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BUILDING- INSPECTOR RECORD COMMENTSSITE.WORK DATE ID/SIG. Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Subf loor/VenVl nsulation 6llDrrn-.>/rr //t'/<?-Rool Sheathinq Shear Wall Framinq lnsulation/Energy Drywall Ext./lnt. Lath Brown Coat l\ilaso n ry Pool Fence T-Bar Handicap Req. Deputy Final Report Enqineer Final Report Flood Zone Certil. tu /D--FINAL nlttlr{ Certificate ol Occupancy Notes, Remarks, Etc. ()l\ Nl.llt lrt ILDI.:R l)1.:1,( '\R,1l l()N I hcr.by alltni uidcr Dcn0lly ot pcijury rld I nD cxcnur ri.m th. Cofllrf,ci{ns Liccnsc Llw ror rhc following eostr (Se70ll'5 Busincsr arU Prolission Codc): Any Ciry or Cohrt whi.h rcqutcs I Frnlit lo c'nddcr' rllcr. nntrovc dcmlish 'r N[''ln onv io.rur., riorio irs is.umc. llso rcqlit\ lh.iPplicrnr ior \uch Fnnil ro nt ! \igncd strtcmnr rhat h'or shc iq li'ctr$d Puruud lo lhc Frisio.\ ol thc ConlEcioas Li.cnsd Llw (Chapr.t 9. Com'tn'iDs wilh Secrnrn 7m0 of Divi\ion I oi rhc Busirrcss lnd Pn,Lsionscodc)orrharh.orshcncxcr.PrrhcdtondlhebasisrdrhcollesedcxcnrrrionAnvviolarionofserionToll5br!', nptlicinr tu n pcmir subjccrs lic smli.0nr lo ! civil Pcndxy of nor mre rhd ,lvc hundEd dollds {S500) l.0s oqrcr oirhc pop.ny. or my.'nnl.)t{s sirh *!scs a{ rh.t vncconwcnshtr. will do rh' wort axl rhc {dur' is R' inhnn.dornlTcrcdturelc(SL{70{4.Businc$andI'tf.sionsCodcTh.Conlrrtr'sLi.cnscliwdo'snoraPplybano$ncrof rhc pn,p.dy *ls builds or iq,ows lh.drn. d'rl who d@s su.h f,od nim\clror lErtlror rltrouSn nis orhcr owtr c'rdovccs- p",rlO"U rt * .r"rt imPrcwrns m nol inlcBl&l .r oftd for sL lt hos$!r. llt bnilding or trtmEmnr is sU uirhin 'nc ,trr ;f drpbrion, ilrc O*;r Buikh will haE rh. t ftLn oi F)ving lhar l* or shc did nd huild or impmvc rh' pslrnv nt rhc ,uryrc ot l. .s oBncr ol rhc ti(,rdy, !n ekluiiv.lt co.rr0dina sirh li.cnsd conrD.ros Io conslBcr rrt pmilrt (s& 7(}44. Bu\ines lnd h.rssirn Codc Thc Coikacrols Liccnse L,w docs nor lrPlrb anowncroftrop' vwhohuil'lsorimrovc\rhcrcon- and who onrdch ro. such ImiErs whh a Coft0chnn liccns.d lnnulnr k, rhc Contracror's l-i'cnsc L!w) I rncxcnDr undn scliorL- B.&PC lorlhisr.a$n tlatâ‚¬: owncrl WttnXrns CttitPl:l"tSltXtN DECL N,\TION I hcrcby lmnnund.r pcnllly o, p.rjxry onc ol'rhc li,llowlrs d.clnrln,n\: vc l*illnDi.r.iraC.difi.d.olCorsctrrt,SctflNurclir*orkc^'..rPcn\rrnnr.rs,'ovidcdf'rbrSc'rn lT0Oofrhc c, tu lhc p.rrunMncr otrhc wod( lor shich rhc psniir is nsucd rcquftd byS..ri, l7lx) oi rh.l rhor Cod.. lnr rro Nr,n.rrunft ol i,i i'r{mNc crtri.r {kl l{li(y nu ft.t {rc t /-a I3/- l.cdilylhlr inrhc prrfo uncc of rh. sork n)r s hich rhi\ Fr.rir n i\{rJ. I nr ll nol cnPb} rny PcNr i'r rfv mrnncr * rob".-,"$bJ"._iblh.oork.iscon!.nsari.nlnwsufCrlibrnix-ri alrcclhrr il l \h.ul bccotrt \rhlc'r roric *nrkc co'nNtrsilion poriqbns of Ssri.n ]7m of rhc t]txtr Cfilc.I.hrll od[$irIrr ]t)lt \irI rho{ wARNINC l'rilurc t, t.trrc rorkcr\'c".If,n\dior co'crnlc '( uilx+ k) onc hunlrcd rh.usaM d.llar\ (31(x),0U)). ir iddir dr Ecs r\ prclidcd litr rhc :::?ryry" I h.rhy allirnr undcr ncMlryolPctiury rhd I rnt (itrnnf,n.nt! \irI S(totr 7{xx)) ti l)nr!idr.l ol rlr Btr\ircs\ and lrofc$n)ns(tJ., rfrl y li. ?. Ihcrb!rlltnrundcrFrlryolFrjrrrrhnrrh.rctaconnrudt{lcndinsrgoi.tntrrh'rrrfoniunccolihcworkhrwhi'htlrsoctin I f,n,l.r'\ AdJEs --- '--- APPIICANT DECL RAI'IoN I lra$v i,irm undcr Ijtialry olpcljlrtotu.frhc iollo*inr dmlnfuriotrs l)enn,lirn,n PcnnilsAstEios Noiificarioo Fcdcrdl RcSuhlions ('l'irl.J0. Pin6) rh rlrl col rquldions rusuding .\hc{ol rcrmvrl r,c Dor rlPli.xhld ro 'hn Pr+'r lirhir lhr\c r. l rhhlprrliut.r I r r lxfrcch..nplt(irhallCilyrndCrnrry ud srrr. Irw! rchlirg i) huildirS scrrriirc\olrhr (irym C udyt, circr ,!c nrtrrn{.d tnp.ny lar a .2t -I I h\ncd iscc.3097. Civ. C.r. Lcnde''\ Nrtr: ---