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- BUILDING- INSPECTOR RECORD SITE-WORK DATE ID/SIG.COMMENTS Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Subf loor/VenVlnsulation Roof Sheathinq Shear Wall Framing lnsulation/Energy Drywall Ext./lnt. Lath Brown Coat Masonry Pool Fence T-Bar Handicap Req Deputy Final Report Enqineer Final Report Flood Zone Certif FINAL lz-vl'l ,k-W\t.l Certificate of Occupancy Notes, Remarks, Etc. OWNER BUTLDEA DE!(AT(ATION I ha!6y .fm uid.r FEXy of Fjury lhd I m ddF 6Dm rh. ( 6drdc Li.dk Ls ror th. folb*ne ,en tS- ,01 Lt Bsin6 lrj Profdion Co<h): Any ( ily or CoEty shth r.qun6 t Fnh lo oNrtud. .lla, inFDve ddtuliln or rgat D, !Eu.rd.. piior ro irr islmq .!o rcqlt6 lhc q,9lfd lor $.h pqnit lo fiL ! 3'grad lldml lhd h. or CE i! li.o!.d P{e!,n ro thc povilioB 6l th. ConLacto. t t,ic.nt.d Llw (Chrpn 9. ( omm.nciq wilh S6rion 7u)0 of Division I oflh. Il[ilEr md PDadrion! Cod.) m lld lt or rh. is d F rhc.6om ed lh. t rit tr tlE tll.e.d .xdBhi. Any lioldion oasdlbn 70:! I J bv dv .pplicul tu . Fmil 3ubjeir th. .ptli..ol lo ! .ivil pdsty of str mE lhs fiY. nuid.d dollr! (t500) l. s orc of rlE EoFty. d ny aiplold wnh *!s6 s llEir -L onp6rio( rin &, dE rcl tn $. $td@ ir ri idad.d d olH for i.L lsa'7o{,1, BsilB &d ProfdbB Co<|.: TrE Codr.cld'! Liu* L.$ dG @r +,ly lo d 0*6 ol rr. FoFt, *lb hiLl or itrp.oE *EElr !d $lb .!.6 rdr s* hilrtror hd*lf.r tuoush nn hd oM odo)te prcvi!.d rhl .u.h 6F!\qE ! e ml irnxtad or o&!d hr rl.. l( hotw. rh. hddiE ot itrmvdE i $ld wthn' d )d ofcomplab[ rlt O*G Bli]dd wil hlw dE hdar ofFoviis lhd h. ot th. did ml hi6 or ihprcE fi. FoFtv lor 0!. F,por of -1. s o*E of rlE FDFly. D .xcluiv.ly.ofisli.g $th li.dE d cotr8i6lo orRM tlt F.ial (SE ?044. &ilE .d PtDEo.r C.d.: Th. cotued r I-a.N l,w dB ml .rply 16 d 6w olp$Fly uh. b{ildr or inFoE thson .rd rtE onr-lr lor sh Foj.rlt snh . Cofirro{.) licE d FlBod lo lL Cdtdd r U.cv L,v). I m.imd 016 Sdrn , a & P( forrhar@o D.r. orner wolxtrtts' r rrlt Prrs,riLott I)f,CL,lR ll(lN I h6.by amnn uni6 !.nshy or r<tury on. ofrh.lollowinr d..ldlrntB -I h.r. rd eill Eilnli! . C.nifrr. of Co@r ro Sdfitu. for wlo' @m0..!.r'6r\ 6 Fvll.n for h, Sdbn 17@ olrlE t !r Code fd rh. Ffre of lh *qt liir x7trid dE Fnn i ie.d -l hr\. lnd will m!inr!', wortda cnnp.Nliotr iBmrc., d r.qutrq, tv, Sctioo l7O0 .I rlE lrbor Code fot lh. p6aoll1u. of th. worl aor which lhir Fdi i! isal. My mrr6 otrrF!.lion iul@c..eia ,n polc, iumbd a.: / - t -2P17 -lcqr'tylh.ri.rh.Faolrffi.orrE$ortlor$hihrhiFnnBsqll.nllmtmPlotdvFenberffi$ s ro bG.rc {Ud lo lh. *!rtd @nFdion L$s of Cditodir .!d +r lhd if I ilsuld la.m sbcl !o lE $ortd .omtEnsrion povnEBofsdion 1100 ofrlE t b.r('od.,I fonh{iri corpl} \ irh rhrE pnvisioN WAttttNG ljlrtur. kr ssc worl6' comlqBlrion co\@x. $l. !d shrll subjftt e 6ploF 16 simi.d FulE dd rh. con ol (on!.Mlion. &@!6 s provid.d tor th.civil lin6 up k) oft hu.dEd rhousnd dnllur (Sl S(xon 11076 olrh.ll&).t{lO-t&- I h.Gb lllm lnt ' FEny of Flory lhd I @ I'c!6.d und<ilion of Ch,pl6 I {.ommdns sin Selion 7m) or D'lirFn l of rh. Bcins 4d Proli*ioB Cod., dn my ltd is h [ull torcc nn.lI(l t 1{7-</3 /o4-E tE ss- fr" I ffil llIm u'xta 9a8ty of pqjury lhd ltd b . @tutu.tb. lqdi.g cdy for lL FfMc of llt *ol t'r etih ltii Fdi i ilsu.d (s{ t097. civ. c.). AfILICABLIIA;IJSAIIA! I ha6, dLh un& porlt, oa Fjq- om ot ln. follo{ irs &.hJ{irB Damlniin Pmn!-A!tEr6 NoriaE rhn tdE l R.suLlFd ( I (1.,t0. P.n6) R.qtrftn 1..1t6 olNoi6dion -l csrily rhli rh. f.daal r.BuhtioB Estdrg ab.stos tm\al e tur arpli.$k b thi! pq.n I cdifr rhd I h.\...ai lhis tpgli.d .bo!t 'ntoMion 6 c6al I .src ro otply wnh .I Cn, .,n (.osl' o.dila6 .n] s'.r. l!*! Eliiry iu,lbriz EF@riird o I rhi. Cny d'd Couly lo or. uFn dr !to!r Mrirn.d ptuF , ad Applicrnl 0r,r*.nl si[ rrur. Gt 5*a---,., /a-/&,4 I [T