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BUILDING. INSPECTOR RECORD SITE.WORK DATE ID/SIG.COMMENTS OWNER BI]ILDER T'ELCARATION I l6.t_ry 6IIm !n& FtEny ot FJUry lhi I m q.rpr fron rh. ( on.rcr@' Lic.a t w aor rlE lollostB @n (Sc./0t1.5 BBiods .nd Ptofdiion Cod.)r Any Cily or Coudy *hi.h r.quir6 s For ro @.Eo<r. .hn. inFovc d.mlitt or rqir Dy n u.rurq pmr lo n! isu&q al!. r.quir6 $. 4plicot tu 3u(h Fd 'o fi|. . !i8n.d 3td66l lhal lt or JE ii licasd purird lo llE ForitioE of 0. Contr'di t.@nr.n L!* tcluis 9. (tnnftins s sa16n 70fi of Dirkio. I of lh. Busind dd P6l*i.B ('od.) o, rh,l lE o. ds i. .r.r9l tlE 600 id dE bGi! for 0E nh.d a@Fi'.. Ary ri,Llion ol S<rD. 111 I 5 bt d, !p{,lic!nr lor ! psnn rubjclr th. lpplic&r lo r civil p.olry of not dorc $d fivc h,Dtr.<t .kJllB (lJm) _1. 6 offi oarh. FoIEiy. n my .npb6 $'nh w+6 s th.ir iL of,Fq6rio'! ulI & trE sdl nn rlr srrE it Nl itcrLd or o,t(cd for sl. (Sd 7044. t!6in< ed Proli*rioB (-od. Th. ( o,rru.ld ! Li.@ t,w &6 .or 4,ly b 6 o{G ol tlE F.oFiy *hr hiikk m i'wo\ 6llEEr ad who &E sh N& him.lf ot h.Elf or rhmu3h tit or hq o*t .6phyc. provlini rhd tuch inF!6G{.t c d hcx,.d d otual ir sk. I[ ho\6v. E trildi'B or irFsqEn i! $ld *ihn @ ]* otsmpLriol' tlE (rrs Aoila * l hsv.lrE hrd6 of Fo\rB thr lE N 3& dil,Dr hild or iI{.nrtl,E FbFl, tu tlE Frrb*of _1. s oM6 of rh. Fnpdt. m .i.luriv.ly contrd D8 *ith licdscd co r.doE lo conrrucl rlE Flj.tl (s< ?04.1, &!i6 .!n Frkir Cod.: 'fh. Cont.crof, l-icG l,s do6 mt rpply ro e omd ofprcFny who bxild! or ihprovd tha6n. od *ho .o.nr-i! fd uh FjGr! *nh. Codraro(, li@.d p.llld ro'h. (on'..rn r LEdE lrv) _l m.rmF undd Sdrbn ,Il. & P.(- forthG 1600 llri. Onnâ‚¬r \1oRl(FtRS', ( OnlPENS,\l rON !D(]3l8dIA! I h6cbr rllinn undd rmrl', olFrloryoncofthc roll,Ntr,! dNlnr0rotrs I h!v. !d will Bi,nlh . Caiifrd. of Col6t ro S.l!lEU. fs *r,ld!' omFBlior. s FDvil.d for br S6tbn ITOO of E l,bor C.d.. for rh. F6l:11e. of lh. mrt for whi.h th. pdnn ir iscd. _l hlvc !.d vill naint.in wor[.( .onFN'hi itqme 6 r.qoiEd t] Sdrion troo olllE libor Co<l.. hr rlE Ff(xrl@. of rhc *6rt ld *'[ih tn! pdnn ! i$.d My mrt6 NdFGdion iE!rs(. cnir !d poliy rumbd a. Poli<y Nuba:-ErpnB: I cdify $u in rh. Ffol ncâ‚¬ of thc worl for *hrch lhis psn't t i,rsu.4 l3h!U.or @phy any FB.n in dy m4E r a ro hcor st*rr ro lL *dr6'6nFndio, h*! olc.t'for.ra !d.BE rn ill shuld h..orc subjdl lolrt K*d' comFul ion Fovi.ioa ofsdion I700 ol lt. lrhd ('o&. I iElL fonhrit oBpl) rth thos Fs\irnN uaRNlNG: F.ilur. r' Gu. wortd omrEMior cov6dt. ie ubwtul. &d 3hdl rubjcr o dplora lo snniul FutE !d cilil lin6 up ro oE hudEd thoMrd 6llrs (tloo,(x)o). h..EnFn lo lrt.os of oqEMrior, &h4B 6 Forid.d fo' rh. Setion 1076 olth. Lihtr( ode inr(6r ud.( 7_ I hch) alfe urj., Falrr of Fiu$ rhd I F.\tion of(tuFq 9{omttmins rnh Sc<1Dn 7(xD) olDnision l oI ltc AuiI* Md ltoL.lioE Cod.. !d my lt.e B in tuU lod td.lT<r )7"7 < {e, ov"<AE-lT;g@+7_,2/Q/t 4 I tElby ltiim u.dd rarly o a Frjury thd isu.d (sa 11097. (\r. ( 1. i! r ..tr(rudi,n Lndi4 !s6cy lor lh. F ro@.. o lrh.sorl lor r hi.h thir Fni i! AIIUCAILDICIJAAIIO! I hdivrtrnnunda Fnalry ofFlury on. oaLt aollowinr d.chr.lbB D.mhio. P@irs Asbâ‚¬lor Norilic.rion F.ddal RcSuhtioN { rnL 10. Pan6} Reuircd lirtd da Nouhcdion f.d.al r.e dioB r.grtlB a66bs rm\d e. ftn !ptlE.b!. lo lhn p.oj.il. r6d rhb 4?lkrrion ald nll. rh.r rh. ahv. iDforurbn ir corrr. I a{G ro conpry whh Cny Dd ( o6ly .t $ rcl,B to hillins co'Endior rn td.try rdtlE kFend( 6 of rhir (-ny Dd Colnly k' 6na urnn llt G-a -,,,?/eltl Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Subf loor/VenUlnsulation Roof Sheathinq Framing ?.,rt -2-z-t9 hultc'l^ lnsulation/Energy Y.-,1 Drywall )'zs'19 h.wj4l Ext./lnt. Lath Brown Coat Masonry Pool Fence AT T-Bar ilalu'Trr.l $a<1,(vtL Handicap Req I U I Deputy Final Report Engineer Final Report Flood Zone Certif //\ FINAL 1-\\-11 k-wJ0\ Certificate of Occupancy V Note Remarks Etc tll-- I Shear Wall ,etl9 --------T------