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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE COMMENTS Ow|lEN BUII'f, R DEITARATION
<br />I h6.n, .rm !.d6 FEny oa pcj',y rhr I m ddpt 600 rlE Codrtd Lio& L.* aor ttE ftltbwioe rd$i (Sq.7Ot I 5Bdin< .d ftofGio. Cod.) }\ry Cny or a(M, tih r.qriG I Fnn b @dn r. dtq. irFove &mlnh oi lt,.n -ynmce Fn loir! isllGe.Lo Equic tlE +9liz lor Et Fnh 16 6Lr.isrd r.oEr thr lEor dEi licqlcd p@.ln
<br />to dr. FlyairB of dE (.oddd! Li.aB.d trs (Cn Fd 9, ( ('llll1rftins *nh SEtioD TOOo of Divi.ion I ot tfic Buin 6d
<br />Ptufsio6 Cod.) d th.l l! trri i qaru thq.6o6 dd rtE bGir tu th..lLr.d sanFiotr. tuy vhhion of Satb. 7Ot 1.5 by ry.p9lic!t for ! Fri $t'e$ llE .pplt trt to . ciril p.6ty ol tul nor. lne fie. huadrld d.tle {ltOO)
<br />06. - .*r orrt r"p.ry. o, ry.npb)€ wnh w.a6 d rh.t bl. codFerion. witt &) d!. ssr r*, tri rnrrE it ditldt.d orolIs..]aorslc(Sc7044.BuindddPNtd.hBCo.lcTIECo.(rd!LitEL.*&6d@tyroeowof
<br />th. FD|EI, vh hil6 or itrprlE fic@n, dd *ln rlc rdr *orl hi@tl N fiddr or thmldr hi. 6lE ow mpblE.
<br />Fltid.d rhd Mh inFo€Erl E d iici.d 6otu 6r t,L. t( ho6E rtr hritdi'E r igD6a !.tdpihhm )Eofcdrpldi.tr tlE O.F &ilb sin lrr dE hd6 ofFltrB rL h d rlr dit d hrild d irq.or rh. ,oFq 6r llE Frro* ot
<br />l. 6 oqE ofrt p.DFry. m.r.l6ivcly cotrE ting *tfi ti.6!.d c.mrrlo6lo orddd rlE Foix1 (S< 7044. S'!iE
<br />.,'d Aobix C.&r Th. Contklo.r Li.@ Lrw do6 mt .!pt! ro s oqG 6f Fopdry wno hoi!.L or irF.v6 0E@r6d who Nlnr*r. for luh Foidr *ith . Colndo(, liE d FeEi b ltr Colfus'r Li.c* tru)
<br />l n.r.mDr trndd s(!on .! &P('nrrh6r.r$n
<br />tn I iO -.L7 .'t-9 Li "-",, f V-' - -VZ.
<br />' \I(Jrurrrls,( u rlNr4 iti\
<br />DICI.IAAIIQIi
<br />I h(.h, am.n unds fsalr\ ofpsjo,) on..frh. r\nhtrh* d(t x,nr
<br />I hh. .n *ill ruinr.h . ( diffl. of ('o@i to S.lf-tN(c fM $ stss .ompddion. s F.vijcd for hr Selion t70o o f lhctltlr Code for llE Ff.llr:d. ol$< *ort ftr shi.h rh. Fn is isu.d.
<br />_l lEw.,i willmint.h world srFE{jon 6ud.q E (q!t.d bt Serbd 17@ otutr t bor Codc. hr tb. F6.ffi ofItt vltt fd B,hth thi! pdnh i i!.d My *6td ohFlrbtr i6lrc nb rn poEy lMba c
<br />Cffi_
<br />Poli.yN@bc:_ _ Erpi.6: _ _
<br />29'"-iry,r,,,,t"por"*. of rn erl fo, $hrh rhs Fnn n a.u.<!, r sh.!ttur dtpbr o, FD. i!uytuE
<br />m a ro h6oft stld ro rlE @rt6'NnFdi,. l,$, of C.li6h[ !d BE fir it I ilDuld bdor rtict lo th.sorta @n!6!dir FuilioE ol Seibn trm oarlE L.Er (-odq I ilrlt, ftrthsith otrlpty $dn rh.i Foriti.E.W RNING: FiluG to c@ wtd omFdioi Nr6+. t uL$,tul rd .ldl NbJ6r s oDpbF lo ciniul FDnb srt.i\il Rrd !p ro oE hud.d tlb6&d dolls (IIOO.OOO). in tddilhn to thc cd of comp.etior, &D4q s Foridcd for th.
<br />Sclion 1016 ofth. t bd Cod( itn6.t .d rlonryi 16.
<br />'/ zo f?
<br />DECI-AX Tl{)N
<br />I hat6y .llm urldd Fdtt ol Fjuy rld I & li@.d ur.ld Folbhn of Ct fl6 I G.nllrEine wffi sdrbn 7O0O) of Divirion !ol tlE BdiB ad Ptrf6io6 CoiL. .d Ey ltoa ir i. tuI toc -d.IIdl.
<br />( oirsTRt cnoN LE ntt(tacEt(1
<br />I h4hy ilfm und6 Fn.tyofFrjuryltn dE ir. odMbn bnins.stry f.r ilE Fflllrllle otllr trsl6r *nj.h $! Fii !
<br />irucd {sd. !097, civ. c I
<br /> PPLICANT DFII AR TION
<br />I hd!b, ,fEr u<Lr Frk, .lFjuy or ollh. folh$ in8 d< t&!l ione:
<br />D.mhl[r PmnlA$6ld NorifErion Fald.l R.suhriod (tirt.rto, Pd6)
<br />R.qun.d llrs ot idniar.dF.
<br />. I cdiry rhd hc f.n r.l r.sul.iioN E8ddi.g std6 rm\i e mr @tErbt to tllt r.otcr.
<br />P4 "ariry ru r r-,. -a rr'. 'pplidbn id rdc rtr rrE.hir inrornrirn L c6Er I rEb @n9ty*.nh nl (.ny&d cowiyordiM6 atd Sr.r. L:B tdrry ro hild,'s codruliotr ,n n6.by.ulhodE rcFerdiv6 ot thi! Cny dd Cou y ro 616 uFntlr.hoE 6rbi.d PrlFty nr iBrclion Flpos.
<br />^ppricrnr
<br />or
<br />^rdr
<br />sirnrur. !(, tr;-'Z/ ,
<br />?.fth* rro.,prin,,: l<Dt o, n .1. G i rz t Z
<br />n,.1o 1/ t"t?
<br />Set Baoks
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUlnsulation
<br />Roof Sheathin
<br />Shear Wall
<br />Frami
<br />D all
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Pool Fence
<br />T-Bar
<br />Handica p Req.
<br />De puty Final Report
<br />En ineer Final Re ort
<br />Flood Zone Certif
<br />FINAL ll-2r-'1 klLUa
<br />Certificate of Occupancy
<br />Notes, Remarks , Etc.
<br />-+
<br />ID/SIG.
<br />Lic6c Numhr: _
<br />Forms/Steel/Holdowns
<br />lnsulation/Enerqv
<br />Masonry
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