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BUILDING- INSPECTOR RECORD
<br />OWNER BUILT'ER DEITARATION
<br />, hE ty lmm u.& FDlrt o, Frury rh, I m amF nlm rh. (-ofrd6 l,toe ls for llE tout*ln! la)n (SG 70lll t
<br />lrBin6s ltll P.ofdion Cod.) Any ( iry or Counry *'hkh ..quic ! Fiir ro .odNd, .Iq, intr.tq &nolilh or Ep.n My
<br />!rtucr6.. FFr ro ir3 suM.4 !tr. ..qun6 th. atpltd lo. ru.h Fnnil ro nl. . ri8n d rrrtmor lhn lE oi ltr 6 licaed prud
<br />lo rlE FlrBioB of rlE Conrr-rd . l-a.r*d trs (( ilord 9. Coffii.* q nh sG! io. 7000 of Dilish. ! or .l _ * D,r
<br />Pbfdioor ( o&) o. rhlr h. or !h. i .rdF thd.6.n ud rh. bd6 for rlE .lLt.d (dFion An, viol!l6. ot.c{dion 701 I 5 by ei
<br />raflicer lor . pdnir .ubj<r ih. appli.ol lo r civil t6,ll! of not morc lh6 fi\ c hun&d doll4 (1500).
<br />ts. r o'r onrr roparr. or ny dplotB enh { re6 6 rhcn xn. FmFMn)n. $ill rh rlE rot !d dE rnxrc. br
<br />inralal or oIIe.d nn nk (Se 7014. ,,u n6s rnd ProftsrioN Codc Th. Conrr.doa! l,ic6k ta dE nor ,pplt b u otrffi of
<br />rh. FoFry srnlx'16ortrr..\6thdF(&n*hd.6*hr! hm*laorharlfor mu8fi his ls o*n oplorc.
<br />Fol ir.d ttd e.h mlmrqEi! e r{ iiod.d orolrod ,( rl l( L'tr6q- llE tuildi* q rq$Gi i! sld lihin ft ta
<br />of frnphna dE (rn6 Brililc "ill n v.l,E h,&n of pr.\,rs llE lE or lnc dA ml hikt or inF.rtl}t F.F, 6r tlE F,ID! ol
<br />l. dos6ofrh.FlFly, dn.(ldi\.|, ..drarins lnh [co!.d (o do6io 66Nd rtE F.j.< (Sa 70r.a. &!'6
<br />dt hnft.gion cod.:1n. Conretoi! l-i..Nc l,aw doe nor.ppl, to s own6 ofprop.ny sho buil& ot iml,r.v6 rhdon,
<br />tud trtF orrrl' lm tu.h Ftrixrsrirh r ConEl!(i) ltou.d tu6un rorlr cbffioir Lt@ L!*)
<br />I nnr.rcnrpl undo Sernnr
<br />D.,c t((L((r1
<br />TIS,ABAI1q!
<br />I hq.l,r anim undd FDh! of tl6jur^ oE ofth. n,lkl$ i,B ddls.th.t
<br />Ihaycsrd\illmainrain.(d,n.ar.of(il1srk,S.lf-ldntr.for\orks.onnderon.eplo\.dlorb!Sa(n'nUlnotrh.
<br />I !h,r ( od.. lor lh. p6fotrM.. orlh. s'orl for *tah ltc r'6nrr t su.i
<br />Ih6r€.ftjqrllmrif,r.in$o d. comFMlio. irour!rc...r r.qun.d tt sdrion 17u0 df rh. htbr ( .d., lor rh. F.olffi.c.f
<br />lh€ sork tu shichlhisD.n.il ir isu.d Myso 6 .ompaerion ituurme ra,hd andFlltynombd (c:
<br />I cd ift rh6! i6 rh. Faonmn.. ofrh. $ o.l aor tr hrch rhir Fmn is nru.n. I allnor mploy!n, pqv,.,.,hy mek ,
<br />$ 6 lo lxcor.. sutier ro rhc workd' comr<er tun hur of ( slilomig. ,nd .ere
<br />'hd
<br />if I shJuld b.com. slbjdl to lhc
<br />tro,td omFsnnn Fornba of s.dkr 1700 ol rh. hhr (-dL. I $sll. aodh{ nh @mri! \'hh !h'{ Fo\ nFB
<br />$ RllNc l,rlhr. b sur. *ort6 mmFEdr'. or@tc ii u.htrful. ,nd indl .uhJ.<r m an LJd ro riminal Frltis r.d
<br />.Nil lin.! u,, r. on. hundrdl thousnd dollG (1100,001r), in lddiriofl to rhc c6n ol corrceri.i. ddig6 a provid.ri nn lh.
<br />S(rion !076 ol rh. Lh.r Co!.. inrdcsl Dd nlom) J 16
<br />(C
<br />u.(rl-5Illg)!r&1(1!]"8l]}(Li&!Ia:
<br />I @ .llm ufrt6 F.!h, ol Fjury lh, I s [Gu.d u!d.r Fovnon oroqrd 9 (cbmffi,n! *dh Sdh, 7000) oa l]i ision 1
<br />ol rh. Brin* dd Pof.sioB codc. Exl my li..e is in full forc. o.d .iIdl
<br />ca!$al(Iloll.EllllclliENcr
<br />I hdrt^ .ffm u.&r Fdy of Fjtnt rhr E. ir r NrEtu.lb.lodlB +dy fn llE FfolrM. otlh. r-I li,. sli<t lhit Fmi i
<br />i$u.d (SG 1097. Civ C.).
<br />L...l6 r Nm.
<br />AIII.LCAILDESJSAUA!
<br />I hdrbt .lrm ui&r pollh, of Frrry oE ot rlE folh* in8 dc.hrd ionr
<br />D.rohion PmiE-A.t6r6r Norificd ion Fold.l R.golri)ni {Tnl.40, Pd6)
<br />R.qutcd tlrtd of troriftdion
<br />I cdiry rhr ltE ftdorl asuLrioG Egrdilr d.no. @v.l r. ml +?li..bL 'o
<br />rhir F!t<i.
<br />I.difyrhd I nrv. rftd thn lmlic i.n dd st!l. ihn lh. atD!. irfom ion n corccl. l .rra lo .omply snh lll ( nya.d(_ounry
<br />.r.linm6 ed sEt. lls r Eb hs ro hildirs coNd.riotr sld h6.1,r .urho,,. rcFs di!6 oathi! ( ny ed ( o$r, to al6 qrn tlF
<br />SITE-WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUlnsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framing
<br />lnsulation/Ene
<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 Certif
<br />l.,l^I
<br />FINAL (E Y\
<br />Certificate of Occupancy I 'l
<br />Notes, Remarks, Etc
<br />]TTEIETII/RL'ZVIA
<br />il.\( morr,(J nn.tf \ f.r nstnlnin FnF,tt
<br />\prlr(rnr \rd' \h .ru* I\ U='t-
<br />P*n krnrn.,pnn,,: Zh;wu' /,1*,
<br />L((t+lt?
<br />Erection Pads
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