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BUILDING- INSPECTOR RECORD SITE-WORK DATE ID/SIG.COMMENTS O\[ N'X AUILDEN DEL(-AI.ATIOIt I hqcrD .Ilm und6 Frhv ('f Frr6 rnr I m 6mli 6on rh. Codrld LF.B l.$ f.r rh. 6lloui4 r@n (St Tor l 5 B$iner sd ftord5n (irl.l Anv Cdy or Cdudv *h(h ,rqu,6 r Fmir ro conrrud. .hq. idFsre rlmlirh or Er.r m\ ,tuduc Fi, h "3 Bue.. rk Eq!t6 rh. +plkMi tu su.fi Fmil !o 6L.3is..<l {trdld rhd lE or stE a ltdB.n N&td ro rh. Fv6ios of rlE ('onr&tor! t-icos.d L.u ((luFd 0. (\,mfti.S $nh Sdio. 7c(x) of D'ri!F. ] or rh. Brind i.d. lrol6sions Cod.)o. thlr h.tr rh. E.!6pr rtEcfom rnd rh. hdr6 for rh. !ll.8.drrmdrn Any !'olarnnofs.(lill 70ll J h, lny aprli.dnr tur a p6nn subJ(B rh. sml(.nt ro r .iv il p.mh y of nol mor. lhan liE hundral dollm (lsoo) l. B o$n6 ofth. rnoFnr. o, mynployG $irh s!x6 s lh.n sh c.mFMion. till6lh. strI ind th. ntu1E k nol i od.d or off6.d for $1. ( Sd ?0.14. BuinG Md ltnf*fuN (-oJ. 11E Colnradoir lj.e l r$ dE mt !pPl) n] m .\ nd of rh.IFpdy $no h'kboruI{ror6rhE@a ti $lb dE h tr$rl hr,elf .r lE*lf or ltmu8h hB or hr o$n mrloy.c, ro\d.d rh.! sch imretsdtcml non d oiIs.d tu !l. l( ho\6t, rh. ltillmA or lqmtffir 6 5ld {ihn o.. !d orstrpki^ rh. (xc tlolldd rnl lf,r. tlE hda' of Forllu tlu lt or rlx dd mr hxl, o. EIrtr!. !h. FlFry ft{ rtE l[,Ile of l. &r o(M .f rh. For6!, m â‚¬tctusn .ly conn&1mr tr n l(n<n .ontadots ro (onrrud llE tf,i)dl (Sd 7OtJ. t arnnGl ind E!&ssir (odc I hc ('onrrxror'3 l-icd3. Law d(E nor appltr. mo$nE ofFopdrlrb huild! or mpror6lhrq,n. rtr,l sh nrntnrrsri'r !'.h Ii!cc*nuxuanr b rh. (i)nn..rtr r l.[ds.l.s) I rm.!.mpr undn S(rtr.n D,t( / ,t-2-17 I nqchr Bmm und< FDlry ol Fru') ok of rh. folhn hr lh.\.!t\ill m$tam ! ('dra*ar. of(tlMr h S.ll.lBUr. L. tr$ri6 l-trbo. (-od.. tor li. p6r,nMr. or th. * or{ aor *hih rh. Fni! i irso.d bn.6 Fird.d for brs(lo. rTuroarh. I ha\.and$illm.inl. workoi comp.nsalion mnr!nc.. tr\ r.qun.n bt s(tion I70) of lht I ttNr cod.. aor th. Ftunn.n.c.l rn. $1,tfo.whichrhGpdnr n irnr.d My*orL6s comrE sr'6 instrran.. ceid md Frli.y nu 'nhE u. I cdib rha ir llE Fromtu. of rh. sort fd shkh rhr Fm n s!.d I sh.ll 'l dnrh, r.r F$. h.ny mannd n s ro b.$m {t*il lo rh. *dtn .omFrek,n h$ J of('.tifomi& .d .sc rhd rl l {buld tE(m subi.tl lo rti sort6' .ohFslroo pov.Fs ol sdio. 1700 of rh. t,!r (iiL, I !h.ll. fonh* nh omdy wnh rh)r FDviiioro. WARNING: Failur. tu hrr. ro!k6 comFs5ln,n cor i nnl.s6'1. Md lhdll subr..t u dnrh)6lo dinlinal pfflria itui .'v,l nn.s ur ro on. h ndral lhousnd doll s (Sllr0.lr(fcon'Frelnrn, d.n,tg6 6 pro\dal ror lhc s(n\n:rl)76 olrhc I ahn (i c. nr66l and ai6n!-r. \ ) I hd.ttt afm und.r Fmlr) of Fllrr- lnd I mt trnh S<rFn r(r)0) orDrs$n I ot rh. BueiE.al l\nf6rk\G ( ,)d.. dn mt lt@ it 'n aull car aucuoNrElDllc_acElcl I HD alrm nnd6 Frh'.f IErury thn rhs. is r lTrrrudFn ldrdms tstr) for rlE Ffruc of lhluorl6t $nKhrns Fsi s &!cd(sc 109?. ctr ( l I cflk s Nm. APPLICAN'T DFCI AI'ATTON I lEd,y dlm unda r.nalty olFjury oM ofrh. aoll.win8 dGl[llnin3 lkm.hion Pdmils-AstEsr.i Norilicirion F.d@l R.*ub!ion. 1 Inl( 40. Pan6) R.runcd Ltlls oa t*n'6crnn I cdia) thd rlE f.dd.l r.xuld nc rcsadi.s 6lBror rm\,I e. N {9li(abL h 'hB omF I cdrfy rhal I hs!. rrad rh. q'nlr.r ndtsra'.!h..hrr. mtonl,ho a coG.r l.$ct'conpb snhal Cn) tnl ( otr^r\ nrdn.nc6 and Slnt. ln$! Ehi 'hr t,di!6.lrhi! ( it' sd Courr_ ro drd uFt. rh. ilt)!. morion d pNrEny appli(.nl or Aaâ‚¬rr Sltrr CL T*,t(-z't1 Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Subf loor/VenUl nsulation Roof Sheathing Shear Wall Framinq lnsulation/Energy Drywall Ext./lnt. Lath Brown Coat Ivlasonry T-Bar Handicap Req. Deputy Final Report Enqineer Final Report Flood Zone Certif FINAL Vte qa.) )rl"L ,@v) Certificate of Occupancy t "^",2:l'-z ta I Pool Fence Notes, Remarks, Etc.