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BUILDING. INSPECTOR RECORD SITE-WORK DATE ID/SIG.COMMENTS Own6-Buildn D..lerion I h...by amrm und.r D.M l(y of pdl!ry rhr t !m .i.opl form th. Co.trdo6 LEnr Llw aor rh. lo tto* 'nB r&i lG 70l l 5 BBin6! trd Pba6sion ( od.l Ary Cny .r co6ty *hich ..qun6 I Fmh ro sdM. .nd, inF.tr. d.@li.h or aD.n ey lttu.iR. Fpr ro irtnrurc..h. c{uG rlE.!?hc.nr for twt Fmn b nk. r'c..d futasd rhnh.or rslic.rd p{86 b rlE pNrnhB ofrh. Conttddi l-renr.d lre (ClEprd e. Comn.rra*nhSdb. r0oooaDrrsEn ] olrh.Bcrn6r..a P!ol6rb6 Cod.) or rh lr th. 6 .r.mp hn.fron.!d rtu b.i! tor rh. ill.s.d .r.f,prio Ary viohion of Sd ion 70t I 5bymyrpplicr aor. pdrn.ubjccit rh. .pplic!.t lo i civilp.(hy ofnot morc lhm frv. hundr.d dollm (1500) L s otr'F ol rh. prcFny. or m! .n9!oyâ‚¬ *trh *.3B a rh.r $L c.mp.turF( r 'll d. ih. rork .d th. riru.ru. u m! inr.d.d or olTd.d fo, sl. I Sc 7O4{. Au!c! rd Proa6tont (od. Th. Co.h.rd'. Lr.M l.* do6 d .pplf ro .n or M of rh. pDp.dt *ho huildt or inprord rtshn. &d wlE do6 lxh rorr hirllor h.Elf or ilrouih hi. or h.r o*. .mDLr6. Dtuvikrl thrt .u.h rmp.o!.m.di rc nol i.lod.rt or o,Lrcd for sk. ll ho*.!6. th. buildinr or ihpro!.m.nt ir sold wihin om y.d orcomplaion. rtE ()wEFBuilda eillh.v.lh. burd.n orp.o!i.8 th.l h. 6r th. not build or inprov. for tn. purpos.of$k) l. ! 0*6 or rh. F.rdy. o crclqN.ly corm.rua r ht lt.E n .o rKoE ro oBrrud tll Fojd ( Sr ?04t. BuitB dl PmEsbn Cod. Th. Conmdoai L..@ tr* dc d .ppty ro.. o*E of p.oFry *ho blrldr d,op.ov6 Eo. , .rd *-ho 66rncB tor *h ,role8 wnh . Conr.cto(tr lE6!.n pcrud ro rh. Codr.dolr LEM bw ) I am cr.nrpr und.r S.crion \o!trnf,jlQllrqllallor!!1r.AB -lr(rr I h.r.ht rflinn unJ.r p.nihy.lF.rur! onc ofrh. tollotr 'nS d(lirillu I h.t. ind *ill min'.in . Cd i,l.n. or CoMnr ro s.lf'l Bur. for rc.kdr com0.Mr 8., s provd.n fo. by Sd6n I7oo ol rh. I rbor Cod.. ror rh p6fo@N o r rh. *'ort for *'hi.h rlE Fmh n !3u.d I h.v. .nd *nl ru rnttrn *o,rdr' @mp.Mrbn rnrurm.. a ,.qu .d by Sd E. l?(x, 6a th. bhor Cod.. for rlE p.rforfle. of tl. wortlorwhrhrhupdmnRBu.dM!*orl.n'con,pcnsrFn'au..cair!.dpoli.,numb6.r. PolkyNmbn: Erpc (Ttn diotr E d ml bc co,pla.n ilrlE D.mn ir for (}r hudrcd d,ollr5 itlml or L!) l.cnifyrhlr itr th. p.rfomnc. oa lhc gork rorwhich rhis p.rmn ir n!u.d.l !h!ll n.mployany p.Bon in.nyn.nnq ar aro b*.nE subJer to rh. mrld!' 6mr.n!r6n h*r ofc.lllb.ntr. rnd.srft rMr lfl rhould b..oft ilbrer ro rh. *orl.rr' ompcurion Fo\ ila'a or s..rio. l7O0 or rlE L.bor Co&, I slrll. ton& nt oiply v nh rD,,. ^er,*" x-(tIARNtNC l'i'lu,r ru k,'.*ul.'\' !omp.n$r'on.{.i'r!. " unL$ful in6 up ro on. hundEd ihou.rnd d.lliB ( t I |]o.O@).in lddn ion ro rh. .ox o rh.lrhor c6d. 'nr.rar t.d tfr6r*r'i fa {n ..ndth.lliub,(lin.Dploy.rroohiollp.uhi6.nd.ivil f conp.nst ion, d.daB u pro\ a.<l for th. Sst[n ]016 ol LICENSEN CONTR CTOTS DECi-AR TION I t.aby lmd undd p.uly olrnju,y rhll I h lic.N.d und( pmririon oaCnlptd c (comm.ncin8 rilh Sdion 7fir01olDivnion l or ln. Buircs!.d Prcf.rsioN Cod., ud ny li..B. n in fullaor.. Md.fid ,,,.,,"...'I(*un1 qolsla{crQlitElDllcrcIlc.r I horly .ffm u'nd FDhy of Frury thr ln.r. i r .6lMb. ldxt63 .a.ay for tlE p.rfolrm. 6l rtE *ort for $hih rhir F6i ir i!.*d (s4. 1097, ci!. c ) aftlc^{rlt-0tcllaaUa!l).fttb. Pmnl.A!b.36 NorifF.riio [cddl RcsuLrior (TnL 40. Pal6) Rcqut d L.rr6 of NorifKlrbn l..nifyrhlr rh. Ld.dlr.luhrn,tu r.3rding sb.nor r.movllrr. nor rprlrabl. k,lhD pr()(l I cditrhd I h.\. rar' rhn tppli.ji.tr rd nr.r rlr.b.rc infomrbn n oc.r l .ac ro onpl, *irh .ll Cny md Cou.ty odior6 rd Sr.,r.lr*! EbrlA ro b{ildi4 coBrrudbn. !i lE by.!ll$riz r.F.ddnB of rhit Cny tnd Cody ro 6rd upo. dE .hrr. m.nlioncd prop.ny for iED. on pu P.mnre n.m(Fid): !4 Set Backs Erection Pads UFER Ground Roof Sheathing Shear Wall Framrng lnsulation/Energy Drywall Ext./lnt. Lath Masonry Pool Fence T-Bar Handicap Req. Deputy Final Report Engineer Final Report Flood Zone Certif. FINAL I Certificate of Occupancy tl \JV \L--.,' Notes, Remarks, Etc. M.\WP51\Pamrt-hspsclronFoms\Buildi.9]Bp6crionR6corddoc 0331 06 Forms/Steel/Holdowns SLAB Floor Subfloor/VenUlnsul. Brown Coat Rr-\An,9l /