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BUILDING. INSPECTOR RECORD
<br />SITE-WORK tD/stG. i COMMENTS OWNET BUILDER DAl'ARATION
<br />I nr.h? rnim undd psEty oi p6rur,v lhd I 6 crmfl 6in Ihc C..trlcroB Lrde bw forlh.lollowtrrs l.eo (Sd.7oll5
<br />ttain6s d P.ofaion Co&) A.y Ciry o. Cou y whih rcquiE a pamn lo coirrucr, i[d, ihp.or., ddrolirh or cFn ey
<br />rtru.iuq Fnr tu ht t ll*.. .l$ rc+i6 th. .aplt&l for ruch Fin lo nL r tsicd trta6r thi lE or {E i lica'.d Fnlr
<br />& rlE FovBEG ol tlE Conr-roa3 t!dB.{t t * (C1l4rd 9, CoMtrirS s nh Sdrbn 70OO of Divbb. 3 of ilE BBitB ad
<br />PisfBbN Cod.) d 6d lE o. rlE i aa,r rha!tron &d th. b..u for dr dh.d d.r$br ,{,, vbLrio. ols'crion 701 1.5 bt ey
<br />lprli.er for i p€Dil 3ubjeB rh. lppli@t io ! .iv il pdElry of ior mo1. $& lilc huddrcd &'ll4 11500).
<br />Ls o{Eutrh.Fopsly. myc.phr6 *irhsr!6 s tl.n $konFEdion. ull& dE sdi.d ilE it'Ec i Dl
<br />dorLd * of6.d tG eL (sd 7ol4. auiB sd PiltdbE ('od. TtE Coft.ttr r Litr t w do€ nol @ly lo e ow oa
<br />u! FoFry e !- hi a d oFoE lt.qn rn wb dc st'{tl huelr or hdGlf M ttuot8h hn G lE o*n dpbrq
<br />Flvlc.d rlr.l *ch irFlEEnr e d i,nqd.d o olH 6r et Il lrffi. tlE bildi'B mirq$cc!.eld*iln@ )G
<br />of$npliDi, tlt O"c &ilds *in haE ltr hs.rn ofF.vid8 th, lt ot CE dd m' hru or it{.oE $. FlFty 6r th. FrF* of
<br />-1.
<br />s N6 oa E FDFI. o .r(luir.l, comldug wnh li.on d $llr-rd to @rHtud tlt F$Fr (Sc ,0,1,{, Alir
<br />td hlkir C.d. Th. C.nrdoir Lic.G tr* &'6 mr .gplr ro d M6 of Fopdiy vho bu,ld, o. i-pov6 rho6L
<br />lid vho sdEr' aor $ch FnjcB wnh r Co Bro(, lic6E d pdun lo lh. CoMoi3 Lkdu L!w).
<br />I m.x.nO undd Serion
<br />D.r.: _ 0116 _$oxxrqs;coirPr\s notri
<br />DECITEAIIO!
<br />I hdoy- sltrrm undd Dcnahy or ffilry onc of rhc fouo*i.s d(l&d ioN
<br />_l h& !d will uido. Califrtl. of C.Mi ro S.lf-lBm fd @*6 .ohFlriotr 6 F$vild for br Salion 1700.f llE
<br />L.tor c.d.. fc rt' Ff61iwc 6f dc s{ ld s'hit lh. Fnn i i$.d.
<br />I hlr. and *ill ,Minhin m,t6 orrFcMtioi 'Brec, 6 r.qur.d b, s*l nr 1700 orlh. t bor Cod.. for lh. Ffonl@c or
<br />rh. qorl lor *hich thn p.mir ir isu.d My worl6 @nDdurion iNurncc .ei6 od rDlty nunlbd d.:
<br />I carirytfidt in llE Ffomii.. olth.wort for which lhB pamil is i!su.{ I shlu nol oploy.n! P6on in ey 6std
<br />s s ro bdom iubjrxt lo rtr m*6 ontElrni.. Lwr oacdiforti.. !d .sc lhd ill {Du! b66m tubjBt to llE
<br />work6 NniFB.rb. F!\ ir6u ofsdi,. .! 700 of lh. Lltd Codc l lndl lonlsnh @mplt $nh rlN* FotilioE
<br />\rAR.{lNG lriluE b sre q{l6' @nF!d.n oynrs. b qLwtul- lrd rh.ll $bir e diploF to ditdl Frri. !i
<br />.nll ao6 uF lo oF hundr.d rlDusd dollu! (1100,000), 6 ddiion to rlE rd of of,rFsdro.! &,n e6 o F.$d.d tu rlE
<br />Sdlrn 1076 otrh.;torCodc, i"r6.n Md rbftr! lc.
<br />Applltur:
<br />trcErsrr.(otrrlacraa
<br />DlClJaArqX
<br />I rEe* .lIm u.dq Frty of F)!ry thd I m licqE d urda Fo6ao! otcb.9l6 9 (@Miir wnt S.dnn 7000) of Ditnion 1
<br />of rhl lturilB .!d ProfsoN Coda sl m, li.@ ir in tull forc.d .IId.
<br />SI!,UBUqIIAU.IIDIICIGIISI
<br />I hdb}''rm un&r FBlt! of Frurylbc rlE L ! coldru.l6n bi,rs lgdy aor rlE FfM. o(lh. sort fo, *'ll.h lhi! Fma a
<br />N.d (Sa. 1l)97.Civ. C ).
<br />Lt dd's N@:
<br />lPPllcaNT nrcl {qATlol\
<br />I hora,r aiBm un tq F.liy of Fjorr om of
<br />'lE
<br />folh* uB &.Lr!l i6B:
<br />&mhion Pm'rlA.b6ror Nc,ri,i.!,rion l-.dr.l R.gulariotu (Tilc.l0. P!d6)
<br />k.qun.d l,rld olNotifKd,.
<br />I .6! 'fi lhd rh. a.dal rcgulli.B r.8rd'n8 ltdos romr.l d. ,or rFpl.lbk
<br />'o
<br />rhi! FoF
<br />I .dii, rhsr I h.v. rad lhn .r4lrcrr,on ed nd. rhd lh. rbnrc rnfon..lion n coft.l I &sc ro .onplt win tll Cny .nd Coul,
<br />ordindc6 Md \.tc lis EIdiry lo buildins conrtu rio[ od hr.by aurlDrizc r.Fclrliv6 oflhi! Cn, md Costy lo o16 upon dE
<br />dlsv. Mte..n p*oF, for iitlali.n pt p.s
<br />rppricrr.r.ltdr silmrur.
<br />,'onIlR nrm( (Irl'rl):
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />ltSubf loor/VenVlnsulation
<br />Roof Sheathinq (o il /l 7t)ovffi?
<br />Shear Wall -l
<br />Framing I
<br />I
<br />lnsulation/Energy
<br />Dryvva ll
<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 lt
<br />Certificate of Occu anc
<br />Notes Remarks Etc.
<br />q tr
<br />.u.
<br />(
<br />DATE
<br />t((@ Numbd
<br />UFER Ground
<br />Ill
<br />5_lGn;#t-
<br />II lv
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