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BUILDING. INSPECTOR RECORD SITE.WORK COMMENTS OWNER BUILDER DELCAR TloN I nd.by ,lfm undd Fn.lrt of Frury rhd I m .rmF &.n rh. Co ,xloE l r@ lr$ lo, rlt lolk'$in8 lts. (sd r0ll 5 86in6s dd Proadion Codc) Any Ciry or Coudy whrh r.qutB r p<mir lo .odod, ah6. improv.. &nolirh or rq{n dy xru.1@. F;r ro i! i!sim.. .ka Equr6 th. +pli.si ao. $.h Fmn tu 6L r s[.â‚¬d irtur lhn li or lrr a n ded pursd !o rhc FovisioN of tlE ( onlEctor's l-!cos.d b\! (Cnry( s. Com6.ms r h Sdrio. ?000 of Di!L!io. I ol lh. Bu,r6i dd Pofdndnr Co&) or rhd h. or rh. ir .rmd rn cfr.m r"d rlE t .b for lh. .lks.d .rdplion. A.y v hhlion oasdlio. 70i I 5 t y any .Fpli(d for aFmn subdr tlE 4?lk..l io.orrlF t)ofml mElhd 6\. hu.&.d &llas(r50o) t. s olE of rl! FrIrdly, o. 6y nngloyG r'in $rs6 6 rhci. $k comFsdhn. $iI & tlE uqt td dE rndG i! ht 'nrodcl n ofi6.d f6r eL {Se 704,1. Blrils o.l EolshN Co& Tlr (trnr.clois Li.c t* tl'â‚¬ d Fh h e ouF or !h. pmtEty who tlilt or impmv6 thd6n, ed * th dc rRh ElI hiB.lf or h*lf or lnFugh hii or hd om .oPlott6. prorilai lhd ru(h inp.orffi e d nqd.d or otuld tff tl. lt ho@. tlE boildiB ltF&ttE i rld vihin 6m 6 ofs!9hi.tr r(xc Rildd uil lE!.fi.hddr ofFrsrB ! lEm CE dil mr tlitic !rs!E dr FiFry frrill tltpo*of l. 6 o$E nf rhc !ron6ly. n cr.lctr.ly colr.&ln* snh lic6B.d codr&!.R '. slfrd rE proF (S( 7Ot1, BUtr6 6,11 Pn)t3ion Co& -I h. comr..ror'3 l-i..n* l-r* do6 mr rpply ro e oun6 o f propqiy sho buildr or ihprov6 lh6on. sd $ho (odrrl] td lwn p..F(! r'ith. Conrno(!) laoel F4un ro th. ( o rdd'iLtct,f,) lor cr.mpl urddSdion jtof,{tt8(oMPiNsArlo! OECIJIAI]A! I lEcbr lmm uda Fdry of Fjury o( of rh. t!\llo*Ds ',..hr!rFB: . I h!r. rd s'U dnlr'n ! cdrifr.tc of colq! ro sdr.lEe for emls orpdsdnr d Flridd lor qL sdi.n 1700 of rlE ljtn Codc tm lh. Ffm of lh. *orl tor rt,ch lh. Fin i isu.d I hr..n<l *'ill tuinr.'n *0116' .onqEsioi ilMci c Gqlt d bt ki,n !7m oldE t b.r Co&. for lt FfM. of rh. N.t h{ f,hth rhi! Fdn i! iq.d My *ort6' 6nl,.r!iion rM. .ris rd polt, nmb.r a c--'N6rL/u"r'l L(r( ', ^* "**-; wD7<- 6z pu-, :, 4 b 17 V _l c.nift !h!r 'n thc Ff6,l1e. of lh. wort t. whkh !h! Fmn ir isu.4l shlll nol6gloyey Fe. in yne.6 r Btob..omsbidrorh.w 6 $dp.tEdion Lsr otcditodi.. .nd lsE rhd ial lhuld bdom $bjcl lo tlE st*d' or4aurion Foviio6 olserm 1700.lrh. t E, code I tdL fdhqnh otrph *'nh rhr F!\iii,6 WARNIN(; Farlu.. ro sE \nnk6 (ompcosnn co\mBc n ddoF ro aiminrl FEhE ..d ion, &naaB 6 prorid.d t r rh.civil fin6 up n' onâ‚¬ hu.d.d lhrurnd.lollc scrhn 10?6 0l rh( Lrhn co<!. nl6.r uxr I h6.ny.rm und6 p@hv of Fjury lhd I e licd!.d lnda FovBior of( luptd'r (commo.i.8 *rh S.(lion 7000) rfOivsi.n ! ol lh. t!$inB md nn.6si,B C.d.. nd my lr.E i! ii flll lorc !d cfidl ,_*,.*_ ,tr -,.r+lTTlt?^}{,--,L/ ' ,67# P loltlalJclloN.LllDrNc.dcEd(aIndiryrfmu.&rFdt!ofIEurythtllErbrord.tb.l.n!{.sdyrorrrEFfreofrlEr.rttutrtrrhltuFnn. ilrucd (S<. 1097. civ ( ) knd6i Nm. APPLI('ANT DECLAITA ION I hdd1v llfm un&r p6nhy of Fjury oE of th. aollorinB d.rl,.l ions: l).nolitnn PEInr Arbdd Norin.rtin t.d6,l R.ruh!6tu(Tnka0, Pd6) R<rruirsl lard of Noriftdnn I co1'ryrhll rn.Id(al Esuht.d r.!*dinN dhGror rdovale. hor apr,licablc ro 'hi! projd I coi,t) thri I hr\ . ,.!d rhir .rplraiio. lld drt. thd rh. &o\. infotuhn t coEd I .gre lo anpl) r (h lll CiU md Counrt odrnrncF a.d Slal. La$s Ghlin8 rurh.n,. Bpr.sbrivd frhis Cny Dd ( ou.rylo dr6 ursnrh. .th\. Mrirn d FoF!! tor Alpli.rnr or7ti.nrSiqnrhire e^t.*". ,Oa^rl' / ,..lefuilD Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Subf loor/VenVl nsulation Roof Sheathinq Shear Wall Framing l-16-lc k.\414 lnsulation/Energy Drpvall l-t6 -tg.Y-p/ril Ext./lnt. Lath Brown Coat Masonry Pool Fence T-Bar Handicap Req Deputy Final Report Engineer Final Report Flood Zone Certif /^\ FINAL t-tq-w v.w.1t) Certificate of Occu anc Notes, Remarks, Etc. I DATE I ID/SIG. I I I I I I I I I I I I I -,.. ^1"u2//7