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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE rD/srG.OWNER BUILDF,R DETT NAAIoN
<br />I hq.try .llm und6 p6.lr, ol psjury lhd I m cr6npl non lh. c. rxlo6 Li..d t.w fot th. aollow.s rt&n (S< ml l 5
<br />Bc,n* !d Phldirn Cod.): Any Cny o. ctudt "tth r.q{n6 . Fni lo odM, .116. inFotq <bbl.[ ot.t9.t xv
<br />nndE Ft{ lo it! i!sle.. ilo Equt6lhc adkul tor such Fnir ro 6lc t 3r8r.d n.lffir lhn h..r JE i lic.G.d p@el
<br />lo lh. FovilioN of tlE Conrrrloa. I-iBr.n bq ((tEPla 9. Coddins $nh Sdhn ?00n ol DiYnion I of th. B.ariE rd
<br />Prcf6ioB Co&) d rhlr E n ilE b daF rhq.nofr d lh. b6i! lor !h. .llc8.d sdFiri Any violdion of Salbn 70115 bv env
<br />.r4l'..fl aor. p.mit rbjel3 th. omlic&r ro..ivilpcmhyof mr mr.lho fivc hun&.d doll4 (1J00).
<br />l. 6 6lc orth. pr.Fdy. or my mploy6 wilh wrg6 c ihcn $L mmpdsdiotr. will dr llc *sI rn
<br />'lE
<br />iixiw i! 'blidar&i ofi-.d ar sL156 7olt, B€iE 6d PrcfghB ( od.: Tr. (irnrtroir LiaE t,$daful+Flyb6oqcoa
<br />rh. FtH, "lb tuil& or irpo€ llEon i.i who .106 uch Fn himJ.lf or h.rlf or $NuBh hi 6lE oM dplo)6.
<br />prDviLd rhrl 3uch iiFo$dted irdrLd dotu 6r rL lr. 1n*6q. ttt tlildit| or nsEsEr b sld$ihroE )€
<br />oam,phbr llE OrE B{itta sill lEr tlE hrla or p.otins lhd h. or t€ did nor hlld or inF.v. lt€ l,lFty 6r tlE FtrF* ol
<br />t. s o*nd of in. Fopdy. m sclutiv.ly .onrdtio! { dh Ii.dE i .odr6oE to Nreucl ilE FDid lsc 7olil. BeB
<br />,rd hDkor' (o& l1E( odrsroisLi..e Lr* &6 ml qrly lo & nsG .f proFi, qho b{il& or inprovd lhdmn.
<br />..d wh. codnd3 for !!ch pro.i6lr *ith ! ( ontuo(!) lkoB.d t un@ lo lh. Coddoa! l.t.e l4).
<br />I m.r.,n rndd Sdion
<br />D.t. onn.r
<br />lr{rririas' aoMiENs rIoN
<br />D'CI ARATION
<br />I h6.t^ .nm und.r !.,.llr oa !sjq- oE oI rh. aolrtr h3 &.1{dn6:
<br />I h!\r -d eill ui, .h r Catif*ic olco@n to s.lf-!M aor w.t6 otrrFllbtr 6 FDvii.d fot by S<ri.n 17m of
<br />'h.t-6.!r Co<!, f.. inc Ffolruc. oalh. srt fo, q hkh lhc Fnn k ii$.d.
<br />I h.\. r.d sill n.inrlin ]'o.tn- comrEE n'n iNrtrc.. d rcqut d b Srti.n 1 r00 ol lt l ibor Cod.. for th.
<br />!h. *vldo, *hrch rhB ,.rf, 6 Nrd M! rorl6 6,nFsFn 'Nul*. ffi, !n Fky nunb6 4
<br />.-" 'Srq+e CoqL futs. Eq"\
<br />por.)Nunbc/ iqL\qqg2 ,.,,- l2-\-\1
<br />I cdlifylh.l in rh.ldIotu..rth. worl for snictrhls t rnn i! i$u.d,I shtlt,ol dpby
<br />'Feoi,..tmdEs 6 b tr..G ltid h rlE $0*6 orpini6n lr$! of c.l'tomia !n tsr thi il I rrhtld taom $hiEl lo tlE
<br />*0*6 onllcBdn)n ImririoB of Sdtio, 170( of rh. l,hor (-ode I dEll. lonhs nh Nnplt * hh dE Foviltrn3
<br />ll^iNlltc fnhe lo ilfr sql6' onp..lihn o16!*. is ubr'tuI. {d sldl $bj.rl u ctrrlorn ro oimid Fdb &!
<br />cnil find up lo.tu hundr.d rhousrd dolld ($100.00.J). itr a<tdn'o. ro th..o, of compd&lio.. d@te6 6 Folil.d r.r ih.
<br />sdrnn 1076 0frh. Lh, co&. mk
<br />".,..10 -30-lQ
<br />I h€.ti, lllm un& F!h) of Fjury rhr I s lica!.d u.r,a FDr irion otchrt d'r (comMcins *ilh S61ib.7000) of Divbion l
<br />of rh. Bo.in6dnd Pmf*io6Co&. i&i mylicak t in tull aorc. rn dLd.
<br />,..,,.., ".. €*3q
<br />,.," \C -3o -\t
<br />q56zq3rvo'1,/uv
<br />calilal]l;uaEtEdDldc-AcElla
<br />| haltt.,Im un& psdly otDqjuty rhd tlE ir. odruGlion ladns.s4t ht th. Ffolrm ol$. *.rl f.r qtih lhit Fnil i
<br />is!.dlsn 1097.civ c.).
<br />tndd'! Ne
<br />Artu(AtlDEcLalallo!
<br />I h.dy ltrm ud6 p.n.ty of Fjury oR ol rlE ,ollowiq &tlatl Fn3
<br />Ddmhiotr P6nnl^rb.ior Nolif..rion F.ddal i.auL'io trnk40, P..16)
<br />R.quiGl Ldrq oIl']diftni.
<br />I cdia) rhd rlE folsd r.*uLrio Gaed'ns BbdN rm)EI e B{ 4'rlic6bk lo lha pro,.<
<br />I .dlrry rhn I h,r'G @d rhi lpplr.lhn !d !rd. lh, th. .bor. inrotuion it cor.d I .sE lo @opl, snh .ll City ad Cou,ly
<br />ord'Bnrd od Srd. li$r Elnring ldiis .ointuc1Dn, &d h<.by 6dlbrn. rcpr* arr6 of lhi. cny .nd coudt lo ora upo. t
<br />.h)\c'ErnNdlr.Fny rot ra4aqV b /^rqlrnt
<br />Vo+ouu(u
<br />Lo-30-lq
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUlnsulation
<br />Roof Sheathing %,*/o:
<br />Shear Wall
<br />Framinq
<br />ln su lation/E nerq y
<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 />FINAL t-tr-t9 .&,ar,/-s
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />COMMENTS
<br />Flood Zone Certif.
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