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BUILDING. INSPECTOR RECORD SITE-WORK DATE ID/SIG.COMMENTS OWNER BT]ILDER DEI,CAR.AT('N I hs.ttr llrm undd p6ahy of rqjur) lnd I a â‚¬!.flpr nDo rh. Codndo6 l.ttr lt* for th. tollos n3 ..en ( s( 70r l 5 Burind &ld Profsnr. ( od.) Any cil v or ( oulr whi(h rcquE4 ! rEFll to coNlrucl, allq. inrrovc. d6nol'ih or l.pu uy slndu( F$ h tu sft.. rb. Eqlc rh.4lkd for $ch pdifi !o 6L i risftd {n.,6n rhd rE or nr i! lkdMd potud ro th. F,!i.ioa otrh. Conrreroa3 Lic.ntd lls (( h.rr6 a, ( omm.hcins wilh S{hon 7@0 of Dirision I of rhc Bw'nâ‚¬s lnd PNfsrN cod.) or ih,i tE or dE E ndll, thc.&oE .id rn b6s for rlE rlks.d croFni A.1 vnhrrcn oa Sdrid 70rl 5 b).i) a,r[ca.r for r p.mn s{hj&!r lt rpglicmr to !civil,oahyoaml mo,. rhe fivc hundr.d dollB (l5m) l.aou@ofth.Fopdry,ornyoploydsiliwaa6Nlhtrsl.comrE!.lion.will&rlhcwortddlhcnrutr!fi itnax!.d or ofid.d tu sk ( Se 7041. BBil6 dd Prolilia Co&: Tr!. Codrdd't La.e Irs &6 mr .{Dly ro u.$k of lh.rturHv *tF hril(h or lrllIov6 ttEon. .d who &E $rh wtt hinr.lf or h.Rlaor thBu8n hi or h6 oM dFlot6. F ij.d rhd ir.h mFltâ‚¬rd3Ed -iaiLd n o,rqld ir et lt hor-q. tlE hlrl]i,e ir{mrttd isUrrhnrR16 of .onl'ldi.tr rlE Owno B{rlta wi[ halt rh. hrdd or provins rhr h. tr d'. dA mr hlild o. mproE fi. FoFly tur rh. pl Fe of l. a orn of rh. Fnpdr, m .r.l8tr.lt .o,ur.iinr *irh licqE d cotr6c'.R ro cotdrud rL Foj.d (Sc 7Ot4. ll4rs 6,rl AnfrBF Cod. 1fi. ConlEcroii !.ic6* ks &6 D.r .rplt 'o u o$ n6 of pr.Fr) sh. buil.I! .r ihpro\ 6 'h6a'n.!.d rl$ (ddrf iu.h Fsj.(r $nh r (\ntrdo(n lt6B.d gru brhc(nn.loir I ic6& l!*) lm.to und6 sdKn D.t. O*n.r $oRxrrs coiiiris^rroiY !&C',A8AIIO! I lECt') .flim und6 FMtr .f FjuD oe of rh. rolh\ i.s .k(l&nio6 I har. rn tr ill mimril . cd rf$r. .f (-onsr rr S.lt- lNurc for r orko comr.rsd ion, 6 For i(k lor by S(rn n 1700 of rh. trhor G{e f.r th. p6rtu. orrh. u'ort aor *tlrh rh. Fmi ir isucd I h*. .nd $ ' ll mlnr.in tr o.Ia3- conFM! 'o. 'NUi!E-'.- d rcquu.n b) s<trn l7m of thc I .b.r Cod.. ,or rh. Frolrr@c of !h. NorL for f,hth rha Fmir i! i$El My woil6 comFEnion icu,ucc cffii.r ud Fl'cy numba & l..niryrhlt inthc pgftrm!rcc oarn. worl aor *hkh rhtFmn ir t3udl,l sh.llnor mploy rnt la$n i.a., nMn6 $ a!o b*am $ttd ro rh. r.rld'ofrFliirn hs of Crliromia ad 4E tt'i if I nsuB b<oE rut d lolrE wortq comr.Ninon amvisioN of Sdion uoo of rh. libor ( odq l srqll aonhq nh comrb * h rt . pio\ tiod WARNINC: r'!ilu.lo sE \0,16 onrEsdbn mrr'8c ir unLstul, ud ndl suhrd s oploya to siminal FBhi6 md c'vn fine up lo oE hundcd lhoNd doll.B (lloo.flr)). in andnn'. ro th..ort olc .mFerion. d!,r.*6 6 D.orn.d for rlE ( o+, dd.d ad llloft1 s fq v0 701 I Hry lrIm und6 Frnr of Fjury lhi I m li..rB.d !,rtd Forilbn of (tupi6 9 (onnr*ine r nt Sdion ?firo) oa Dn thn I of llr BBitB od PmadioN cod.. lrt ny li.@ i. in tutl lora ed .Ir{t. l[zol b 24n) (a!sB!,lgl0!-LDrDt!cac[!(a Ihcr.ty a,Irr undd p6!hyofprjury th8t lhâ‚¬. i! !.oNtucrion kndin* a!6.y nr rh. pdfomft. oarh. ro tu{hihrhlrFni i! Mci tsa r09r, cir (') PPLI('AN f Of, ('INR,tTION I hddr a&n un&r p.o6h y of Fru!- oR ol rlr folLsins d6 Lrdhn! DcnFlilio. Pmnr-Arb<ros Norificarhn t-.d6.1 R.tuhrion! (l ill.40. Pd6l R.qut.rl Lrlrd oa t{<'rifi.6! ri. I c61,fyrhar rh. Ldml rcruldn,ns rcXmli.g Bb.srr movalsr. mr.ttl'.ihl. h rh'r,nrrcd Iccliryrh l h!v.rdd thi\ ipplalrion dd sr.r. rh4 rh.atu!. infoffiri.n i! cold I.grdroomrl!N h all (-ny .nd Counrr.rdi,e6 rd S!.r.1^! rch,ry ro hu,ld!ru codru.1 dd hdqr Ntrrhon/. r.Fshlir6 of lhh ( ity rnd ( ount! to ai6 trFnrlk at{v. 'n6rn,ncrj pmtEn} fu BpciFn l]qrlxls ,tpplic.nr nr,\E6r shn.r re qo -" rl[zolNq Set Backs Forms/Steel/Holdowns Erection Pads Subf loor/VenVlnsulation Roof Sheathing Shear Wall Framing lnsulation/Ene r9y D all Ext./lnt. Lath Brown Coat Masonry Pool Fence T-Bar Handicap Req. Deputy Final Report Engineer Final Report Flood Zone Certif FINAL tl /lf i. r.a)m-gd Certifica te of Occupancy Notes Remark s, Etc UFER Ground SLAB Floor I I I I