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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathing t2/14/ii .=aff(
<br />Shear Wall
<br />Framing
<br />ln sulation/E nerg y
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />t4
<br />FINAL 0t/6b//4 aN^
<br />Certificate of Occu n
<br />Noles, Remarks, Etc
<br />OWNER BIJILDER DEI,CAR TION
<br />I hd*r lrm !n& Fdy ol Fru,y lhr t d qdp( 6oE ltE CMrdd Lice t^ fo. rlE 6llorirg lE,n(Sd701IJ
<br />&BiB &d t otaEn Co&): Any Cny or C@nt *hah ,!quc r Fmi to odrucl. .!a. iry.orq &6Eh d EF dy
<br />tu@.Fsrodr iMe &. Eqri6 tlE +ltd ld M[ Fnn ro 6L r 3*'Ei nrdcr l, lEot JE it li.lu.d Fltrd
<br />ro llE Frniro of iE ConE*bi Liard ti* ((i.cl6 9, Conrtljcr8 $nh Scrbn 7m of Divilbn I of E &!ilB xd
<br />Pmf6i.6 Co&)6r tha lE or iE t ddF tha.6!m id th. b-ir for EdL*.d qdFbi An, ftLrion of Sdb.70ll., byry
<br />tpplicsr for r Fnn iubjcr! th. +plic&r to . civil pdlr, of mr mc rh.n li!. hundGt doll6 ($m)
<br />-1.
<br />s o*n6 of rh. popart. or ny .nploy6 wilh *.*a s rh.ir FL comrdslion. Mll d. lh. rqk ,rl thc liiIlrc b mt
<br />i q'd.d or offd.d f.r slc (SE 7044. Buird &d ltotgioE ( odr Th. co nctor't Li.mc lrw &d nor tpply h e o*nd ot
<br />rh. FbFi, vho hril& o. irpmrB dE6tr di eho 1106 Mh wlt him!.lf o. h*lf or lluoush nir or hd 6m dplo)6.
<br />Dro\id.d lh.l luch imD.orEcn!c 6t -idld.doron,!d ft', $lc I( rbs-a. tlE bu lna ot E!.!!qEn it$ldvthi.oE ra
<br />of 6mpkiol! rlE (xE B{i!a "iI IEv. 6. hnld' olFol,rS dr lE n llt {,i1 Dt hild or in$.N. lh. FtrFy for llE pt[!G of
<br />l. s orE of rh. Fltdr, m drhsnr} @fislIu *nh lic6E d c.rrtard to 6dM rll Fr.< (S€ ,Ort. 8616
<br />!n hDisn co&: Thc conr.ad ! Li.as b* &r€ mr .r?lr ro e om6 oaFoFry sho hlldr or inpb6 rh6@
<br />ud *ho s .r! ft{ sn Foj.tr! filh, Coilraro(r) lrd!.d FdM ro dE Codrrld r Lt6& L!*1.
<br />I n c&mpr !nd6 S{lD
<br />lloa5llltgrllllNlAra!
<br />DEClrAlAlq!
<br />I hs.ny ralm u.&r pd.lty ot pajui, on. 01lh. folL*lilg dd-!t ioG
<br />-l
<br />hlr ed w'll dllnu . Cqriiid. of ColEd b sd lE@ lor lql@ @nF!.!id, - Fri{,.d Io, by sdion l7O0 of lh.
<br />L,tc codq fc rlE Ffoffi. of $c e 6. *hit rlE Foir a i$.<t
<br />_I hr\. ad *rll minr.in wnrldr 6Bp6.lion iMe., d GroE.d b-r S.(n. l7o0 of trE l.t ( od.. for tlE Fa(ro.of
<br />'(h
<br />rh6 r.rn 6 sEl lty sqldr rnhn(M'onttrriaa.Ll,tnlrs.,,iBulm. . G t i lDlq nufttE E:
<br />z7
<br />I cdit lhd in rh. pdfollffi. ollh. wo* fd which lhn F n i! i3su.d I3hdlm' anqh, a, Fsn inanyn1,lE
<br />F d ro hdN rub..l ro rh. s,i6 @EFE iof, !.*r of (.,]if!tua.!d.gE lh, if I rlsuld taoft stilc1 ro dr
<br />Eit6 6nFsdio! Ftiriod of Sdi'. l70o of rh. Ldq Code I tlEll fmlhrilh Nody * nh llE FDrtioB.
<br />\tAR]ltNC: Flilm lo sU. uqt6 olnldrbn.o!€rsc a uE"tul, ed Jdl 3ubF x .rplo)s lo o@rd Fdi.r !i
<br />cnil fh6 up ro oE hulrtcd tho@rd .lour: (1100,0001. in .ddrion ro tlE or comFdirtr. d.:us6 6 tmlidal f.t 'lld., inrad and lndr.y r 16
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<br />nrct a{ TroN
<br />I hftby oflt'n unds pcnally ot psJury lhat I @ tc.$qi uddd ls,vssn ofChopls 9 (con'nflcinr snh sc.l@n 7000) olllivirnrn 1
<br />ol th. Ituin* ud Pn'f6ioE Codc. ad hy licce B 'h aull litrc. drl .rrl
<br />(Zr b twrlDo
<br />c0!t[8llclu!.l,r!DlNc.AcE!(1
<br />I rEea .ftm urdd Fuhy of Fjory lld the n r mnrtudbn lddina .stry for lh. Ffotu. ol rlE $!rL 6r $nrh lhi pcna ir
<br />Lsucd {S(. 109r, ( iv C )
<br />AIII.ICATLDICI.ABAIIO!
<br />I h.*t reb lndq F!t!, ol Fju,y oE ot tlE folbwhs &.L.dioB:
<br />Dnmlnb. Pmi!-A.b.ic MrifEni,. Fcd-.1 Rcgulri,a (ThL 40. Pfi6)
<br />-Rcqlt
<br />d Lal6 of iLoiftri.o
<br />ty $d rh. fald.l r.BUhnrE cs&dios atd$ roo\ al ac nor tr,plklbk lo rhs Foi.ir
<br />rhat I h.!c e.n rh6.pplic.tion dd r!r.lld rh. !tnv. i.fomalion n corar I .llc lo.ompt *nn.ll Cny.nd Counly
<br />md sr.r.l,s rchriqto btrildingcotrntu i('n. od h.rcbyrutho!,. rcFcsr.r
<br />n,o.{ I,lp.ny tu impalion
<br />P.rmirr n.0r(prino: A(<:€a
<br />";lil;
<br />ZtrZE'-
<br />Erection Pads
<br />Pool Fence
<br />Flood Zone Certif.
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