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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG O\INER AUILDIIR DEI.CARATION
<br />I lE 6, rmrm !nd6 Fmlly ot psjur, lhn I m .ictupl iin rhc Conl,acior' Licc$ L.w for lh. follo*ing @. (Sa 7031 J
<br />Bwi.es id Prolsion ( od.) Ary Cily or Coudy *hi.h .dtuiE . Fnit !o codru.l. ,116. ibgrovc. &nolkh or EP.t D,
<br />rucruc, Fsr ro !t! isunq .h. rdtln6 !h.4olkut aor ect D.nn lo 6L a !e.d idmr rht & or CE it lic6E d PEf,!,
<br />lo lh. FovBFB of rlt Conr&kr! l-aa..d Lr* ((1uF6 9. Conoocins vith S.dtJn 7000 oa Divilio. I of rh. Builld ed
<br />PNlsi.s cod.) or thr! lE or !n. ii .roF tha.tofr dri liE b.!n lor lh. .IL?ci .roqion Any violllbn ofsclion 7011., hy o,
<br />!tpli.&! for 5 pqhit.uhjeR rhc +t icut ro i civil pnulry ofet mor.thE 6r. h!.dr.d &,116 (3500)
<br />l. .r o{F olrh. FoFry. ot hy 6n b}d q th *.s6 . t n rk orqdsdio( wil do l}t *q! nn dE inEE ! mt
<br />idd'dct or oiI6d ae rt (sd 70,14. BdilB ed PDldbB Co& TIE Codr-ror'! L.qE bw .i,6 nol ply lo a ow of
<br />ihc FoFiy *'lb trild s nrrmE Odor rn who dE rrli wil hiE*lto' hE*lror lhttud h! d lE oE .iphtB,
<br />Forii.d rh.r Mh liFrEGr. G Dr -iciLd d o&nd &. -1. ll h.w. llE hl'ldlB 6 i4!r@E it sld Pili. oR )r
<br />ofoqliir.. li. olrG &d.k eill is dh. h!d@ ofForrB di L d rL dn bt hlild d ilgDE 6. FDFry 6r tlE F!po.. of
<br />Wi. o**"rr*p"pory, -.Kl6n.l) @nrd!B wrh l(s!.d.offi6 ro mdm r,E FDF tsE.7o4.l. Bs€
<br />a'd hot6E Co&: Tn C6nr-ro. r Lsqe Lw &6 mr .p?ly to & oyE of FoFry who builds or iDF.vd rhdo(
<br />ud *h6 6d*r lor rct FoFrr wnh. Co .*r0(r lrcr.d F,!Ei to tlE Coddd.! liu* tlv).
<br />I er.rd,i lNld SarFna:-blo o,,,:
<br />lEcttaAtrc!
<br />I tE.l,r !r,n undd FuhyotFiury DE onlE aollosrc d.dddbE
<br />I hlv. .!d will tuinr.i! . Cdrifr.r. olco66r ro S.lf.lDe fd $t td otrp6.ioi, a rovid.d 6r h, Sdio. ]7m ol dE
<br />t !d Co&- for th. Ffollrs. ordE *st fn *tih tlr Fnn i! iBr.(t
<br />-l h!v. rnd *rll n.intrin srta .ohFltlion iGum.. B 'r$ir{ br S6rb. 1700 ol$. bbor C.d.. for th. Ffo|]rlB of
<br />rh. s6l ror *,ub rhi Fmir ir eEI My mrl6 6nFEdio! 6u,e. ceE !d Fla, .umb6 e:
<br />v I cdrly rhlr tr lh. psn'lrlre. otrll. *{rI ror rh'.h rh6 p.ntri! n isu.d. I nrllml oplo} &y p.e. i. s, .l,lffi
<br />s 6 lo b<om. ruqer ro rh. *.d6 .of,Fnsdhn bs of Crlifodi.. 8rd .rG rhd if I shoold b6om subjel to llE
<br />*0116.omFslionFovirioEofS.clion1700oltfictrh,CodcLuU.fonhwthcomplywirhllD$Folisio6.
<br />WARNINC: tlilur. ro su. wort6 omr6!a'.n covds. i! ELwtul, ud shdl rubFl d dploF lo aftiul FuhA Md
<br />.ivi! iin6 up lo on. hun&.d thousd dolld (1100.000). in rddnio. ro lh. cor of compsslion. ddag6 a Fovidcd for ln.
<br />sdrn.:1076 olrh.l,.h!( .. 'nrscnMdlIlorn ljs 16 Jlu W- tr- )1)x
<br />r.rr,lrriln itr r f,ii toti l/
<br />uu!trxar()[
<br />I h*by lrlm und( pdrxy o r pdjury rhu I e li.stral und6 Fovision ot Chall6 9 (onm+69 w n S..lion ?0@) of Divilion l
<br />of thc iiNind d PmfdioN Cod., &id ny l(d* a ,n tull iole md.ftd
<br />callIalll;IAd.MDllCiGENC[
<br />! @y .irm uid6 p6dry.a Fjory rh! rh6. ir r co'Eruclbn lodins .s*, fot $. Ffolrffi. of llE wo br snich $n Fnn u
<br />iso.d (Sr 1097. C'v C)
<br />la(k ! Nu.:
<br />,{PPr ro\rrT nr-r . tlaTloN
<br />I halt .&D u.dq F tlr or Fju'y oE or tL rolkxiar d..L..rioB
<br />D6Dtnio. Pmnl^rbdro Noriftaid F.<h.l L8uhN6 OiL.(,, Pm6l
<br />RcquiEd Larq of ilodf.iin
<br />I .diry thr rlE &d6.1t.gulrioB rt3idine otalor lgmv.l a. iol n li.bl. 16 lni! FDid
<br />Y I d'b lhr I h3. rad lhu .Dplr.r.n .d rnc rhd rlE .tow intornrion ir drtd. t .€rc lo ooply Yitt .I Ciy .!d Cod,
<br />ndi:e6 rd St r. Lls rbit ro buildite o!J^arb( td h66, .dlffiz. rqerriG of lhi Cny dd Couly ro d s r9otr lt
<br />n,, J'G >O
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framino
<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 />Engineer Final Report
<br />Flood Zone Certif .
<br />FINAL ')-2*zc /4c,s,^/r.ras, #-2,
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc.
<br />COMMENTS
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