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BUILDING. INSPECTOR RECORD <br />SITE-WORK ID/SIG.COMMENTS OWNET EUTU)AR DEI{:ARATION <br />I hdrty dlm undd poE!, ot FJury rh, I o GraB tom tlr Codrcrer L.or t* for rlE follo*ins la,. (sd mll 5 <br />B6in< !n Prof6io. Cod.): Ary Cny or Colrry "tral' r.qurd . Fmi to 6Dnru( .Xq. inFoE &mlirt or le.n e, <br />nh.ldq Fnr ro ilr iBtl,e rL EquiE llt +ptill 6r q.h Fni lo fik. rgD.d iiotEr fir lE or tE i li.6.d Ftsi <br />ro rh. Fovii,6 ot tlE CorEEld! Li..it n r.e (Ct d6 9. Coffiing *lrh 5<1ion 7000 ot Drnion I ot lb. auB sd <br />Prca{ru Co{k) @ tbd & d nE i Gr.flpr lhd*ot &d tlt bGr! tor th. .lk8.d dqr$rrn. Aiy ra,hi.n of Sdbn 701 I t bv &v <br />.pplicetfor!Frbnsubjetth..rgli..nrlo.ovilpcEhyoamlmor.lhafiv.hu.d..dtlolhrlt5o0) <br />-1. <br />s otrGoiln Fopdly, or my oryrhlE with wts6 s lh.i. sl..onFNliotr will&dr$oftt d th. rildE i nol <br />irnarql or o,Isld for slc (58.7044, BdilB ud Pro[BlioG Cod.: 11l. Co r.doi! Ltdg Lrw &]6 ml +rly lo u oso of <br />rh.FrFty *ho hrikt q i,e.o!a ilE6( !i *h dG *h s{,1 hi@lf or ha*lfot rhrcusrr tn or hs oF ahpLrd <br />FoviLd rhd lkh iop.qqtd! e br itcid.d d otuEd 6r eL. l[ h$e. dE bildi$ c in+.od i sld xilitr oE rd <br />ot@i9l'iitrl. d. O*c Bdrrr liu lIE tlE hnb! of FDri,* fii lE d tE dil d hild s inFort dt FDFr, nr dr FrFa. of <br />-1, <br />! o*G of rlE FrFry. h qch!'vcly co'irxli,ts *nn l'.q6ql .odrdou to @r&uct ttE Foi6! (se 'rort. BtEiB <br />ul notrid Co&, Th. Conlncrtr r Li.ru l-.w {h6 rcl !n,ly ro o o*nd o f ropdl, who buildr or impmra rh6@.. <br />&d who $nlrxl! fq such Foj<r! wnh . Conuxlo(s) lkcE d plnuln to rh. Codr.cl( t Licae liw). <br />I ncrcmpl und6 Sel <br />Drr. ()rnF: <br />\t oRxERs' conlPr I sa ll(lli <br />Dl:g/3altq! <br />I ho.h\ amr trn&r FEh! oI FruN .nc ., <br />'hc <br />,olk'q iq d(hr,' ndr <br />rd FlviLd lor by Sariotr 1700 of tlE <br />f ilE t bo. Cod.. for th. Ffollmc of <br />o- 5- <br />I .d'fy dd h rh. Ffolrrl.s ol E srt 6r *nah rhn Fmn ir is.d I nrll m! nploy uy p6$n in Dy illllE <br />$ d ro t@c stld b tlE uut6' @mFErior tM of Ctl'lomi !d {E rht if I tlEuld beoE et!.d <br />'o <br />tlE <br />f,.rtd onpsdion prlrirbB of sdon 1700 olrh. trt r code I ttll. fonhs nh o,9ty $ht rhor FlviioB <br />WARNINC: feh@ ro su. sorl6' <br />.ivil find up ro 6N hu.&.d rhourld <br />sdion 11076 0lrh. Lrbor cod.. ir d.n <br />mmFrdron corarr. 6 dploF ro airuu, Fuli! tn<t <br />io.. d&u*6 E Ford.d for rh. <br />.) <br />I 16.6, ,nm u.da p6rly or Fjury lhi I @ Ucnt d d'dd Folnion of ( h,Ird 9 tcoMarg qnh Sd hn 7000) ol Diri.iot 1 <br />ol tlE 86rnd !d Pr.ld6c aod., ald mr |EGE is in tull rr,@ rn.rdr <br />^,., /6 ' 2y- <br />I hftby rmm uds pqEhy of Fjuy lhd Od. ir ! odtuclion kndi4 lsdcy for th. pafollruc. of lh. s,l n)r whth lhi Fmn i <br />is!.d {s* 109?, Civ. C.). <br />llflllABrDlcllSArlo! <br />I hsq .trm undd FEhy or FJury oE of r& 6llowin8 &clr.l ionr <br />o.molirioo PmnlAsbBro, l.Joti,iclrio. F.darl R.guLtioN (Tnt 40, Pd6l <br />stsrd rfiovrl s. .or q'r'licnblc to lhB pmjd <br />thi d. rtor. infornrFr ! cof(l I !88 to or{ y xith dl Cnr.d Couny <br />.b.\. mrirEd FoFnr fd - ?/-Appli(rnr o. ,\tdl Siar.tuE <br />Epq.dtivs oftli Cny dd Cosi <br />- <br />o.*'/b' <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />Subfloor/VenUl nsulation <br />Roof Sheathinq // ////c I ''-llnanl ,/6> <br />Shear Wall <br />Framinq <br />lnsulation/Energy <br />Drywall <br />Ext./lnt. Lath <br />Brown Coal <br />Masonry <br />Pool Fence <br />T-Bar <br />Handicap Req <br />Deputy Final Report <br />Enqineer Final Report <br />Flood Zone Certif <br />FINAL t//t // t f?+ttttl-/n/ <br />Certificate of Occupancy <br />Notes, Remarks, Elc. <br />\ <br />DATE <br />SLAB Floor <br />f-------T------