BUILDING. INSPECTOR RECORD
<br />DATE ID/SIG.COMMENTS OWNER DUII,tIER t'I]LCARAIION
<br />I hcNby.llinn undcr pcDrhy ol,.rrury rhar I rn.x.mpi lll'm rhc G'nkrttrr l-ftnsc ljs fi rhc f(,lk'wirt r..arn iS(70ll5
<br />Busincs rfrl Pror.$iotr Codc): ny Cily o! Coutrry whi.h rcqnircs r t'cnnn ro con(ruct. illcr. inDrcvc, dcnr)lish or rcpan rny
<br />ntocrtrE. nri lo ik nsuincc. alv, rcqun s rhc aplli.lnr lbr\urh pcnnil t, filc r si8'kd {icntnr rhrr tror sh. i\ li.cn{d NNrnr
<br />lo rM lrovhions ol the Conr..nn s Li.cnkd tiw ((hanrcr q, Connnci.ii8 *ith Scclion ro(xr ol Divhion I ol rhc Bu\nr$ lnd
<br />Pm,crsioD\ Codc)orrhd hcorshc hcxcmpr lhcrcr'ronrnndrhc l"1sis idlhc (llcsed cxcnrprion. Anyvi{,larionofsccri,nTorl5h)rny
<br />ap|li.rnr for I Frnrir \u$jc.r\ rh. npplicr io acililpcrrlryofnor 'nm rhM fivc hunilmd doll \ (S5m)
<br />-1.
<br />!s orvner ol rlE rmpeny. (n m, enrloles with ua8cs .s lhcn sh dnnpcnsari,'n. will do rhc {ort !trd rhc {tuloR t ior
<br />inr.Rlcd.ror1cftdforek(SdTfi.4.Busimsaa Pmfcs\inrs C, r: Ihc(inrrackr'iLi.cnscljwdocsnor.mlrro.nowncrof
<br />rhcpmpcny wh. huilds or iml,l'!.s rhcNn. lnd sho des skh s * hinrclior hc,srlio,lhou8nhis o,hcro*ncdpbyc.i.
<br />!rcvid.d rhd \uch i'npmvcmnrs E tror i' cri.d or oltcrcn tu salc. l,: h.*ei!r. lhc huikling or i.DrEmnl t skl sirhin ,,nc }tr
<br />.fcotrtplcri,n, rhc O*rcr Buil cr lillhxvc rhc ttrdcn ofprovin8 rhir h. or nE dil mt h{ilt.r iqrolr rh. Dmfdy for lif, Dqms ol
<br />L.sosncr.lrhc fiopcriy. {ncx.lusivclycoMrdirg rvirh lrcnscd comrcnn\ to constnrlhc lrqccr(S$ 7(Ir4. Bunn.\\
<br />rnd lrtrtit\i(r Cod.: 'Ihc Co0krcrois l.iccnlc l.!s doc\ tr.r rprly lo sno*trcr.inropcn, \'ho buil.k or imniovc\ rh.r.on.
<br />rnd pho.onr(Gfir{.hpn'lc.r\wirhrcohrtr(\)li.d\cdpur\r rr(hccrfircrtr'\Li.cn\chwr.
<br />I rnrcrcnr|n undcr sc.ti(i
<br />.Uaf,(liBli:l(JutliNiutLN
<br />I}E!;LAAAI]QN
<br />I hcrrh!rllnmuftlcrpoMl(!olpc'jrryoicof rtu,nl[)sing rcl rrri{nr:
<br />I hr\c d*illnBinr in rC.nifi.arcolc.ns.nl h Scll l|{m lin $o.krr\ coflncisnn,n. r\ pn)ll.icd tur hySc.rn lTU)rlrh.
