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BUILDING. INSPECTOR RECORD SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDEf, DELCARATION I lE b'rlfm undd F3n, oa FJ!r, rh, I md6{,6omtlE(dtr6 Ll..ns U* aor ilE follo*ry tEn (Se 701r! B6ind i.d Profdiod Cod.): Any Cn, or Cofly $htfi r.qun6 ! Fni lo @rsru<r. .t6, inForq datulah or r.p.n &y lh.lue pmr to irr is!M., ateo r.qut6 lh. 4plic&l tor luch Fnn ro [1. ! 3igi.d 3tddd lh{ lE or 3hc b licaral Pumtr ro rtE For.ios of dr Contkld! Lt.i-d lrw (Cn+lq e. ColMftils snh Stlion 7000 oa Ditisi,n I of lh. Iroline &d PrcadioG Co&) n rh! tE d dE b dapr lhdtfron !d llE bGs for rl! rtLs.d .raqion Aly vioLlbn of Sdtion ?011 t bD, .rplicer for ! prm bjd$lhc appliclnr to !civrlpnlhyoarcl mo..ihe livc huodr.d doUm (t500) -1. s o{coftlEFoFry,or6ymplo}E snh*.s6sdEnskomFdbtr riu& dE*ut rdtltridEad iirqrLd o, ofrq.d tor slc (sd 7o4.{, Bqin* Dd Pmf<hB co{.: Tn codr.dd! Lt.e rls &6 m' .p?ly to e oss of th. pllFiy wtn hi!& o' hl!.o6 llE6.. id *lll .lE Mh mrt tirulf or tdxltor rrhugh hi! or hd oun dploys. Forii.d rhd Mh mr.!\gl,s c d nod.d q o,Ed itr *. l[ lnM, lll boili,g BrFDrEi.i i! ild with d ]6otcuqkq $. OrE B{iB6 $i[ hrw UE hr&r oaFori g $i L d CE dn d hild or F+ot tlE FoFry tu dr FIP(E of -I. 6 onr ol tlE FrFrr. o aclun lycoddi,uunh kdlql c{iraroB ro.odtud !!E D.oF (Sc.7OOl. &8d6 rn Prokm Cod.: Th.contncrof! t-icN lr* d6m!.p?lyro uof,ns of FoFny who b{ildr or inpmvGlh6on. ..d who co ftE for such roj.dr snh o Conr,lclo(s) li.ou.d purd to rh. Conl.lclltr ! Licru llw). -l m doF undq Strion-, B & P C lbr fii l6on D.t. Orldl trq8a!8slcautENtAllq! DECIISAITO! I hd.by !flim un'ld pâ‚¬mlry ol psjury on. of rh. fdlo*ints ddltrdnlB Ihacrdsillri.b.Cdrifrd.ofcoM{ros.lalBo.16rwkdr'comF!.r'on.BFord.dforb,scrion1700ofllE l:hor co&, for rh. Ffoffi. of lh. rorl for wh'ch lh. Fnn ir isu.n -l h!v. !'d *ill Enllin m.Isl con{tu6n iM., 6 r.qun.d try Scihn 170n of rh. t bor Cod., aot lh. Ffolrla. or tl! Nrt tor whth rh! Fnn n asd My portfl comFdior immc. ffi ttd poli) nmb.t E -l cdiry rhr in rh. Ffol]rw of ttE wort f( r'hah rhi! Fair ir &u.d. I JEll mr @ph).ny Fs in ay trffi 5 3 ro taor $tixr ro rlE wr6 onpddion Ls! ol(_JifoE4 r.d cr rhd irl ,huld b..om sbd h ll! worrd' ..nipnerirn provnioB of sdion l70o of lh. L,h.r Code I .na[. fonh*nh @mdy wilh thi p.ovnioB *ARNING: F.ilur.lo s@ Mrt@' conpdr6n ot6+. i. uL$tuI. rtd {all subj.l n npl6F b aimin l FrIb dd ciyil li6 !p ro oE huldcd thouerd dollr! (llm.ooo). h .Arnbn l. tlE $r of.omFsdstr d.886 6 FoYilcd for $. S6ri,n 1076 of rlE tltor CorL. iddlc .ftj .tdn y r fd Arpto.rr_ IlctrsED-coNrtaclaa TICIJ8AIIQ! I hs.by rfm ur&r loulry ol Fjury rhd I m lic.osd un.Lr FDrnrn of clEpta 9 (sn.mi.g wnh S.dbn 7Lloll) ot Dilaiod 1 of rh. ltuilB md Pmfdi'B Co&. rd dt lre a f, tull fora drl .lTd (ax au(:lrQ rf.t[lliclqllcl Ihd.by,ftirfl undd p6hhy oIDqjury rhat llsc B i connrudon bndin! axdc,lirr rh. p<lnmoc. oIrh.*orl for which lhis Ism is isuai (sd 1097, ci! c ) AIEIJCANLDECBAAITq! I td*y dlta und.r !o.ly ol Fjury oE oalh. aolloeinS d..lIdio Dqmhbn Po nl^rbdo. I'lorifi.di,. F.d6.l R.*uLtbN l1nL 40, P.n6) -Rcqun.d lllld of Nolifr cne! I .6iih rhr rh. falarl E*uldioN r.s.dins stdos moul s. d F?li..bk 'o thu Fojcl -l cai& lhn I l!v. r6d th! .ppli.iion -d id. thc 0r ft.v. iltorrub. i! cotrEt I {E to o6Ply wilh tll City md Couly odio.lE.!d $& t^! ELig lo trild'ls oistf,lb( &d lE byuhori& !t .Ed.riv6 of tnir Cily od Coury b dt '4o. tlt .tow,E iotr d FoFry 6. i6?diot FrFc Ap9lk nto.AtrllsbEt@ D .:- Set Backs Erection Pads UFER Ground SLAB Floor Subfloor/VenUl nsulation Roof Sheathing Shear Wall Framing lnsulation/Energy Drywall Ext./lnt. Lath Brown Coat Masonry Pool Fence T-Bar Handicap Req. Deputy Final Report Engineer Final Report Flood Zone Certif FINAL u 'Zrht il 1/1.N7(>'/ a-')-..-'-{ 'l*Certificate of Occupancy Notes, Remarks, Etc Forms/Steel/Holdowns