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BUILDING. INSPECTOR RECORD <br />SITE.WORK DATE ID/SIG.COMMENTS Own.FBuild6 D.clmlion <br />I lE.b, rmrnundd p. Xy of Flury rht l .n .r.n ao.mrlEConrndor'Lft.Lwforih.folb*'ryrdon(r(rotl.5E6in6r <br />.,!d Pmf*io. Co&): Any Cny or Coury *hi.n r.qui6 . Fmn ro 6618r. .16. inprot. d.tulsh or E?.r u, dMrw, F$r ro {tsuN..bo r.qui6llE.pDlk 6rro.h F.mn lo 6lc.3is*d rtr* rll.llEorrlEili.@d psM ro rrE pblirbs of tt <br />Cohrr.bir L'e6.d L.w(Cllprd 9. Conm.ftrns wrh Sd6n 7(xDofDwubn I ofih. Buln6rrnd Pror6tD6 Cod.) or rh.r h. or <br />!h.i.cichprthmlionrndrhcb$taorth..ll.rcdcr.mprionAnyviohtio.ofScctionT03l.5bylnylpplictnlaor!pmirrubjc.kth. <br />ipplicorro..iyilpcohyof rcr e,. thr 6v. hodddollult5m) <br />!.s o*c ofth. proFdy. or my.rproyG rirh y.s6 a $cir 6lC.o.p.n!.lreL willdo fi.*o !nrlErMEimrddrt d <br />or ofi6.d aor qL l Se 7s.1, Bul,E..nd ProLrb.. Codc IlE Co.hd6r'! L'..M L.w dc d.rpt r..n 0$6 oa . <br />',opcnywh6 b!il<! o, inpo!6 lhcen. rd sho dG rEh worl niB.lf orh6.lf or 'holih hL or h.r own cnplore, prcvid.d rh.l ruch <br />imD.ov.m.nt! rc Dr i .nd.d or ofncd for nL. lf. hos.vd. lh. brildhs or inprcv.n.m i! hld within on y.r of conglclion. tt <br />Ovc- Buildd will n v. lh. hrd.n of provD3 rhrt tE or ,r d hrild or i6ro( ror ttE pu,Dor of ..|.) <br />__ L a ow of rlE propary. rn.rclu.ivcly @.rr..r ilu *ih lt.s.d co'!fuor ro sErM rh. prcid ( Sa ?oaa. &!i.dr.rn <br />Pmfdion Cod. TlEConhd6r'r L@n$ t vdGturrpplyiorowoaFopdywhobundtqrmp.ov6fi.r6n,.ndwho <br />.onr..B tor luch proJeB wnh. conn.c{o(r) lr.nr.dru6u.nt to t,E conl,ictoar Lr.nr.l-.w ) <br />I e.r.npr undd S<r6n .a &P( nnthk!.aon <br />IVORKf RS COMPENSATION DFCLARATION <br />I h.r.hr rmm undn p.dh, .f Frjury oE of lh. follo* ing d( lrtr irB: <br />I hrv..".t *ill udi.. CqrifE r. of Coerr lo S.lf-ler. for E,l6 o6r.drFl\ s piot'd.d aor b, sci.n l7m of $. <br />Lbor ('od.. for llt pdfDtu. oallt wort for phi.h rlE Fnn i! irru.d <br />'o.lTmof ,E L.bor Cod., fo. <br />) <br />(11a...tion k.d ret b. conpl.r.d if lh.pcmn it aor O* hundr.d dollns lt!00t o. ks) <br />I cniry th.r m rrE p.rfomr. oarlt vort aor qhah fii! Fnd ! <br />U rlbld.n.mplora ro aimr l!. 1(i6.nd.ivrl <br />6n6 up to o.. hu.<!r.d thou$nd doll,6 (1100.0o),in tddirion ro rh. co{ of conp.uriof,. d@8.r B pbvit.n lor lnc Sction 1076 of <br />lh.lrt r Cod.. rnr.r6! lnd.ri6r(y! 16 <br />llclltl!-c9NrBAgQ8l"llcldEAlla! <br />I hn.b,.frm uoda t olyof Fiu,lhlI I u lit6.d u,nE Fovnio. of Chlp|d 9(6m.n.ir3 wnh Sdion 7000) orDivnb! I of <br />lhc Asies.nd Pha6tioo Cod., od my lic6. ir in tull lor. rd.trfrr. <br />,*.r-,'ClO <br />^" tL/4A X"?\ <br />(! \\rRr( r )\rr\pr\(; !(r!-\l ! <br />I td!b, .Il@ u,rld FEiy of Fj!r, rh.r rlEr. n . oElru.rbr ldl'rs .3.ry for rlE Frfolrle. 01ln. wdr tu which lhir FDn i. <br />L.u.rl (S€. 1097. Cir. C ) <br />AITIISIEII.IICIdIAIJQtr <br />l}mlirbn Pmn}Alb.rrd Nollf(dio. F.&nl RcroLrba (Inb 40, Pm 6) <br />Rcqui.d tala of Norifi{rion <br />I c.nit thll rh. t rLnlreol.rirn! rcaddir! ab.:r8 r.@vrl t. ror ippli..bl.t6 rhar por.(l <br />, l.d,t rh,r l ht\. r..d rhrlprrl'.lrirn.ri n n ! .o.rco I |3c ro complt snh rll Ciry ..d Counr, <br />ordiM.c6.id Srd. hx r.hrin8 r. bri r.rr.gitn6 of <br />'hiicny.nd <br />(_ou yrodrd uron dE <br />ih,\. n'cnrr{cd fr)tcdy <br />r*n,* *.rp""r, Y O >.'= <br />,!rt/ + <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />Subfloor/VenUlnsul <br />Roof Sheathing <br />Shear Wall <br />Framing <br />lnsulation/Energy <br />Drywall <br />Ext./lnt. Lath <br />Brown Coat <br />Masonry <br />Pool Fence <br />T-Bar <br />Handicap Req <br />Deputy Final Report <br />Engineer Final Report <br />Flood Zone Certif . <br />FINAL g/t*/r---Sz(anJo) <br />Certificate of Occupancy <br />Notes, Remarks, Etc. <br />+ <br />MlwP51\P.mil-ln3p.ction Foms\Builr9n9l.s9sctro. R.co.d.doc 0331 06 <br />S