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BUILDING- INSPECTOR RECORD SITE.WORK DATE ID/SIG.COMMENTS O\I NER BTIIT,DER DEI,('AII IIOII I hscby aflirm und< Fnrnt olFrjury lhal I m.r.mpl frem lhc Contr.lou' Li.m. liw for rh. fououins r.en (s( r0rl 5 Bcinel rnd Profsir (o&) An! Cill or Com) \hrh r.qun6 . Fnit ro conrrucl. .h6, 'nFo\i &ml6h or EFr in' srndre rmrto irs ierumc.. iho i.1un6 rh. +pli.ul ftr sNh Fnnn lo 61. . risncd naldnoi rhd tE or snc n hcda.d P6!.d ro rh. Fo\6ioN olrlE (-ontxlc 3 l.rsE d l,s lclErrq 9. ( omfting Mh Scrhn 70(10 ot l)rvision I .rih. ttrrilB ud Ptur*ionr Cod.) or rh.r hcor!& B.r.mfl rho.fiom ed rh.b4! aor lh..llcs.d c\lntiion Any\in ion.fs.tli,n7(r115byr.y qDhcur aor ! Fnir ebjdB rh. .!tli..nl lo a ciril t'.u!r_ oa ml mr. ih,n fi\ t hudt.d dollss tt100) l. B .s'M otrlE p(r{ly, or m! mPlotd wnh $.16 s llEi sl. smFrdil,. will.tr rlE snl td llE nntr@ n ml ddrLd .r olt6.n lor sk tsc To4.l. ltuilB sd Eofdsd ('o&: Itr (ndri-rG r ljc6* l^ de. d {?lt kl d orffi of lhc F!F1y wh. t!il& or inlpn'6 lh@tr,rl *in d.6$.h *! hitucll or h*lfot rhrcoBh hir o. tB own .nplolc For d.n rha sh if,qmlddr c !| idod.d trorsql f' sl lt lb$6q. tL toiu.f, ( iqs€Er L bld $ihn.m )d of.ompkiotrrh.()"€BuiEawillh!v.lLhdnorFornsrhdrE.rih.dndhildormtreE.Ftd!ftr'h.pltlFrof l. 6 or n6 of rhc rnrpdty, M .x. lurn.! .oolrad ins Lvith li.ns.n conl, ^ctn (' .onsrnd rh. Fojal (S( ?0{4 tlBrndi ad! hrlsm c6& t h. coflrsrort t.ic6* litr dG mr .p?l! l. & o{.6 of FoDCny r hr b!'rds or mpro\6 rh(sn. 5nd $to conrrrcls n, $ch liojdk rnh a ( irnindo(, lirft.d ptrAun b lh.Co.ttrclo l-ic.M La\v) I ancr.ntr uil6 s.dFn l).r. Oi rF \\()R(! R-S', ( oltlPrns,it l(tN U}:CL\BAIIA.] I hd.l\ all-rfln lndd p.nnh! olFjun on. olrh. n)llN 'n! d(lar.rk'ns I hN. ,i s ill minr.in . (-dirrr. oacort lo S.lf'16@ tM {ort6-an"FsFn.6 F!\ dcl lor t} S€rion l7({r oflh. tlhrr Cod., for rh. pdfonM.. oarhc rvo* lor *hkh lnc F,rn n 'sudl I na\ . n*l sill mninhii s orld $m!i.rB.! iin iBorant.. 6 rqtrnBj it s<r i,n 17rr, dl rh. Irtn. (-od.. for lh. f6a.mM.. .l rhc s.rl rff shth rhir Fnir i! sul My $0116 .omr.nr.lion rcur . cdfut rblicy .!mhs r. I c.('fr rh.r 'n!n Frforum. of rh.*.rl f.r\hichrh'!rEn is igd.I rhlll ml @ph) s) Fsn in u, mrK $ slo tELom. rlhial lo rh. $olt* .onrdqion l.$! oa( tli()mi!. nd isra Ihd ifI llsuLl bdoft $t (l lo rhc u$rl6 comFBlion rottiG oast(rio. r 700 of rh. l,htr Cod.- I !tu||. li'dhn nn onPb r nh th.r prc\ BioB wARNINC Fnilur. !o cur. *orkd comrFglion c.\da. i3 unl.slut. md shlll tubj.r d Gnplols lo siminil pculli6 ud cirrl n.6 up ro oc h!ftH rtou$d 6ll'8 (tloo.lxx),, ii rUhio. t' rlE $r of .aqieri.n, &1186 a Fo\il.d tor ih. Sdh.1076 ofrh. tihr CqL. id6cn dd nror*v'.ld - Aptlonr,- LTCEIIIILCqNIAA(IAf, D};CIJAAIIO! I hdrlt lmrn u.dn p.n.Iy or Fjury lhal I m ltds.d undd |'oltion olChryrs 9 i.ohdtuinE \nn kion 1)({r)of rr\ oi)n l ot rh. Bu'6 &d Pbf*irc Co&, rn mt lt* ii i. tull ltnc. nn rfitr coNs l l.l(_fl()l I fNllll\ic actNcl I hd.b).fitn unLld Fnilr) orrErjun rhd rh6. n i $njtu{rcn kndms.soc} n rh.tdtumnc..tth. \ork nn \hichrhiFnir i! 'tru.n iS( 1097. ('ir (-l AftulANf[EclJ8arlo! I hdrtr !ir!r undd pcnllr, or Fjury o.. .a rh. foll.*in! ddla.' tuB: D.rmhirn P.millA$6lot Nrlifidi,n Fntd.l R.y!la'r.m (T(1.t0. Pr6) Rcquir.d I tli6 ol I'ldif(!i.. I cdii rhd rh. f.ddalrqruhior r.B&diry f,rh.sr.s , d$r al .r. n{ amli.ahL (, rhir llojd I c6r if- rhar I hlr. (d rhi arFIic.ln,n $! rlal. tlmt thc !lIv. inromr.l nnr it ..trd I .rre lo snply *irh lll Cil, !trd ( flrnly ndnrm6 ud Srd. ls! ElrrB ro hoiuins c.nrtucr rr dd ht h &nlFp. .qt.Frin 6 ol rha ( nr- di (-ounr) to d's u!6n ilt .bor. Mlion.d Imr'6ry for i8r'<sio. rrrnr6. ,\pt,ll..nr r.tB(rsiBnirur. Set Backs Forms/Steel/Holdowns Erection Pads SLAB Floor Subf loor/VenUl nsulation Roof Sheathing Shear Wall Framinq lnsulation/E ne rgy Drywall Ext./lnt. Lath Brown Coat Masonry Pool Fence Handicap Req. Deputy Final Report Engineer Final Report F|NAL // 26/ /1 fin,'wa</'/4.4 fi ? /0F Certif icate oibccupancy Notes, Remarks, Etc. UFER Ground T-Bar Flood Zone Certif.