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BUILDING. INSPECTOR RECORD SITE.WORK ID/SIG.COMMENTS OSNER BUILDEN D'L(:ARATION I h6.by lltm u&16 pdally ol Fjur! lhd I m crmpl Elm rlE cotuiloF LtG L.w for llI lolhslu lEn (S< 70l l 5 BNind !d Prcf6iio. Cod.,: A.y Cny or Colnly whrch r.qutr6 . p6mn ro connrucl. !116. inr.orc &@lah o, Ertu ey rrud@ Fi{ 'o hr ixlff., .to E+i6 rh. rr'plior ritr rudtDmi !o i\ r r'rn d rrddir rhd h. o, !h. i! licaed p@mr lo 'h. FD\ irioB of dE ComBroi! LiG$.d tr* ((lr.pr6 0, Connfth{ n h Sd nn ru00 of DrrEDr r af rhc lll,shB dd Pma.sioN Cod.)or lh.r tEo..lE ir.i.npl thd.fron !d . b6i! lor trt rlLg.d danprion Any viohrbn ot s<ri. 70J M! y l!?licltll ror i pqhi' $bjeR rlE 4plicer r. r .i!il lHlhy oa nol morc the fiv. nun&..i d.ll6 (t500) l. B osE of $. p.lFrr. or my mpblra virh w.s6 6 $.t $k smlEsdbtr willdo ilE *dt il UE iMft ir d ida'ddi or ofrs.d lm sk (SE.704.r. Buird dd PmfsioB Co{.: Tfiâ‚¬ Codrcroir l-icsc tiw (bd ei rpply rd & o$ nd ol rlE FtrF] slr hilb d inF..\â‚¬ dEln rn f,b 4E sh rorl ni@llor lErll or rlmu*h hn or lE osn o9hlE, provki.d rhrt 3uch inFtr\EFl! e tul ilndrLd u ofiod lor sL. l[ hwM. tlE hildrB s itrFovqEn it sld r'ahin ot !doforpkhq tlE O{E Blilb qI lut. 0E hrdor ofF!\1ns rhi hc o, 3h. dd rcl hlild or ioAnw d. FlFry fn. 0E Frroe 6f l. B ow ofrlE Flpsry. acr.tunclyco rdin3 *nh [cft.d codrldoBr' coNru.r 'k prq6r (Sc 70,1,1,llGins !fij A!frsirCod.'rh.Co.rErortLk.@kq&6mr.mllr.mo$n6ofFoFtyshob{ildsorinpro\drhsar, and who conlnclr for ssh Foj.cr! *nh ! ('onrEcro(s) li.dLd p{Mr ro Ih.Codhdoat LiccE L,qJ I a .\mpl undd Scrhn !o85t8:i:(!!tf!!&urq! DIOdNAIIO! I h6.by .flim ur& Fulty otFiury oE ofrh. follo$lB d.cladhc I h.\. ad tr r ll run'lm r CdiaEd. ol CoEa! ro s.ll-IBur. lor *sl6 conrFrod io.. a riovidol for hy Sdtun 1700 otrhc Lat r ( o& lor rh. Ffortla. of !,r $!rt ad *trh lL Fnn B Bu.d. I h.r. afll Bill ntimdr *ort6 .omp.Nrl on r6oram.. 6 r.qun d b, sdrtun lTtro of lh. tlntr ( odc, lor rnc pgfolrMc. ol rh. svl ls *hEh lhi. Fs t isld My *.116 arnFMhn iNurM. cMir dn D.ky nlmbcr r.l I .dit 6ar m rlE Ffoilia. of th. *6rI t rhih tha Fin i is!.d. I 3rull nor dptr) m, F$. i. er m ffi 5 dlob.mmc brcl lo lh. *oltd'ompsBdion bu of('.lifonq ed +rrhn irl shruld t6om sbj6r tollE trvt6' snFldion PrsritnB otsalio. lr00 of rh. l:hr Code I 3h!ll. fonh*nh conply wilh lhrs FrcvBioniW R]IING F.il@ ro g@ s.I6' onFliFn (\E!c. . urh*ill. rrd il'rll ebjer o @rloF to didin l Ftrik ay] .ivn lincs up l( on. hundr.il rtuUsd Srtnn 1076 or rh. r,to. ('&L, i ad d.nDs6 s proril.rl f( rh. I hotb, trmrd und6 ,.f,Ehy o{prJuryIhar I on li.o'slundrrIIo\isk,nof( h$r6()I(n.n,fr !* irh Sdi,. 7001) of Dirirn{ l ot lh. BulB rnd emf6FB aod.. !n my licds s in tull furc..nd.fidr ..*."..- - C-- \1,". qi+LL avtzq'z-!W; I lE h alIEE u,i6 Frlly or Fru.y lhi llEr ir ! ordMioD laxlil4 .stry lor lh. Ff()ffi orlk s!* roi *nd rh6 Fn'l 6 i*u.d (S* 1097. Civ C.) A.TTIII]AN[DECIJSAIIAT I hd*y ll[m unds FEhy of Fjury oE of llE lollo$ 'ns &(lnt ion3 Do{hnrn Pdmilr-Albalc Nolili.ltio. E.ds.l R.tlld ioN (Tnk 40. Pd6) .RquiroJ t lld ot tldificni{ I cd ify rhd rh. tndd r.!!htoE E86dins ab6k8 rm,val e. nol lpplrcdbl. lo rhr pml..r ion lrl !tdr. rhrl th.,h)\. inaomdion ir.onal I agc ro.omplr *nh rll Cn, ..d Counr! .od d'... r l hd.by auihod. ..F Mrarive ofrh's Cnt M! Coo.r! ro 6rs upon E n^)^^ \ t ern,t lVl'tw s)=lq Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Roof Sheathing Shear Wall Framin s lnsulation/Energy Drpvall Ext./lnt. Lath Brown Coat fVasonry Pool Fence T-Bar Handicap Req Deputy Final Report Engineer Final Report Flood Zone Certif. FINAL l?t 't/;) 6Dan ,"* 6'l Certificate of Occupancy Noles , Remarks, Elc. DATE I Subfloor/VenVl nsulation II I I I I I I II I I I I I I l ".,., ,\zl\1