<br />l-rhn(ixlc.n)rrhc |r ionnrnd.olrhc nor( n, wnichrhc pdlnlr is n{'c
<br />I hivc rid will nrinrdin {orlcr\' .onfri\nnD i'Furrmc. rs r.qrinJ h]S.cii(,n l70O.Irhr L$orC.dc. Lr rhc pcrlbnnrnccol
<br />lhc qork ldr whirh rlri\l.nnn,s hsucd. MyworkcN corn tr\rrnr nr\urnn.c(lnrr rt Nh.rnunrhLr:uc
<br />CJrn(r
<br />I ccniay lhrr in lhL pLrnnmncc olrhc worl nr Nhich rhk plnnil i\ i\\htl,I shll.or.hpby trny lf,^on h riy lanncr
<br />n, $k,h.dnm hi.d ro rhc wollds .omFn\dnri hwr of Crlifinnin, ai a8rcc th.t ifI shoold h.c.nf, subjd lorhc
<br />Borkcn.onrNnsatiotrl,ovisionsolsccrion]7(DorrhchtsrC'od..l$.ll.lnnhqirh.onrdywilnlhoEn,ovnn'n\
<br />i/TvARNIN(; F. lu'. L !rn'r (..k/.i.c 'f. .r..,n irt' '!c i. J
<br />/ Jtrrl l n. ut' r', ^r huiJral rh.rs.'nd o,'lll'r rllrx,. xr".
<br />'n ,'dJ
<br />. Md rhall \ubhcr ut .nttk,)rr ro oiminil F.rlras 0xl
<br />rhc con ol comnctrwnnr. daruscs as providcd lbr lhr
<br />Y":diitwY:;
<br />I hcrchyiifin.undcr 0cn0nyofpcrjuy rhir I rr liccncd n
<br />fl rlr llu\i',.\ rtrd I,'olrsirrn Co(lc. xtul n,t h.rr.c i\ tr, ILL L lntu( rrkl.rl(r
<br />g)NSra!Eu0!l,.ENDIX( liliNtl
<br />I h.rcby rlltmund.rFnrlryolFrjur)rhd rhcr. n, con{rucrion h i'igrgcnr,r(trrhcFrronlur..olrhcqolklbrshichrhi\Fnniris
<br />i\nic,t1S.. :1097, Cr! (-l
<br />L.ndels Addre$:
<br />-
<br />I.enifrlh rhc f.de ral ftgx ltrr ion* rgarding arb. os r.ff,lal d. nor {pplicabh lo lhis Fri,irt.
<br />-l
<br />ccnilr rhd I harc rcsd rhii applicatinn lnd nlrc rhor rhc atnvc inlorrorion is coftcr I alre k, comply*irh{llCiryand counl}
<br />ordirDnccs itrd Slalc hw\ rcltring
<br />.hovc nrDlirnrd pn'Nf,y f(tr i[
<br />>pDliunr or
<br />^senr
<br />sienar E
<br />aNl hcrch) aurh,nc '.Fc{rr ,sF iirrhr.ir} JtuI(-.uyrocnrn un trrF.
<br />,.,, d/./argA4zz-- /
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />Subf loor/VenVlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Enerqy
<br />D wall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />l\ilasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req. lLnUQls{-7(nlg ,,</144 I
<br />77)
<br />Depuly Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />\
<br />FINAL -7lxd6 -,r,(^d{A t fqlh*tL"lMry &*c* I
<br />Certilicate of Occupancy u {
<br />Notes Rem arks, Etc
<br />I
<br />e l
<br />\.
<br />SITE-WORK
<br />SLAB Floor
<br />0 A-, t*ratq ,
<br />P(ni.y Nun$c. Exnncs:
<br />|n^i\i( ol ('hnJ,r.r 9l..nn,f,n.i',g sirh S.crio,7(Xr0r olDivni,n,.l
<br />2a'l
<br />AIILICANLIIECIAAAIIIJN
<br />I tmby alinn undcr lcnolly otpcrjuynnc ol lhc l'ollowin8 dcclarations:
<br />Dc,mliliotr Pfmirl^sh.sos Notili.ntion Fcd.r.l Rd8ulario s(Tirl.,l0. P.rr6)
<br />-Rcquircd
<br />k(crof No llcoti.tr
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