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BUILDING. INSPECTOR RECORD <br />SITE.WORK DATE rD/slq.COMMENTS <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />UFER Ground l-zY-lE <br />SLAB Floor :-----r+,F .lr,fl <br />Subf IoorA,ren( nsuIatid)2-k./K 7nRoofSheathind-j-l-l{ <br />Shear Wall 7- t-lY <br />Framing 3v{;/{ <br />ln s u latio n/E nergy J a,/ <br />Drywall g uoL <br />Ext./lnt Lath gx\L$t+Ih I >" <br />Brown Coat ,({A <br />Masonry I <br />Pool Fence <br />T-Bar <br />Handicap Req <br />Deputy Final Report <br />Engineer Final Report <br />Flood Zone Certif <br />ICrtl*c tt-3-22-,*t P60 <br />FINAL ,22 -/&.J/cJ*. <br />Certificate of Occu pancy <br />NoJes,_ Remarks, Etc <br />L <br />r/ <br />OWNER BUII,Dl:R DEI,('ARATION <br />I h(.q rmm und6 Fmht of Fjury lhd I m .rmpr 6om rfi. Codrdo6 ticff L.w for lhc followus r4en lst 70lr l 5 <br />ll$i.s dn Pr.f6F. (-o&): An! ('ily or Couir *hxh r.qu,6 . F ir lo codtocr, tlr6. mFo\a d.ftni!fi o. r(Im e) <br />{rucrrc, Fnr ro s i<um.. d$ (quG th. {,fl'c&l lor 3u.h Fmd k, 6k . risEn dffir rhd lr or slE it licaGl rred <br />k, rh. proviJoN of th. ( o.rrmroar l.ic6s.d l3w (('haptd 9, Connocrnr *irh s<rio. 7000 of l)iviion 1 of th. tt4r..ir .nd <br />h.f*inr (_o&) or rhlr lE o, sn. i!.rlnpr th6.6on and thr t{si! ao. rh. .lkX.n .rtrrl ion Any riohior.lsali.n 70.1I t hr lny <br />qrtli(d f.r r Fsr sblds rh. qrlrd h . cr il p.oh) .fmr mrdha fi!. hrut<n dolm It500) <br />l, d o*'os oflh. ForEnr, or ny .ftdoyd $1h w!a6 a! rh.t $L .omF$nio., $ill & rh. wod E rh. nnrle i nur <br />n dt.n or oll6.d fo. sl. ( se 704,1, lt6i6 ed Pn fsi.B Cod.: Th. ('ontra.ioii l.ic6F |,tr &6 nol ,prlv to an l\ nd ol <br />rh.I'trFit * tF tlikl or 'ryro\6 rhsFn- ,rl { tn d< s{lj {uI hinrlr or hdslao. rl$uAh hr o, h.r o*r dIh! G. <br />Forir.d rhd ru.h mFol.trds -. d darLi or .fidln for nL rt h.s6d. iE t!,!,t* .r i'.F.\ffi it su tr .hm "E ';or.ompkri.n, rh. ()\lnd lt]lll6 *nl haE rh. trmLn or pro\ rrU lhd h. or slt. tln d hill n in{rcE lh. p.!Ft} for lh. Frt eor <br />sk, <br />l. s otrK.f rh. Fr.iJ. m dchln.ly cod,klrs rnh hco!.d conrrxroB r. (dru.l E,nF (sc 7(xl. ABIB <br />.rt PFfrst'n ('o&: Th.conraroi! I-i.6sc uq d6 mr.rolyro u oun6 ofFop.n} vl$ h'lds or inproyd rhaftn, <br />lnd s,h(.onrBd.tuiuchFojrr3{nhaC.d6cro(r)li.dsdptnustt.rh.ConrrdorsLi..Mtiv) <br />lm.\. ,ti trFlf Sn',, <br />".," /o/2///o//,,".", <br />I hddt.min und.. FMhr" oap{jr r_ oE of rh. nnhwrS tL.l,rhc <br />I havc a.d will nri.roi. r C.nifi(at..f co,sr ro s.lf-lmtrr. for work(s- .omp.N.l i.n. 6 tmvid.d lo! l,y Sdion 1700 orrhc <br />l itu Code ror lh. Ffolrucc o I lh. *t for sfiich lh. psnrr 6 is!.d <br />I h,E .nd * r ll maintai. sort6' .omlE6.r io. iNurm.. F ralliEd hr Sd rcn r7{x) o f lhc l,hor C.d.. ld rh. Ffoffi. of <br />rh. q$k tr uhich $n pdmit i, tru.d My worl6r' conpadion islra..ais EdFlicy.uhb6&c: <br />I cdily !h,r m rh. Fforr1r,mor'h. $otl lor *h.h lhit Fnn is isal I stEllnol mploy D, F*n in uy dmnd <br />$ a to tEcom tlur.cl h llE wd6 onFlnfn LE orc.l'rnm( &d +d rhd 't I rlbuld b.tom ebid '. 'lEN*6 comFMrion pro{ oB6lser6.lTmofrh. Ld!" ('o{c l dEll. fdnhtrirh comply wilh lho- p(ovilirB <br />WARNING: Iiailr. ro su. sorld' .ompssdnrn covmt. ir unLwaul. sd shall iubj.<l d dnplor6 lo simi.al FElri6 ed <br />ciil lin6 np ro o.. hund,.d drNnd &llm (1100,000). in,.ldilion l. th..os1 of conpdllion. drnus6 13 Fo1A.n for rh. <br />nrdd MJddR s lG <br />e q,d/ <br />DEgtSAfio! <br />I trqqra llfrm un& F.!ht of FJury rhd I m ltq6.d u.d.r F.tab. of(lsDlc 9 (mnnffiins s h S<rnn 7l)m) or Dn shn l <br />of $. Burind dd PNt<iioN codc. ild ny lt.e a in tull fd.. ,!d .lldr <br />(!)!:iIf,!JCI]ON.LI!DIMi.ACEI(I <br />I huer rfttrm und6 Fdrt o f Fjury ihal rh@ n a cotrrddn. kndins l8acy aor rh. Ffomdc. .t rh. $tll litr s hkh rhs tlmn 6 <br />nrld {s< ll097.Cn ( ) <br />afllllllIJll:clJaarlats <br />I ha$, .frm und.r Fmhy ol Frury oN oa rh. n)lr.$ inB d.cL,dioBl <br />I).nohrion Ptuir! Arhdr$ N6.6..rio. F.d(al R.gul.rioN (Tnl. 40. PAn6) <br />R.q!n.n ld!d olN<{ifkdbn <br />I c6$b rhd rhc f.dsal r.sultrhons rca{diry orlEskrs roo\ il nre nor arrrl'cahl. r) rh'r Dmjd <br />l.dih fin I h.\. r...1rhi .tpl.r' 8, &i 3rrt.rhd rh. ltirr,.aoldkrn i! cold I l*leio comDly snh lll ( nl. c.d Couir! <br />oilidft6 &Il sr,l. tr$. Elrie ro &'ldms 6MrBrF( rrl lE.t, .dh.n,. rcF.5dr 6 o f thn ( nr $d Counlr ro 6rq ur.n 'tialx\ c mdtotr.J pmp.nr f(, 'nrpdron purlxrs <br /> rnli.rnr or Arcnr sirnin..,'.," /a./E7/zoc <br />EU <br />-2r1Yl-?sly <br />I <br />I <br />I I <br />I <br />I <br />r fA<,I,/