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BUILDING- INSPECTOR RECORD SITE.WORK DATE ID/SIG.COMMENTS OTT'NER BTJII-DI]R DOI,CARATION I h(*ry lmm un&r Falhy ol F)ury rhd I 6 BoF liu rh. (oddoB- Ltrot t.$ for rh. Llhsln8 rcai (ti( 1)ll , ItBr6r lrrl Prot*nr. Cod.) Any crrt or Coudy *hi.h r.!rt6 d Fmit k' .onntud. ahs, imro\t. &roli.h .r ,4\rn .nr_ stu.1u.- triy lo ns i!tr.n... sls. r.qond rtu qrli.d for such lEnir lo lil. . risn.d aroot rhd li or !h. ie li.m.d pdN.nt to rh. FovisioN of tlE ( onirsroas Lro*n l:* (Ch!l)rd 9. ( ormd.inB *nh Srtion 7000 of Dnilion I otllE Burin* lnd Pstr('ont Codc) or rhlr lE tr rE s.tdpr lhq.Gom dd rh. hdir tu 'h. 6lL*.d .rdFioi Arvriol,lnnolkiJn 70!l 5 $q tnr ,ppl'r.d for r Fini ettr.8 rh. rpplk.nr to ro\ilF hr of mr mi.rh6lir. hund.d &lld ( !5uor !- .r ou6 orrh. Fol.ny, or oy dplo)d *irh *rg6 d rh.ir 3n..ompq6di... trnl6 $c sql nn lh. llME ir tu{ i 6ddl orord.d forqL(Se ?044. Aurin6r.nd ProfsioN ( odâ‚¬ lncCo r.clorr Lictu. ks dDdnorlrFlrlo ino\rns.f rh. Fop.1v q'ho t{il.& .r iryrcr6lhEt( td rrn dB 3kh Nll hims.la or h6*ll.t rhFusfi his or fis o*n cmploy6, ,.o\ ij.i rhd su(h inlro\!1dr E mt idaldl or orE d aor $l. lt lFtr6q, rl! h'klinS or n4r.r.Id ( sH *nh6.* t6 ororplrnn. rlE OIE ln dd $rll h!\t ih. hdor orF.sry rh, h.orrlEdiid tr l or EFo\.lh. rrDrEl! for lrt trrFvof I. N orn- ofrh. liDtEly. &n.r.lNi!.ly(dnr.di.s $nh lrmrdl ronrracrour(' coNlruci lh. Fojlr Isd 7(x,1. uGihcr od Itr)l6sion Cod. Ihc(onlracl.rs l.rc.nrc l,!\vdod.or.mlylo Mo$nd.fr.on.nr who build!or iFpro\.$thdarn, .nd rhu.o.h.rsnrru(hF.jds$dhi('.6cro(rlicdsrJrdEuntrorlE(irnrrlcroasLi.o*lr*) I mcrmfl un&r S(!kh D.r. (rind \trORKF RS' ('(IM Pf,NSAiION DTS.AAAIIAT I h6cbv lmd und.r Filry.f trtury oft ol rh.lollosing delsirnrns: I nI. -d s'll u'nrM. C6rifrrr. ot(i.!an b s.la IBUF ld *ftt6 onrEuhn.6 Frr iLd ror l'' s<i6n 1rm tf ih. lltry ( ode for rlE Ffolm of th. rul fa shth ila F n u aru.d l.dift rh.r inlh.t6a.!m.c.oflh.\.rl nn whichlhis l,f,. ril tr iss!.d,I rhillnor dnpl.t 0nr lE$n in !trymanno g, trslo hc(omc subjsr r,r Ihc trortd coflp.nshon lr$ of('ihrdnra. and.8K lhil ifI sh.uld b.coDc lubisr io rh. s o*dl .onpsMl ion pnr ttuE .t S.d idn 1700 or rhc b}r, ( orl.. I slull. fonhq nh (.hrly n ilh lrlts lxo\ tiont $ARIINC Fliluc kr kur $o.kc .onFMa.n ..\ft!.hjar s o.plo\- h anniul Frlrc Md .n,l nn6 up ro o( hundr.d rho6.d d.lld (1100,00ot, r .(Il ion 'o lhc .f .oniFei.tr .hrur6 a Fo\il.d aor lh. S(rkr 1076 ofrh. trtr, (ii.. mrdd anl drhr_l-s iG {-zt-r-7 I h6tt y .rm un& pdrltt .r pqjury thr I M nc6!.d undi Fn\ ik. of(-tMarc e (ommins r ilh s.(Fn 7000) ot Dn I'on r of rh. Ildrc . ItofdsE Co&. lrl m) lrc B 6 tull for.c .'d cfi..r E 0o 16 I hd.$ .lIm und6 Fn.h! of Fjury thd ths. 6 r cotdruclnn kndils atd) for rh. tdaomffi. of lh. n k forstichrhii Frd ; irtru.d(s( 109?, C'v ( l Atru( xu)fgJaalla! I hortr orm unds po.hy orpdjury on. orrh. .olL$i.8 d(lararn,n. l).molirior Fcmirs'ArlEkr Noh6citi.n l'.1166l R.lular'one ( I dl. 40. Pan6) R.quiEd lnl( of Ni{,frdin sh6r8 rmr !l c sr rpplkabl. h rh6 Pr.jd .thar th..hnc inn,mdtion is.oE.d I arr6rocorhrl) *nh.llcnyand (itu.ry ion.s lEchy luthoec rqr.frrd i!6 . arhi ( ny ind ( ounly to oi6 Itnrh. "nr'i..n, n. ^*-, ai"n.,u^ ts P n'ir,- mnr.(pdnl,: !L ?-7?-/1 Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Subf loor/VenUl nsulation Roof Sheathing Shear Wall Framing io/9/iz .5. E cllLgtl i v lnsulation/Energy Drywall Ext./lnt. Lath Brown Coat Masonry Pool Fence T-Bar Handicap Req Deputy Final Report Engineer Final Report Flood Zone Certif . FINAL /0/L.ill '., E 4iat,& Certificate of Occupancy/ Notes, Remarks, Etc -+ \. nuruhl Fn.rur\ |,tr NrRl Mr"b I I I