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BUILDING. INSPECTOR RECORD SITE.WORK DATE ID/SIG.COMMENTS OWNEN BUILDER DEL('ARATIO'T I hd.b .mrm unda rEully ot Fjur) rh, I m aor, 6!m rh. Contr:roB' I .Ge tr$ Lr rh. f.lh$iry lwn (S< Tolrl 5 BNm6s iln Profdion Cod.) any Cny .. cou.\ ehi.h r<uir6 t Fn'i lo codtud. .h6, imPror.. &trollh or rqitr d)_ sltucluE, Fd r. rs ntum.., ro r.qut6 th. p?licet for 3!rh rEni b 61. a sitn.d slltool lhd h. or 3h. ii li.ft!.d PuBud' ro th. Ftr\urB ottlt (bnrdrd'r l-i.o3.d l,$ ((tuFd 0, ( onlffi'i3 $'nh s(!io. 7fix) of Dirihn I of th. Bu$d dd Pmr6!6n! Co&l or ihrr h...rh. s.rdpr rl6.6om ad lh. h$6 for lh.,lks.d .rdPrion Any \ i.btio. ofs..tirn 70:r I 5 b.n, aptli(. fofu F6nit suhj(ts lh. lpplica lo . civil pcnahr of nor mor. rh fiv. hun&cd dollrs (5500) Ls0*6dtrh.FnFrr.ormtmph)6$ihr!s6BlltrsLomFMi'n.$iI{b'lE}nt.nlltdnnm6mr inraxld] or olT6.d lor st (Sc 7044. Bs6* dd Prof<ior ( od. Th. ( onlEdoi! Lic.u 1..{ d66 not +?ly rn d oun6of rhc lfr{Eiy trb hikh .r n$.o\6 ilE6r ,rl *lF &6 sh *rfi hiro.lf or haYlf or lhroush hi! ot hs o*r nplo}6, prol iLd rh.i sh insnrEEri G br ddrlat ftoinE d tu nt l[ lDusa. tlE hildtrB or iqm\6d ir bld qinm @ 1r ofonpkbr ir (){E Buldi *ill hlrt lh. hrrlli ol Foriry fid lE or C!. drd ml hlild G insovc rh. FnFry aor rlE ptrFos oa l, x oss ortt Fordt. m n<lBn.l,_ c.drdn* s hh n..nEd codndo6 r..odtud rlr F.j.( (Sd 7lxl, IlGm and Aoftsih( od. lh.Conlriclois l-'cdr.l-ar dod nor tptl! ro m osnd of I'roFly sho huil&or mpro!6lison- .nd *l$.oddrforruchFord3wirh.(-ontrclo(,licordpuBudrorh.(bntr&loisl-ic@liw) I M.r.m und6 SerFn D.t. O*n6 \IorxrRsi coilPfllsdrm,{ !.ECLASdIIAX I h6.h! rm.n unda !.n lry of Fj!r, oE o I lhc follo* lll3 d.(ldixod: I h,v. drl *rll m'mrh . cdr lK.r. of ( olmt ro S.l,'lur. tu *orrd onpashn. d Fo\ ilcd tor t ' s(rrn :r70o . f rh. lahrr Code lo rhc Ffolfucc of lh. "ork fd stich 'h. pmil n irsu.d I h,rt..d $ill m.ht.in *0116 cortrFullon iN,!rc. s (qun d b! sdio. 17m of lhc L,bor C.r|.- lor rh. tEfollM. of th. mrl for whrch thi Fmil ii irucd My !o't6' .a,ipder.. i6rdE. ffi6 ,Id rolicy numhd d. I cqlifi ihri in rh. Ffol1ffi..frlE *orl for trh(n rh6 D.,nn B su.d. I null mr dph! x) F$. D lny huffi $ I ro b..oft JuUd to th. E rd'onFEiio. hwr of cllifomE. xd .sr lhd ,r I J6uld td6n. uhjdl lo ll'. *0116' comFl{lhn Fn tioN ol sdthn 1700 of rh. l.bor Cod.. I slull- t dhs{h comply $ irh rh.s FovLionr \TARNINC F.iluc !o s. svt6 6miEEii,. srF+. 6 u.l$ tul. rd llull $t*ll o drlplott ro dn l FrtE .nd .nil fin6 !p ro orc hun(H lhousnd doll6 (lloo.fi)o), 'nschon 1076ofrh. t tnr ( odq i"rF6l od rlxfty r ts.""'Mi);,;*TLWU)- LrrchsFo r onr*iiiod | [ DL(LARAI III\ V I lEltry ,JIm uidd Fnrlry ol Frury rhd I m li.q&l uda Fslilp. of Cll,Fd e (.offiin! rnh S.nrn 70m) of D\ $ion l of rh. BurlK Bd PmfdrB Cod.. rn my la.e 6 in tull for.. ad.lId. "'/" (]ONSTRUCTION I 9NNINC AGf N('V I M,!.lfm und6 p.Elty of pdrury rh.r rhc n! co.n.u.rion lqdis.snr lor th. Ffolrlrffi. otrh. sort [n $hi.h rhit tqinn i! is.u.rl tS< lt 7.Cir (-) AfTIICANI-DI,CIAMIION I hdtrr! rfEs uBtd Fn!h) of Frur_v .E oI lh. follo$,nB rL.l&rlr.i Dorn(io. P6n'rs A3tE 6iNotin<.riof, f_d6rl R.*ulliiors I l nt {0. P!161 Rcqun.n Imd .r Ndiadi. I c6lifrlnd rhc Ld.ral rcruhn G R8sd'n! dbdkr rmor.ld. mr amlcabl. ru rh* pord Irditrhd Ihs..allhiiqrl(!r...d*.r.lhd rt rb.r. inroM$n t.or41 Irv.dtoonpl!sihdlcii),ndCoort odm.n(6 rnd Srit.L!tr.Ehrryro hr abt. mdrio..{l trop.ny rn inqq--rnn Appn..rr.r ^rar str.rDE V\ q,h{tucl ion, ml ,@'J rdhon,t ..!(6dlnn6 or rhn Cnt dd Cou.ry !o dla uIFn rlEqlnlr a Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Subf loor/VenVl nsulation Roof Sheathinq Shear Wall Framinq 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 +//e//9 --<.<a1;9.) Certificate of Occupancy Notes, Remarks, Etc Set Backs I I I I I I