BUILDING. INSPECTOR RECORD
<br />SITE.WORK COMMENTS OWNER AUILDER DT:T'AR TION
<br />I hd.t,.mnn u.dn p..!lry of psjury rhd I {n d.nl|, nom lh. (iJ.raddn Li.!s l,s forth. nnbwios r.&rn (5670ll5
<br />Usi.6! &yl ProfGFn ('at ) Ant Cny or ('ou,iy *hth r6t!n6 . psnn to codrud. .Jid, improre dafrl6h or r+tu u)
<br />irucluq Fior ro itt isuucc. allo r.qutrd rh. lrplicdi for 3uct p6b't lo lilc ! siro.n dmd th4 qor sh. i! licm*J puRu r
<br />ro lhc ,mvishG of rlE Corrraroa! Li.aE{t L.tr (Ch.Ii6 q, (,onhtuins rnh S<b. 7m0 ol Di*irn, .f th. uNinBr lnd
<br />t\.f*nns Co!.) or rhll lEor slE l!.rmF rrE.tof,r lhc }!sB fin th. llkx.d crdpli.n Any riohnrn of Sal ion ,0:l I 56y,nt
<br />lpplic! for a pdni' .ubjat ih. aPlilic&r to . d il p.Elr]- ol noi ftu. rh.n fi!. hu&lnl dotlr. (ltoo )
<br />I. $ osnd ol th. FoFlt, or mt ml9hrc wlh Na*d s rh.n sk comrENlion. wiu d., th. wod eri IIE rBlE b nor
<br />d.idrt ot ordd for 5L (sE.7or.a. BNilB sd Pr.f<o6 ( o&: rnc Codrrrd t t,ie l,*.&E ml Fply to e o*E of
<br />lhc ploFy ets tril:l or inFor6 fi6i! d *hl &E och mrl hm&la or n.clf or rnmlsh hs or td oM drloy6.
<br />,(oviLd rhar sch hFoEEls eml iddrldl noff6d 6r!t lt lnBq. trE hlildls or i,rprtt,rd t$ld "ihboE !dotcorTldF( lh. O*M Burtja will hAr
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<br />h,{ar of F)u,'s thr lE or nE dd ml hl or !tF.!E rh. Frpdry for rlE pdF&or
<br />I. $oqsoathcFop€ny, m.t(lusiv.lt.oniir.i'ns *ith licds.d $dEclor lo .oretruct th. ruj.cl(S(. 7014. tt6'n*!d t\'t3rion c{\d. l hc contrrl(n s I icrelru &6 frn.ml}ro Md*nd oaFop-$sho b!'lds or impro\6rh6on.3id nho.\drdsaor!o(hF.lds*trh!(il n rd(s)lrd!.d rrEMr futhcft.nrdol-r Lictr L:$)
<br />I M.opr ur&r S.cr$n
<br />\t oR(rts. (-ol\rPFrt{sA I toN
<br />uEq.6aauq!
<br />I hd.t y ,,i@ un.k Fplrr of Frory om of rh. nrb$ ins dc.h,.tioE
<br />I h.v. !d lill Bim.in . (_difEn. ol(_o6dt lo sdr,lEw tor " o,t6 @mFBnion. B p.rvd.d lor t! S€thn 1r0o o I rh.
<br />Lhor Cod., for rh. Ffo'rm.. olthc $!'t rq u hf,h tn Fntr i! isud
<br />J no.. ona *,t, ..'r.'n *",a6 .omFs.. 'Mffic. B r.q!tr.d try satrcn 17oo orrh. bbor codc. ror rh. Ffmm. of
<br />th. *1trl ror shicfi lhi! pcmil i. is.d M, wort6' @,nF&lnrn iauecc .eis &! policy nudb6 sc:
<br />/ , ,,.,,, -i-r i S+a{F-.--
<br />\,*,,r,^,- eecaoSbzbq t,p*t t!r$
<br />I (drt ltd in rhc Ffol1ffi.olrlE worl aor rnah this psnil 6 @di. I lEU mr arhy u) Dcen in ur mffi
<br />$ a
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<br />b<<.m. $b..1 to lh. "trt6 mnFnsd ion las oacrlifomir, dd a*c lhrl if I sh.uld b<oft suw t( I lr
<br />*rlt6 @oraslir prclsioB of S.cli)n lTdJ of ih. I.60r ( odc I Jrll. fndh*hh omply * i$ ilr,F pnviri.dr
<br />WARNING: rrilu. to sG *!rt6 onFBdion sros. ir unLr tul. el fill sbFt m dnploF b sinmd Frri6 d(ivil fincs !p ro on. hun&.n thousnd dollm (ll00.o(r0). in on lo lhc cosl o,.onn Nlnr.. rbmancs 6 r,ovid.tl for rh.
<br />(irjc inr6d .,.1db'e- s a6
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<br />I nd.by tfrm und.r Fcn, ot Fjury rhn I u llGel mdcr Frr irbn of Cnl9ia e l.lltlllxftms *irh s.di,n 7ur0) oa Dn Brn r
<br />ol ih! DB'n6 ud PbldnrE Cod.. ad my licru is in lull forc. dd .rsl
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<br />C^rO
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<br />I hdltry .lTtu uldd Frny olFjury rtr Er i . @l!nErb! ladlB .ecy lb, tIE Ffo!:rB. of llt 61 6, *tth lhir Fna ir
<br />nru.d{s(. lm7. civ c.)
<br />A}PI I('ANTNtsCI ARATI(JN
<br />I ho+' .rm urd6 F6!Iy of rsruq orc o, rh. foll[ i.r. d.(le!r 'odllnolitutr Pdmils-Asbelo! Noti6..tio. licl6.l Rcsuhtnrns ( I nE 40. P.n(l
<br />R.quiraj l.dr6 of |5ria(di,n
<br />I cdiS rh, th. acd.rllEgubrhN E86din! staor r@\!ld. hot qrpl(abk to rhG Fojc.t
<br />I cdritrb, Ih6.6dlh!lppltllion.ded.rhd rh..to\. rnfond$n i conal ! rerc ro onplt $ih a,l( i, .nl (-ou.t!
<br />arn6 olrhis ( n, md (iunty'o dr6 uFr. rh.ordm.n.6 Md srat. l,ss rchlru lo burl .otr(rudon. "l h6rby aurhoiz. r.riMr
<br />atr^. l@rrcn J rrop<ny for inrFd
<br />4ptonr or r*tnr srrnrrurc
<br />qr\<s\ .k I Ut sl' f 'o
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />f,oof Sheathing
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handi cap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />FINAL 6/zr/14 ,-zl*a
<br />Certificate of Occupiffi 1)
<br />Notes Remarks, Etc
<br />t
<br />L DATE I ID/SIG. I
<br />Ptrnrilen.mrlprinl);
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<br />Shear Wall
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<br />I I
<br />I I
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<br />Flood Zone Certif.
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