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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
<br />I h@6y .fltm lndd podry ot Fjury rhc I m o.mpl 6oE th. Coflrlcl@ Lic..k t * for th. lolk wiry r.&. (Sc 701 I 5
<br />Bui.6r lrl hofdirn Cod.) Any Cn, or Cour, whGh r.qui6 ! Fnil lo coNrrud, .hE. improv.. &mli.h or r4.n ey
<br />rlluc'e Fni lo 'r! suse ro r.qriE lh. lrplicul for ruch Foil to 6L ! liSr.d ndffil $.r tE or ilE ir lic6.n P@tl
<br />ro rlE F.virioE of E Conlrkld r Lt..ed r.* (CtrpG 9. CotmmitB virh S<iion 7000 ol Diviriotr I of $. B@in !d
<br />PrcfdioN Co&) d rh.t lE or rh. ir .rmpl lhd.fiod lid lh. b6a aor rh. tl8.d ddplion ADy voh,lio. ofs6lion,01L h, &v
<br />rrpli.er for . Fni $q6l' rlE .pphcsr ro ! civit p.slty of mt mE lne fiE hun<!,.d &1116 (t5m)
<br />l. s ouE of 0E lroFry, d ry dplorE wilh w!s6 s $cn eb omlddiotr sill d, llE *d t ld llE .IME i mr
<br />irdid.d d.fld.d lor sb (sE.70,1,1. BuilB ed Ptlf6o6 co&: Th. codrdd.' Li!& te &6 mr +ly lo o oqG of
<br />th. rn dy stn tlill or mFDr€ Eu -d *ho dG *h lut hirelrd hq*llor rl[ou*n ni, or lE oF dphrc
<br />F.vdat rhd rBh i6Fo1@.n ft d dond d om,.d 6. r.l. l[ hoFq. tlE h&nns tr ,rtril.ld ir rld Yihin m ]d
<br />otcmpldi,l. tlE (xc ltrild- xil h.w tlE hrrb of Foriis llri lE d dE dn d hild d uvott dE FnFry 6. 6. F,BE of
<br />l. s o$r ofllE FoFry. 6 6.h6i!.ly (odrdi,B $hn licdE d.0'r.116
<br />'o
<br />6dM tlE pr$i6! (S< 7O{'l &slB
<br />,n tbk Cod. Th. Conlncrd t t-ic6e Lrs rlo€ mt !p?ly ro d o*'nd of FoFr-Y e'h. burldr ot inpmvd thn@L
<br />ed *ho offi! itr uh FoFr snn . Coffions) lkdu.d Fjfun lo lh. Co ndd t LtoE L!*).
<br />I m.rmd ur&Sdbn .B &PC for rhit l6on
<br />D.r. 0r.6:
<br />wotxt-ns.coMPglsarrd
<br />DECLAIAIIO!
<br />I hclbt .rm !n& FrX' ot FJt4 oE olllE follo*ire d..lt rioB:
<br />-l
<br />h.v! dd will minr.h r C6lilEll. of Co.el to sdl-l6u. fM Estdi' c$Fqridl! s Flir.d for by S.(ion !70o of rh.
<br />lior ( o&. for rlE FlolliR. ol lh. w* fd st!-h lhc Fnn i! i$d.
<br />Ih.vc.dwilltuirlr'nwo.n.omp.NthniBll!ffic.B,.qui'tdbyserion1700ofth.L.!orCod..fottlEFfotu.oI
<br />rh. Nrl for *hih rhn Fo n i$.d. My wska' omF6tlion iitrlltm..aia in poky nutbd @:
<br />,A.. ,rol
<br />-l.dily
<br />rh.r in rh. psfortunc. of rb. $o,l fo. *hi.h thir Fmn is isu.d. I thrll mr ddoy uy rs$n in oy6e6
<br />ar d k1 harftc luhjdr rc rlE wlt6' ompdsdion hrs orcaIlon,r. .ri t{r lhn if I {huld b..of,. 3ubjcl to llE
<br />world' conFB io. pbvirioN orsdion 1700 oflh. llt , Cod.. I slEll. forlhwilh comply virh thoc pmvnioB
<br />wARNlNcr lrlilur. lo su. wort6' coop.Mio. cov6a8. ir unhwtuL ud lhall subjdt M @ployq lo dihi.d pctrti..4d
<br />civil nnd up lo on. hundE{ lhoLed doll4 (lloo.o0o). in dddilion lo th. cosl ol(om!.Mlion, dmdB6 a provid.d fo! th.
<br />s(ridn r(r7ir ofrh.l..lff(ird.. s(dd dd-t
<br />DI:(].AaAIIA!
<br />undc |ro\sonof('hapl6 9lcomnrn('n! \ h Sdkln ?fiXrl oflr$str)n II hGhy .rfm u.d( Fdry o f Fjury lhd ! e
<br />ol rh. liril6 ud ProtdioB Cod., ..d m, lk* is in tull torc ad cffd 'q 281qs
<br />carsrBlcraa.lEllac.AcElll
<br />I hdlt'y ilTm !n& Frh, of rEju, lhn $d. 6 . @tu(iotr Lodins .sft! tor llE Ffffi. of lh. trql 6r etih fi6 Fnn i
<br />N.d rsa 1097,(ir ( l
<br />ATIIJCAII.DESJAAIIr!
<br />I honr .trm udn ,a.lrt ol Fjory oE or lh. tolb* i4 &.|,r{ioN:
<br />t,.rDhp, P6nirlArtBrd NdifrcdhI Fcddsl R.sut{i64 (Tnb,m, Pd6)
<br />Rqundr lik olliotifrnim
<br />I cdlD rld rlE t {s!l r.suldioB r.8tdit8 os rm\al ec el rpplkrbk
<br />'o
<br />rht FlF
<br />-l
<br />cdiry rhn I h.rc rd fin,ppli..orcr. I asc lo ondy snh .ll Cny !.d Counry
<br />mdillN6 ud Sld. li*r crnla I ofrhn Cirv.d Coutrly lo drd '@n rlE
<br />tb\c rmrn,n6l Fopsly tor
<br />ADDli..nl or Arol sk..lur.
<br />ocz)-
<br />i," ro'K'E
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Enerqy
<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 />^\FINAL lz-zt'tg v'lU)d
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc.
<br />Flood Zone Certif.
<br />""x,r," t-, - 1 d oo oo u* (/Cl .,r"-r,--7L:--.,L:36
<br />u,' )o-(
<br />I
<br />Ct+
<br />l..rdi , AddB
<br />\\dtn
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