|
BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.OWNER BUILDER DELCARAIION
<br />I h@by rllm undd p.idry olFjury lhd I m ddpt fron lh. Conlncr66' Lic.M lt* for th. trllowre ra$n (Se 7011.5
<br />Buir6s .rd ProaBion Cod.) Any Ciry.r Cordy whrh rcqln6 . Fnn to conslNcr, rlrE, inFov.. <tatulilh or re.n dy
<br />]l!de Fitr ro tu iBueq .!o rqun6 $. adtd ,or.ocfi FEn lo liL.3icr.d nldcn 'h, lE or dE i. lii4.d plmd
<br />ro rh. FottioB of rlE Corr,-r( ! Lt.fi.d t w (Cll.F6 e, ('omtrins r nh Sclnn 7000 of D'vi..n I ot rh. &aB ad
<br />PrDfdbB Cod.) 6 lhd h. or JE a dalF rhadroE Dd rh. bcir for rlE .lks.d aoFbi An, \ .LtEn oasctio. 70: I J by uy
<br />.rplitrt aor ! p<mil iubjet rh. rpplicsr ro r .ivil p.Gh, ot.or mr. rhu nvc huD&.d dollus (1500).
<br />l, 6 ow ottlE FDFly. q Ey qrphyB pnh s.s6 s tlEn sL o8Fldba rrtl it, rtE $qr.d 0E nnEE ir r$l
<br />lnod.d or ollqcd fu d. (Sr.7044. B!.i6 &d Prof6sd Codc Tn ('odtud t ti<@ r^ {l)6 d +dy lo e o*E of
<br />rh.FlFl} rho hild d insor€ rhaq !d *lb d6 sh f,olt hirull or h*lf or llmu3h his n hs o*n at9lot6,
<br />Fovid.d rh{ rcl iftFoEEt!ft br iddit d dotr+d 6r ub.If,lE*6q.rh.bildiry or inp.Dffi bhhwitlu(rerE
<br />of cul9krh. tlE Osr6 Buirdd * h8v. [r hrrdn oa Fovi,€ thd lr or rhc dil mi hi]d or inFb!. dF FoFly for tlE Pl[p(E ot
<br />_1, ! o$c olrlE FrFrt, m.r.i6n.ly .oddin8 f,th |i..,!.d.odr(6 ro odrud rlE Foj.( (S< 7O,r, Bd6
<br />.d Aotusih (o&: Tn. Conk c1o. . Licm. trw &6 mr $ply lo d o* na o t p.oFry who buildr or inpmr6 rh6o..
<br />&d who co .&t! lor uch Fel6l! wirh r Co.t r.loir) li.dlaj pusu! !n rh.Conl.rclois Lic* llw).
<br />-l
<br />d.rat urd6 Scrirn-. B &i.C loruir tlen
<br />D.r. or.t ya8trE8l:l;Qugi$AllqB
<br />DlCt Af,AuA!
<br />I lE.6y rilim unrla Frly o f pdiury oE ofrh. folh$in8 d.(L,.tioE
<br />_l t v. -d *ill ai.hn . cdiftr. of(oNd ro s.lf-ldu. l rql.t c6Fur6n, s Fotij.d lor b, Sdi,n lrm oa E
<br />L.bor Codc tor fi. pdforoc. of llE s flr trith rn Fnn ! ilud.
<br />Ih,v.Ddwillmd.inwo*.,omD.sdioniNue..6r.qundbySslion17crJof$.trbor(o&,forilEp<fo'lMaof
<br />E rort ftr whkt llG Fmh ir isEd My rqr6r of,rFE lirn i,El,lu. trir nd Ftay n@bd c
<br />I'olicyNumhd Errtrd
<br />_l clliry rh.! 'i th. Fblr1@. of rlE $ort fo. shih $ir Fni ir le.n. I ih.ll mt dshy ay tdln t dy nltm
<br />$ d ro bEom rut!€l ro rh. eortd'omFlErion hE! of Cdiromi& d.eE rhi if I .l'ould bq.m stid
<br />'6
<br />rlE
<br />mrt6'onFuriotrpmvirioNofS4lhnlT0OotrlEbbor(o<L.l*!ll.lodhvnh@nplr*thrlbspr.rtioN.
<br />wARNlNc ljlilurc to Bu. ert6' .ohtasdio. ovdis. s 6b*8r1. lxi ihrll $bjd & dploF lo qiBiirl paulB ed
<br />civil liB up to oE hut!.d rhousd dollsr (ll00,000), in .ddn6n b r,E .d ol conrrE ion. d.r!s6 a Fo!'d!d fo, th.
<br />S6rbn 1076 otlh. L.bo, Co<,e ida6.d.tdrE ra6
<br />r.lcllsllcoaraA(roB
<br />DECTISAIIO!
<br />I bdbt ltfm u,id pqrlr, of Fjury rhr I 6 [c6.d u,'& Flviion o, (1'4'lq 9 (offiiu *nn sdb. ?0m1 of Dlr tio. ]
<br />ot rh. BdnB sd Pref6s6 Co&, rn my koE ir in tull forc. in.rd
<br />I (mc\mhd
<br />(AIIIAJI(IIONIEIjTNj.AGI;III
<br />lhftby!m uftlr FEllyotr.rjurythd lhqci3!d,Blruciiotr lsdi.s 8ro.y for rh. tEtulllmc. of thcqorl fot !h(h lhts pqmir a
<br />isual (s( nr7. cit c )
<br />ATTIIqAIiLDEOJAAIIOA
<br />I harb .trm un&r Frhy of Fjury oE of llE fouoq iu &rlsdioN
<br />Dsmliion PcmneAsbdbr N.ti6c.lion rqk lR.3uhbE(Tnk40. Pd6)
<br />R.qur.n l.drd ol Norifi caliotr
<br />-l
<br />.sllt' thrr rh. f.ddd r.suldio6 asdus ab6id rmvd & Rn rmlnbL ro rhii Fo)dl
<br />I cdifyrh l b*c rcad rhir .pplic.iio. ..d r!r.rhar rh..trv. i.fonnarn'n n corcd.I lsra to codply s(h lll Cirrand ( oomy
<br />ordinmer sdc kn Elr"rts to boildinS codnructhr a h@by lurhori,. rqrernivB of rhis City ind Couiy ro @td uFn tlr
<br />,&'v. IErionol Fopdy fr o!p<tio. F,Fe
<br />lpplic.ni or \s.r( SiBnrrur.
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subfloor/VenUl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<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 />Flood Zone Certif.
<br />FINAL LD{lta "t llt*,. ,
<br />'t74/
<br />Certificate of Occu n
<br />Notes. Remarks, Etc
<br />COMMENTS
<br />t-
<br />I
|