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BUILDING. INSPECTOR RECORD SITE.WORK DATE ID/SIG.O*E-S{ild.r D.(Lmion I hachy.mrn undd Fnlty ofFjlry rhd l.m.rcm fo,m rlE Co.r.doB LEnk he lor rh. lollo*'nA rrD. ( k Tol l 5 8s[dr ..d Poac.bn Codc): Any Cny or Counry which Eqund t D.mn ro oBrDcl,.hd, inprcv., d.mlirh or rct)lr &y 3ttuclu., prior to iri i!ur.. .Bo rquiE llE lppli.Dr for 3u.h Fdi ro ,ilc I !is*d rl.rc lhtt tt or nr ir li.*d p!Eu. to llE pmlilbE of ilE Cont.dori L(.rn d t * lcll.ptd 9. Coro.Nr.S snh Sdb. ?0oo ol Dr! Bpn I of rh. Bur6. .nA ProlBrbs Cod., o. rh.r lE d .h. n .r.npr rhGr'on .rd th. bui! to. rh. rlLs.d .r6pi ion Any vi,li ion of Sdion ?0] L5 b, Dy .pp,i.d tu . pdm rubj..r! 0E rpDli nt to.civil p. hyof mr mrc thx liv. hunrlEd dolis {$m) _1.a .*Eof rlE pbp.ny. or hy mphy6vilfi*q6r rlE el. onp.dm *rll do ttE*orl..nd rh. iMr i! mr 6r.nd.d or offs.d for d. ( Sx 7oa{, aunEr.'n ProldrDB Cod. TIE Cofu..rori Lr@ b} d6 d.9ply ro M o*ffi ol rh. pop.d, *hobuil.t or nrprcvd th.@n. ed qho dct rui work nirulf orlEE.lf or lhrcush hn or hd own.nploy.6. providd thI rEh imprcvmoB E @r id.nd.n or oll6.d tu eh lf. lb*.v6. th. boil.lins or improvdor n rck whhin om ys orcomplaion. rbc o'rF B{ dd q ill h.r. llr buno oa pmrin3 rhx tE or rlr @t b!',<l o. al9ror. ror tlr pdpo* otd.) 1.6 orn(otlh. prop.ny. .m .rclurivrly cont !din! wirh li(Ed conrn.roB io @Brrud ih. projft' ( 56 7044. BGi.63 dd PDa.sh. aod. Th. Co.t do.r L..nr lr* do6 mi.pply ro t. o}M otFoFry Bho hn dr o mpr.v6 rlEr6r,.nd *ho .o ndr fo, tEh D.old! Enh . codr.do(r) hc.B.d @Eunr ro rh! Conr.doi! LEne l,* ) I anr ci.mpl undd S(tion \lJxtrE!tll2!!8[!r Ma_ur.q BAug! I h.rcb .r]itrr trnd( trMlrt oln rlury.n. orrhr foll.r 'ns d.cl!rarL,N I hrr. Dd s ill mir'riD . ('d ificri. of Co6..r t. s.lr-l6ur. ror s si corp.BrE4 13 p'ovd.d tor by S.clD. r70o ofrlE L.bor Cod.. for rh. Frfo,run$ o I rhc worl ro. which rh. p.mn L 6u.d I h.v..d *tU mrtun erldt 6op. r.nNunE.!,.qur.dbySdb.l7mdlh.bb.rCodqfo.lh.pafomftcotth. worl aor *hEh fi6 pdm uBud Mysort@ @Bp.dron Nlrucc cunrud policy nunb6 &c: Polct Nluhcr L\ptr.' ( l hi s.(oi nc.d nor h..on,pl.r.d il rh. p.nnn t td {hc hund..d dollaB l$llrl)i or lcs) I c.niry lhr 6llE FfolmE oath. ro* for shah rhi! Foir s isEd. I rhll mt @pby ry FM. i..ny 6.IE h B to b*.n. rubrel lo th. Erl6 @np.Nt6n L*r of (inaornr, .nd .rrc rh1 lf I rhould h.core rublet ro rh. *orkd' comp.nsdhn provirionsoas..rn,n 1700oIrh. trk'r ( od.. I shlll. fonh*ilh coorly w ^,!t"-,L Cf(j WARNIN(; rllur.ro Kur. *orkdi conp.6.rt'f, .o!.r.8. i unL*aul. .nd rh.ll rubr.d .n .frplorf ro oimi.rl pcohi. md cieiltB up ro oE hurlr.rl rh.ud &[.8 (l lm.o@),h .ddnio. to th..d of .66pcsri,n..l&us6 s poviLd for rh. S&lEn ]076 ol ltl trbor Co<k r d6ttrdtnomyta6 LI(IXIE|L(ANIB^(IOAiII(]AaAIA! I hâ‚¬.by tinm undd p.Mhy of Fjory ihr I m ltcn*d und p(vnio!of Ch.prn I (coMhs $nt S..lDn 70@) of Drllion I of thc &B't{.nd ItlfatioB Co&, .nd ay hc.G t in tull aorc. ud .lf< *i.(Ella&,,ru1 cad[auf,lql.LElltdclcE!(r I hslby.rm unds F hyof Frrury lh.r lhc t r.oanMion LidirB {.ay 6r dr p.rlo,mn.. oarhc *on [,r *hah tno pnnn n i!!u.d (S... 1097. Civ C.). AIILTCAITIjLDICIAAAUQND.ml(6i r@n!-Arb..ro! Nollnc.tFr l.116rl Reul.rhB(Tnk{, PM 6) R.qur.d lnrs oaNolrfi .rhn I .dify rh.r th. f.ddrl r.ruldiom r.grdins ab.rto! r.mvrl r.. tut !pplr!U.lo rhr prer.cr I cdr0 ttu I h.\.rddrnBtpphcdhn od I. rh.r th. rbor. rfomrrbn a orditunc6.nd Srar. t.$ rchrdg ro b{ildinJ coBtruclion..nd hdcby luthoriz. ,bor. i. ord pror.ny ror in + {(-t c.d.d I ilrcro.o'nDl! \nhrll (- r lnn( ounh* * - -,' )) ",i d bl,;*' "' * Set Backs Forms/Steel/Holdowns UFER Ground SLAB Floor SubfloorfuenVlnsul Roof Sheathing Shear Wall Framing lnsulation/Energy Drywall Ext./lnt. Lath Brown Coat Masonry Pool Fence T-Bar Handicap Req Deputy Final Report Engineer Final Report Flood Zone Certif \el6//{-ffi _orL-/4' ) Certificate of Occupancy Notes, Remarks, Etc 9 lnspaclion Fo.ms\Eurldrng-lnsp6cton Rscod doc 03 31 06 COMMENTS Erection Pads FINAL