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BUILDING- INSPECTOR RECORD
<br />SITE-WORK ID/SIG.COMMENTS OWNB AUILDET DSI,(IXATION
<br />I tEEby rinrn und.r p.mlly of F,rrry thd I m.erlpt t$s rlE C.nrrrlm' Li.tns Llw to. llE followin! larn (Se 70:11.5
<br />BuiFri .!n PFf.libn Cod.): Any Ciry d ClMy f,hih EquiB . Fsi ro .Nnrr. .ra. iry.oE &mlirh a EFn {y
<br />srMtue Fitr lo ih issr4., d.o mquiB rtr ,ptilkM ror seh Fmir ro fik r.ign d $d.Ml rhd lE o. slE i! li..n*d ,!o.M
<br />lo rlr FovnbB ol UE Cmrddt Lirnrd L* (Cnrflr 9, C.nwNin! wri Sddon 7m of Divabn I of dr ABicr. xd
<br />Prur.rlhN Co&) or rld lE or tE n .rcqrt rlEE im .rd
<br />'lE
<br />h.ri! for rlE rlL8.n .r.n$i . A,y vhLrnn of Sarnn 703l .5 hy uy
<br />rtplic.nt for. psmn btil, llx .lpltd ro a civi! F lly6f mr mE lh.. fiv. hudEi dollGr ( lsm).
<br />-1.
<br />$ o*Br of rhc ,roFny. or my cmpk,y!.s *ith w.8.s I rlEn sh Nmpcnsrion. *ill &, tlE *-l ud dE l'rEiE n mr
<br />ddrLi tr oll.rll ft, sl. (Se.7oa.a. BuriEs id Pror6:bN C(*i TIE C.tu*rd r tj.oE tir dB d .|joly b a owE of
<br />rlE Fr,'r ry *lbt ill d t pr.6 r,EEn nd *ln dB ryn q't hiffilf tr h.mlf r llmult hii G lE o*n cnploy6,
<br />pr.vikn rhd su.h imtmEft.Lr e mr i{cnd.d o, otftEd fd {l la hoEw. t,E tlildin3 or iqmmd is mld wthh w }arofdrpktiE r o'rffi auirhr will hE 0E hnrd ofF@t ilr l! d {E dd d b{! d n!.nw r,E F pdry frr d. lrrF* oa
<br />l. I 016 oroE I,DFrr. o.rchsihlr.olrrrror *'nt tosd.ahr.rcro^ lfl @nr.xl rli pmial (S.r ro1.l. BBiEsdd lHdsir Codc: Th. Conrrrro. s Lic.nsc Llw dNt dn mrlylo rnoqmr otr,rcFny who huildr or imDi(,v.s rh.r6n.
<br />ud *t! mdl1rfor uhFoFdr *ilh. C.ddonr lirnBn rrlld b tlEcDdrdd s lirE L!v,
<br />_Im.rn,,r un&r Sclion- B. & PC foi tnii Easn
<br />Drr.: ow
<br />wotl0ts' coifursATloN
<br />DECllAAIll)!
<br />I rrr.hy r,nrm unJcr FdtrlrrorFrrrrronc oI rh€ n,lhwin8 d(hrotions
<br />I h.E .rtl riU mida. Cd'fri. orcodnr to S.ll.lIM tr rortd onrmdion, { F.viLd ld by s<rirn l?m of rrE
<br />tlu C6d.. ntr rh Fll()trrB. ol llr $o* for *hl h rhc Fhi tr ntu.it
<br /><hrE rnd *'llnrmt.in smLR ..mFN.rFn rMuN.. s E{un d by Ser6n 37m oriL lrbor Cort , t rrrEFflmof
<br />t/zr
<br />I cnify rld htlE p.rnrmN orrh. hrt rd phrhrhi Ftu is ilML l .hll d.npby ry FM. in.ny mE
<br />s &r lo b.roft $bc.l lo llE wrtsi conpcnsalbn hwt of CllilomE iln lar tt.l if I ll[uh h.cor ubj6l ro llE
<br />vortn on{ENrk r psuri,6 .t S..ri lTOofrlE L,trrC.dc.l {dL fnh,nh oryrr wirh ihor,!6vi!i8
<br />WARNL\C taihrE l. EE wt6 drqEm.liln ('m8. ir un I .rn \h.ll $hFr .n d!'l'F to .miml FEXar.rd.ir'l ltr{\ hI n, o'r hu'rlrJ rh\i\md Julhn (11(ir.(xxr)n lo rhc co{ of.oqrn{lion, damsc\ !r pn,vilcd tu rrE::y/,p;':
<br />I Ercby r,lm ur&, Frdry of Frru.y thr I d li6!.d ldb Fiviri,4 ot Chrp6 9 (onm8o8 wirh Sdrio, 7m) of Ditiri,n l
<br />or r,r DuriBs r.d Ptoa.sir6 Cod., rd dy ltce i! in tull fo& nd .,fcr
<br />{4 e7l./>t/;
<br />sr&flrurJlQd.tailariAcarl
<br />I h.rcb_v nflnm unl.i Fmlty oaliluryrhd rhm h r onitucri'n lcndinl r8cMy ntr rh. pololrMc. of rh. work f whichthh Js'nir i\
<br />rq.drsd 1097, Civ C)
<br />AELTCANID!:CI.dIAITA!
<br />I hrlny inihn rh&r JEnah, ulFrJury or ulthc followint dccl&trrion\
<br />I\lr,lihn It,mh \trr.\ Nd'r'rrpn l.ns.l fi.BULrnnl r'I rh.lr.I'Jna,
<br />-lJltq,,^.1 1"r., ur N.r,r. r,,n
<br />-l
<br />c.nily rhlr rh. tuml B8lbr ims Eg.rdyth..kx rcmvll E mr amlicrbh to rlrn pmr€r
<br />I rdify rhar I hrk (.d rhn +nlK.!9nr. rhd rh.2br mfomrx,n is mfl.d I lFd h oqrly
<br />odi.orEcs an l sGlc llws rcla!nE to lnskrhtr !n hcrchy rurh,ir EIr.€nrarirs oflhnCily
<br />albr ftnr jmd pmFny fr i.
<br />,\ppli( or/lsctrlSi[nnl &:5.--
<br />'?)E[
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathino
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<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 Certit
<br />FINAL A/0/"ur2o Uful/.Y+*fl
<br />Certaricate of Occupancy
<br />Notes, Remarks, Etc
<br />Rev.08-07-2015
<br />DATE
<br />!rkq{ onlEn{tiin inqnr.6ilrn F'layrrumbcr
<br />S-tlr.-s{k- Q:*,
<br />Ilddi Arlds
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