftl *rllma'nram *ork.r'conlrn\arR,n trNrhr., !\ r.qur.J by Sccri)n .!l(,o of rh. Irlx, Cdc. nrrh. rrno.mrtu. or
<br />whrhrhn p.mn ir Kqd. Mys,{t6 ortEd.n rore. ff.. rDl Fiiy oomb.r e:
<br />u,,., *"*", @Jf p{ olaEo L
<br />I id'iyrhlr mrhr lErtormtu.,,l rh. *ork l;r whrh rhtrn(mr F trucJ,l th:ll n .nllkry t! IEB'. o.ny lMEr
<br />w, r b trrom sl,rrr ro rh. kxt6'lr)qf,nsrrm lr$ of Crl'lomr .ntl .fc rhi I th.uld 6qor ohF! k,ttt
<br />*orl.n' $nqirei nn pmvrsn! of Salon 1700 of rh. trhr G{.. I rhall. t'nh*irh $trll)ly *irh i h,r pn,vtnnr
<br />WARNING I luE n' e@ s)rlc^ .r,ml.nelrr....rr3. r unLptul. td !h.ll rutr.r s cirr'bFr t' lful lf,El.r,r!
<br />rNrl ltrr.r trt n, oN hur rhotr\r ltollx^ll().(XXr). r rdJiB,n o tlr .oll of .dnrt^-.treli,,n. Jrnug.t r\ I)n'vrl.J ,,tr r)f,i,nil t.r
<br />r.rt r-nsiui:6nr [itloY
<br />I2EIL,IEAIIO}
<br />I h.Eby ull.lrm undcr lxn.lrr oa 0.rpry r har I rh [€nRi und.r In vtr r)n of (lEpl.r 9 (.lmmBrry w h S..r $n 7(lI)) oa D,$hn ]
<br />or lh. Bu!ftrt In PDftr.rnr C,iL. rn ny h..s ! h ful nrN .nr .lkl
<br />!:o!$allflqlllEdpaclcErcr
<br />I h.Ehy rtlth uBl.r F..1, ot Frjur, I h, rh.R ! t !-n(tur!n k'rto! tS.By ru th. Frfotrrl&t ol rlF kxt ft, whrh rhr Fm. .
<br />Nsu.d (S....109?, Crv. C.)
<br />trhLr! N.m _
<br />LcnLat A&rE(:
<br />-
<br />AIILICANI.IIECI.ASAII(A
<br />I hddry dlim lrLr Fn.ltyol F ii,ry oE oftlE fdLrmS &.l{{$.r:
<br />D.frni$n P.ror+Ash.nos Nonn.{r'n Fqtcr.l R.ful.ri)ns (l(lc40, Pr(6)
<br />R.qur.d l.n.i ol flt.f.drn
<br />l..nnyrhnrrhc lcJcrrl Fguhr('n\ rgarJmg.\h.no( r.m!$lrc fr rff']f,1hk n) rhtr rh)Ft
<br />_l r.drlyrhar I hrv. tordrhsrmlrdln lrl (!r. rh.rrhr thrvc 'ntomurirn rcotr.r | !Bi( n, .nmnly *ih rll (-.! .d Counry
<br />,trJn.nrc\r,rl sirrr lf,*\ N
<br />ltblc mn'i,Ed ,)n,Fny
<br />Appli.inl or AA.nl Shmlr.i
<br />{d(ri)n. xni h.r.hvaurhtru..eI'(r.rivs ol ihn Cry,ii County('.nl.r uNn llr
<br />ITIBEIIIfT[Itr\
<br />CI
<br />Or*r
<br />hil,
<br />Set Backs
<br />Shear Wall
<br />Flood Zone Certif.
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