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SITE.WORK DATE ID/SIG COMMENTS O\[NEI BUILDER DEI'AR I('N <br />I hq.tt .rm uidq p. hy or Fiury rh, I m ddtrF film rh. Coli,rcldr' Licd& L.r fr'r ftc roll,yi& la$n Ise ?01 I t <br />Auif,s Jrt Proasion Cod.) Any ( ny ot County ehich r.qliG s p6ii ro conntu( .nd, nprot., daelilh or,EFr uy <br />3rrudue Fior ro il! isumq d.b Equn6 rhc a09licrd lor .uch p6hi lo fiL . li8rtd siidd rhd lE or sbc ir licd!.d plBdr <br />to !,E FDvirioN of lll ( onllrlq', l-ie!*d L.w (Ct pl6 e, Comftins wnh Scrion 7000 of Davilio. ] of rlE &!ilB ..d <br />PlltdioE Co&) c rlEr h d in i! .idF th6.&om dld th. bGir br tlE .L*.d a.qdotr Ary vi.Ltio. olscrion 70! LJ br ey <br />.pthcr! 6r ! Fin iuti.rl3 rlE ,p?u.d lo ..n ilp.un, of Dr rcE thr 6r. hui&d d B ltim). <br />l. s own6 oflh. FnFry. or my dplolE with w.s6 s lh.t sL mnpdBdion. will &, tr *orl lrt ib. tu1@ i! rDl <br />nnsd.d orolTad for st (S* 7044, BciBdd ProfdnrB Cod.: Tn (intn.roir Lic.M Llw d.6 mr .9ply ro d oMd of <br />lhc F.Fly who hill! or inqlvd ttEEl! !d vho d6 ucn wn hi@laor h*lror lhsulh hit .r ha om . plo,6. <br />FoliLd rh.l uh inForElEa e d iddrLd c olkal nr rl ,f, hsE. rlE hliBns m itrsuqcr i! $B *irhh .m ,t <br />ol.or*i{ tlr (xG &!ktd * h.t! dE h,rb of FD\irt rh.lrdS..!id d bild n !tg!E fi. FlFq turtIE FlFcoa <br />-1. <br />s oM6 of rhc trepcly. M crclurilcly co'idcrhs *irh licdEd .0llr&106 ro .o.irud rlk Foi.<t (Se 7044, AuiB <br />alrl hlhso. Cod.: 'l-h. Conr.ctoir l.ic.e tlq do6 not rpplyro m osn6 of prop.rly who build! or inprov6lta6.. <br />&d who codd! for tuch Fq6lr wirh ! ContE ior(r) lkae<l p!a@ ro rh. conlr.ddt Lke IlwI <br />_l u.!opr uRlq S<1 <br />D.l. Ornd <br />wo R(l r.s' (:onr eENai1 loN <br />IJICIA8AIIA! <br />I h6.ht_ .mm unda FuIy of Frury onc of rh. foln,u ins d.LleslFB <br />-l <br />h.r &d rill rinbnr ! CqrifEd. otcoEn ro Sclf.llEe aor rntat omFulb . F!!li.d 6r b, SalF. 1700 of dt <br />Ubor Co& for rh. FfM. of llE *!rt lor etth llE Fnn i iscd <br />_l hlvc ,nd *ill oriirlin m*.r' comFoB.rio. iEura..., 6 r.quir.n by Setior 1?C{ ot lh. tlbor Codc. lor rhc Ffolmc. of <br />rh. "ork for uhirh fib FDn L iq$.d M, wo*6 mmFdion iNud€ ffir dd Dolay nunhn @ <br />Po|(! Nunbd <br />-lipr6 <br />I ..niry thal in rh. Florrorc. of th.*ork for Ehrch thi Fnn is iesl I rhrllml dploy.ny pd$n ir uy frtu <br />$ a ro b<oe sbif,t lo 1lr wi4' @oiFltio. lr*. oac.l'6mil d .gE tfi, if I ihould bcotu $tirl lo dE <br />ert6' srloos.lbi proririos ofS<iion 1700 olrE trt6, Coda I $.11. fdli"tt ordy wnh lhoi piorabd <br />WARNUIGT F.ihF lo GG Nrta 6np4.bn or6.s. s unbf,rul. &d rltll st*tr & dpbtt b ainin l Frlis tn <br />.ivil li6 up ro oE hu&.d thord & 16 (t1m.000), h d.lnion lo tlE .on ot o6F@rb.. &r+6 a FoviLd lor lhc <br />Sclhn 1076 ol rh. L$or Codq i 6.n &d.rrdrr'r rd. <br />UCEME-COCrIACIAa <br />DECI'8AIIa! <br />I hdlur'lFrE ulxla ,6!!y of Firy lt I m liE&l ur'{, Folirir. ofcll4ta 9 (oMils vnh S.dbn 70@tof Driio.l <br />or th. Bsind ..d PrltdbB Co&. !n 6y ltde n ia tull foc &d clfei <br />-l,ic@Numbc <br />ca!$aul:llalJ.EBDlxclGllcx <br />I hftby .rm undd lEnahy o f Fjury that lhq. is . coBlrud irn ldding !s6cy lor lh. lqfoll@c. o f ihc torl fo! whth lhis Fmit it <br />itiu.n(56 3097, ( iv C ) <br />APPI ICAN |:rCI ARA'T(IN <br />I hodt afm utld tEllrt ol Fjury o* of tlE aollo*ing ddhnl ioN: <br />DdEhEn PftnlA3b.dor Norili.d b. F.(brl R.tsuLt bN (Inl. 40. Pd6) <br />-R.quiEd <br />Lard of N,c.,ft dim <br />-l <br />cd iry thd lh. f.d6sl r.suhxdG r.tedrns 6bdro3 roovil et mr sptlicabl. ro rht pro]al <br />I .d'ry $a I h.!c rad rhis .ppltdion ri fit. tht dE thov. irft'mdb. ir cMc1 I is6 ro orj9ly wnh rI Cn, Dd Cou y <br />oditl.lE rd sld. l&! Ebic ro boitl'.s .ore!.lh( .n hqctt uhrt. qrrfin6 of thit cily drd Co! yro srq l4o.dE <br />.t w nEtbn d FtrFry Ir ryran FrF.d <br />ADpli.{nl or&61 shflilure <br />Set Backs <br />Forms/Steel/Holdowns <br />UFER Ground <br />SLAB Floor <br />Subfloor/VenUl nsulation <br />Roof Sheathing <br />Framinq <br />lnsulation/Energy <br />Drywall <br />Ext./lnt. Lath <br />Brown Coal <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 z.lb1 t/t i I/AlAEAZ 7)-/ <br />Certificate of Occupancy T W <br />Notes, Remarks , Etc <br />BUILDING. INSPECTOR RECORD <br />Ereclion Pads <br />Shear Wall - ----T------