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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS Ol,Nr-l BUIIl)ER DEII'AT NON
<br />I hccby dIm u . pa.r, of Fju!, thr I h 6dtq, fNo lh. CldrmoB l.auu ls ln, llE 6llo*h8 .en (SG 70t1 5
<br />Burin6r lnd Pma6rio. Cod.): Aoy Ciry o. (ounlt snkh r.qoir6 . Fnn ro .o^ntud. .n6, inPrcvo &tulnh or r.?., m,
<br />irucrd.. Fi, t6 h! iMq .ho r.{lB tlE {pltdl for sh Fmn ro 6k..i8tEd nitul lhn lt or JE it lic€E d Pu$!r
<br />ro tlE Fsviiio6 ol dE Co.rtrd r Li.ar.d L.w ((tuFq 0, CodcinB $ih Sdhn ?000 ot DilBbn t of rh. BGiB dd
<br />tNlcsionr Cod.) or lld h. or sh. L .ldfl th6.from Md rh. bsis fot lhc d1.8.<! .rdflion. Any liohion ofSclbi ?0ll.t !y a.y
<br />.rpli.mi for . Fmn $bixr! rlE .ppli.&r ro . .ivil p.uhy ol ml m.. lh& fiv. hu.d.d &ll-. t$m)
<br />l, s o$E orrh. FoFdy. or my mplorG wilh tr.sB s lh.ir $1. conpdldbn. will &,llE wo.l ed llE rnn@ i! ml
<br />idqi.d d ofra.d fn et lsa ?O.l.l, BditB dd Pr.lisirB co&: l1E Colrrr-lM ! l-tqg ti* dB d Tply l. o 6\c ol
<br />rh. Ftrtd! *h. tuldsor inlF!\s ERn id *tD dB s-h $.ll hiNlf or h6*lfor rtlNgh hit o.lE o*r drhlG
<br />p.ovid.d rhlr 3uch imtrorsEd! e ml i ad.d or olH f.. ulc lr. lr*6s, rh. h{iEiry or inF.$vdna i. 5k wnhin o,. tq
<br />of s,pldia E o$E &iEs {dl h!(llE hr&! otFotilE rllr lE or tE dil ml hrild d i4.oc dE FlFly &lr tL F,F{ of
<br />l. BosE.trhc FFr), d.rcluivcl) contrxii.s s'nh liGed $drdo6r. odNcl rlE Flj.tl (S< 7lx-l ttlliB
<br />.d Plrkrir Co& Th. ( onrrEror'r Li.c ll{ &'6 mr .r''l} to s Nr6 of prop.dy $ rh h{ildt or inpor6 rh6o..
<br />rnd $ho @nr6crr ior loch proj.d! Nilh ! Coil6dn(, licaa.d puRuMr ro fi. Co.tr.clois l,icdc Lrw)
<br />. I @.roF un&r Sdion . B. & P(' forrhlr*n
<br />l).1. O'rd:
<br />naSalf,i-(oalrElsalla!
<br />DE('I ARATION
<br />I hftby lmrm und.r Fuliy ot p6jury oa o flhc rollowins ddllaii.B
<br />I h . ,i rill ruinrtin . Cstrli$r. ofconhr ro s.ll-lNuE atr N.rt6 .omp6srion. 6 povid.d aor by Salior 1700 of th.
<br />kbor Cdc hr tlE Ffoffi. ol llE sdt tor Btkh ln pqnn i! i$u.n
<br />C!iq... -o "r, ."""" "n 6 comFBdnn ,6u,!nc.. 6 rcqundb,sdrn17oo.rrh.Irl cod.. rorrh. pdroll@.. oa
<br />JIE u'orl nr$h{hthB pqnd. BEd Mt e,trld'omp.Mmn rNuruc. cdnd dd FIk} numb( mE=>
<br />clrt,p ttlgO -- t9 r q.. (6r.2 -1 - 2o?D'
<br />I csrii thar in rh! Ffnmm. ol lhc *orl foruhichthi! Fmn i! is!.d,I thlll ml Ennloy rny p6$n !n oy BUF
<br />$ E ro haom rub.cr lo rtr rsltd ornFdion h$! orcrrromE d! CG rhd if I .lould b.toE rut <r 16 llE
<br />$on6.omF$lFnFlrtriodolSdi,.U00olth.t,hot(odcIiluu.fonhwhn6npltsthll'.-ForilirN
<br />N,{RNIN(;: Fa'lur. ro K.''urc \o,k6l co ,n .slion u\ru!.utrl,nrli'T. m(l nrll {'1,r.r m onrk,!rr
<br />.iril nn6 up to om hu.{n.d llFura'd (I'lld (!loo.lrOo). in
<br />.frh. Ltn ( nle 'nt6d dd
<br />Ir 2@F7
<br />I ,Fe* ilIm uid.r FEnr_ .f FJUr) lll' I m lic&l un&'bris I (offiins whn s4! hn 7qD) of t ir itior l
<br />.r rhc tlu.$< ind Pn,fdio6 CGj.. ard my ltro Lr in tull t(
<br />**.*,C-35
<br />rt{o/zorr A-,"""^
<br />(loNsrnucTtoN I-ENDlNc acFr\(-Y
<br />I h6rb, llIm ur& FEhy of Fiur) tht rlE. i! . odtudioi ladis !e*y f$ rlE Fnlllw. of tlt ldl lir *tit rhi. Fri i!
<br />i.ru.d (s6 1097.civ. c )
<br />ATTII(3BLIECIISAIIA!
<br />I ha*,y s,nm unds Da.lry oa pdjury on. ol rh. aollo$ inB d..L!.iioN:
<br />I).,mh$i PoaneAstds NotifKdon F.d.6l R.suld6m (Iik,t0, Prn6)
<br />R.qun.n Ld16 of Nor'ncdion
<br />! .d 'fy
<br />rhd ih. fal6.l tcslLlhE Esddirs atElt,ts roor dl d. nd gFli(thk lo lnit Imi€i
<br />lY lcdil
<br />'hd
<br />I hs(Bj rh.@r..'ll m!nc6 .nd srdc I rs Elrnu ro bui
<br />!tFv. mdrnr..d pmp.ny f0 iBr.crbn
<br />,nratrh{rnt.htr. rnfonNifn (.rd I .ArG ro mnDD' s'irh .ll Cn r ud Codry
<br />.ddr6 of !hi3( ny arl (
<br />llAppllrnl or&dl shnrlun
<br />Pdmitd tr.f,.(prlno:.4<.../ \ GffL a-F/7ol ?
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Fram inq
<br />lnsulation/Energy
<br />D all
<br />Ext./lnt. Lath 2-'25-to dlot
<br />Brown Coat t hv(?o Dtltr) 62-fts7
<br />Mason;y
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enoineer Final Report
<br />Flood Zone Certif.
<br />,.@)
<br />FINAL yzTlp'il -tlu,d,,(r
<br />Certificate of Occu n
<br />Nolesr Remarks, Etc I
<br />-5c rt lorYloq!o. V.-e}:.t,;-6
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