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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Brown Coat
<br />It4asonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />FINAL -r-18 -O J)^t"-t a9
<br />Certificate of Occupancy
<br />Notes Remarks, Etc
<br />OWNER BIIII,DER DEI,CARA'NON
<br />I rErcby .fliiin ondd p.nalty or p.ijtrry tn l am.r.mpt from ih. conracros l.'ccns.lr$ for lhc folloNins r.$on (S..70:tt5
<br />Btrsin6s rnd P,olissiN (id.)r Any ( iry or Coum] Rhrfi r.quircs . p.flnit lo coodflrt. .hd, imrdr., d.hohsh or rc,lat M,
<br />nnrcxrc. lrh, to tu nstrih... rko rcqufts rh. ipplic0 lor $rhp.nnir r. rik. sisn.dsrsr.mdl that h.orsh. ! ti.ds?d pxNUinr
<br />r. rh. p6viri.n. ot rhc contncroas I rc.ns.d lrw (( hl|)r.r e. Coincn.ins Lvnh S.clion 7000 ol Dnision J of rh. Busin.$ ,nd
<br />froLsioN (id.) or rhar h.orsh. ii.x.mpr ih.r.ftomind lh. basL Ior rh. .ll.!cd .r.!nprion. Any viol.tion.lS.crion 70:l I 5 bt ant
<br />!I.t,l,c f.ra pmnr (.'hi..F rhc rrr'(inr'oa\trr,n.nalrt.lnqmo'.rhrn tr.l-'.trd,€dn'rs'\(l<10)a\t
<br />lrl[4,r,<"*' -t tr,, p-e,n5 o, ,n) crpt.]r.< Eirh s,s.r *,h.f et cn'nnm!.,nn. tr,rrd. rh. q.rr
<br />'nd
<br />rh. {rudu. r nnr'hr6q4 4.Ir.rd ror sk (s( 7O{4. Bu"n6s !n.l PFr6sio.s cod.: Ih<contncror's l.icc(\.I:s doBnorapplyro inown.r.r
<br />,h. plsglnv uhn huilds.r ih,nn\6 rh.6n. a 1trh.d16such*o*himrclforhcB.lforrhorEhh!oih.rown.hrluyccj.
<br />nr\idcdrh.rn(h 'mnro,m.'srrtnor in'.nd.d or olT.rld lix s.l. lf, how*.( rh. h'ildiry or improwncnl isstd wirhinonc r.i
<br />of comDkrion rl[ Ownn Buil{i,n rvill hav. lh. htrdo oipoi4 rh.l h. or 3h. dil Nr hlild or impn\! th. pmF.ny fo. rh. porro* of
<br />Laso*ns.frh.tmpdlr.an.rchril.lv.onracri'rg\rilhticcns.d.onkkrorckr.onnn,.Uhennl..r(S€.70.14.8Nir.rs
<br />0nd ltuli:si()n(i\l. rh.(.trrrid.is I icc'sc I aN d..s nor ,Irltr.in.qr'.rn',,nc"\sl'. htr'd\n' nD'.\.\'l-.rcnn.
<br />.+rd PrnH h rhc r fln,nor < Iic. F.lr" Irnd Lvln conrmcls f.rsuch lrol.di$irha (nnh.n)(s)
<br />rulru7ro (i l-{'Ae
<br />I h.r.hr afiinn trnd.r p.nxlty.f poiry onc ol rlr
<br />Ih.vc.d$illnminlaini(fiin..rcorco.s.nrroS.ll-lnsurcfor*orlc6onrpcnsdioi-.sp(trid.drorb!,s.dion1700olrhc
<br />Lah.r (,!d..lorrh. fdfomanc. olth. wort for which th. pmit i! issu.d.
<br />I h.v.and wilr m.inrain worlerr.omn.nsar'on irnm.c.. a\ rdt t.d hyS(rion lTmofrh.l-.lxr (od.. rorrh( n(n,mdnccof
<br />i,b n.!qFns'.d M) tro,tf,r cnmrdsarion in-tir< lA3.tro41bzsb
<br />etran.e cari.. and p.li.y.trnrh.r.r.
<br />(4l,lc( (c)
<br />o/r 5LIt
<br />lcenirythal irrhcasforhin..orlh.workror*hichdrisri.nnil h h$.d. I dmll$ asio ltco'n.
<br />'bj.cr loIlrworls conrp.nsartrn l.(sor( aliaomid.,nd agr..rh.l
<br />mr.nrDlot a !tt'snr i'r aiynFnB
<br />$.ik6 conp.nsrrii,npmrisi.nsols.ction:rT0Oolrh.lrhrQ)d.. I
<br />ill sh.uld b.conE rhj(t lorh.
<br />comrly wnn rh.* I'mvisions
<br />I subi..r .n mDloy.r kJ aini@l rilri.! {.d
<br />,lcomr..sation. d.ni!.s .s rrt\idcd for rhc
<br />WARNIN(;r riiilr. ro woR \r.rk ^ co p.nsariotr co('a
<br />n. htr.dr.d iho sand d.lhE ($100.0(n). in
<br />lhcrchyifii trndo p.nallyol pe ryrldlon nN rirI se.ri.n r0l) ).rl)n ti'r I
<br />ot rh.l\rin.ssand frofc$iorr( odc. ind or h..i!.
<br />'::,"*ffit<gTzo
<br />I h.rchy allinn u.dd p(nnltyofp.rjulllhi rho. isa
<br />nsucd (S( 10c7. ('n' C )
<br />y tor ln.p(fo.manc. ofthcaork lir uhichrhis p.nnii n
<br />APPLICANT DECLARATION
<br />I hort y ifilm undd paihy olt'.rjtrryon. orth. rollowins d.cl.r.tions:
<br />D.m.lnion P.,miri-Asb.sros Notilicalion tid.ral R.Erl.rions(Tn1.,10, Prd6)
<br />R.quir.d Irll.. olNrrilEtrtion
<br />I calii! rharthc iend0l.qol.ri.ns ,n!.slrdorr.nx\ala,e i.r affl'cahle h rhn trnie.r
<br />l.enilvrh.r I hM readnrh llerhal dEak,v. rnfonnalion tcon..t li8r..ro.onrdv $ 1h rll( irvind(in,nry
<br />rrh,s( ir\ n,drhtrnr\ h. o Ltdtrrlr
<br />n.,. Ffruf6
<br />ot
<br />ordinin.datrd sl .lr*sr.Llins ro h!ion. ar h.rcby rl horiT. roi.s.nh t n .s o
<br />rlFr( nrnrion.d nron dy ror iNn.d
<br />(:::".:fl:,P (4t Ll Lzr-trs L0
<br />l?F! tl !i' . r I
<br />Erection Pads
<br />Ext./lnt. Lath
<br />Flood Zone Certif.
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