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BUILOING. INSPECTOR RECORD SITE.WORK DATE COMMENTS OWNER BUILD'N DDL('AR IION I l6.tt rfim uBj.r Fuhy ol Fjur_ rtr I m d.mF trn lhc Cod'!tuu Li.ru lis lor lh. hlh*inE rc]n (Sa?oll.t aGind an PiotdnD (o&) any Ciry or Cour y $hi(h rcquud ! Fmi to cordNcl. .ta. inlFore damlih n qu dt rNdu.. Fnr !o ir! irrMc., !k r.quir6 lhc apilltol for such pdmit ro lil. , 3irncd naoiH rhn lE or tll ! li6.d Fm.Ir k' rlE FovnioN of lrE Cont.ctor3 Lic6s.d t,w (Clupr 9, condcrB wnh t{dDn 7000 ol Dilitbn I ot tlt BGi6 Md PFLshs cod.) or ihd lE or c d.r@p rhd.from xd rh. bGit for th. tlL$<t d@gn. A.y violdhnols6inn7011tbv&v rrplc&r for . Fhn rubjd$ rh. rpgli.d lo . cir il pdull] of mr m( rhtt fi!. hud,.d dollB (ltoo) r. s o*E oarlE F.Fl', d my qiploy6 *ilh u.86 s th.it sk snpdsdnrn, will& tlE s(i rd $. nnrrE i m' il od.d or ol[6.d td lr]c (sa 7044, Auin4 ud PDa6rnrs Cod.: Tlt. Co.lfud ] Li(fu l4 doâ‚¬ d ?Plv b e oqE of th. Fnrsly *lE bil&or iIp.ov6 rluEl\.n *i[ dctEnw hilrlf or hs!.lf o. rlmuSt tir n tE o*! ctrpbt6. pFvid.d rh !!ch imF.ErEb E r)l nd'd.d qotu d 6r rl. lt ln$!â‚¬. rlE tlildiog d itsorurld i!' 5ld *illil w )s ofcorpkia rlE ()\c &ikb *iu hE dE h,rb! ot FovilB lld lE or nt dA N t.id m nnFlw thc poFty br th! Fr!... or l. soM6 of$. Ir.pcry, oqclBtrtly.odrdin8 $nh li.qsd co,rr.i6 rc olfud llr Fojdl (Sc 704'l BGIB ud hliibd Co<L 'Ih. codra-loi3l,k.B lls &6 bt !t?ly to d o$E of FoFry sh6 b(ild! or imPrcv6 th6.Dn r.d wlF o'rEC!fo. *h FoFtrrih. Conrdo(!) ltoB.d I)16@r r. rh. ( ontdor't UcGe tiw) I e.r6pl ud6 S(xon !aaE$i-lo!ll[!lA]Ia! DECIAAAIIAB I hs.by lmrh undd p6ah, of tcr!ry on. ofrh. rdbl inr ddltr.rh6 I tuv. .d * 'U tuFrrn . Cdif.r. ofco.gl lo Sclf-Ituu. lor *orld conpqBdion. s pbvd.d lor bv S..lior 1700 of rlE tlbor ( o<L fm rh. Ffo.Ie. olrlE $ol lor q hth th. Fnn i! isu.d I h!v. lnd sill n.inuh uorlm conFdio. iMrft., s 'qliEd br Sdio. rr0o olrlE L.boi Co&.lot lh. Fnffi. of rlE mrt for $hrch lhir rEin a iqd M, s$I6 ohFurion ilgc..sit &d polty nu' a@ I ..nify lhd in lh. Ffotu. oait wo ror whth lhn Fmn i! i$ucd. I lhill ..1 mplo, My Frsn r Dy maE $ 6 ro h(oc Ntiir ro rhc hrld'conpdlolior hwt of Crl'tomi& !i.88 thn ill $ould i'dor sUFl lo llE *orld' .onpc$ri6n F.viioN of Sdir. l70o of $c t.bo. c.ie I ddl. fonhvilh onqry vhh rlb* FDri3io6. WARNING. FliluE b sr *vld s,rpddion 6td.a. i sltstuL ri tull $bi<l e dnpbF lo aitiel F*lai! tnd .ivil fb6 !p lo m hudEd rhouldd rt lEs {tIOO.OOO}. in lddnio. 16 $c cor of cotup.elioi. dauB6 B Fovidcd 6t lh. sdi.n r076nfrh. rrf,or ( oda hrld rdrtolBi f6 L.-- ,.,., ld[5r]rq^fut 'I ucrrlEDrallua(Iaa DEC|ISAUAX I lElty lftm ud6 Frty of Fjur' th.l I d lica!.d undd F.vilion of Ch!F6 I (@6,i@in! snh S.dbn 70001 .f oi ifin I of rlE &Bind !d PDfsios ( od., .!d my lacr i! h tull forc. rd .iEd. ,.,. r_oIbr{\'t I haby .IIm udq Fraty o f ,qju.y thn thq. b . olnMlbn lrldiB .a*y fot llt FfomE of rh. wt lbr *hi.h 0!i! FBil ir isu.d (se. 1097, Civ C ). l.n- AIfII(AILDECI.ASAIIA! lhd6 drm un& po.hy ofpsjury onc oflhc folh$inB dc|ftlaB: Dnrln6. P6milr-A!b6lo! Nox6. ion F.ddrl Rqll.rioB ( t k r0. Ptn6) R.qund L.rl6 of llorificri, .l cdli& lh.r rlE f.dd.l r.suLriod Egedlns sb.tro! .cmvd e nol .al9l.lblc lo rht FoF I cErit) th.r I hiv. rad G6 e?ltdion rd cn. lhi llE .lnrt infotuion it .ntl I tsrc ro @mply unh rll Ctv ud coulv ordiffi6 rd St.t. L&! Ghrg lo hildins odrl*lio!! .d ho!b! .lll[riz (F&lrdi!6 of lhi. Cn, ed Couil, rc dnc .pof, rlE rho\. rmttui.d lropgry tor rspdrio. plrpos Appli(rnl or AIcnl Sisnrlurr l+-*r-t ---1*17-61q*- ,,.,. td[3t/r<T Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Subfloor/VenUl nsulation Roof Sheathinq Shear Wall Framing lnsulation/Energy Drywall Ext./lnt. Lath Brown Coat Masonry Pool Fence T-Bar Handicap Req Deputy Final Report Enqineer Final Report Flood Zone Certif. FINAL ll//lln 'llt->"tx alert ) Certificate of Occu n Notes, Remarks, Etc ID/SIG.