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-BUILDING. INSPECTOR RECORD SITE-WORK DATE ID/SIG.Ol{NER DUILDER DEL('ARATION I hd.by rfim urdd Fr.ty ol Fiury thd I n .Etrg nlh ll* Cofrd6 l.toB l^ lor rh. folhwiry rdn tS< 70]!l i s[ind sn Protdlirn Co&) Ary Chy or Couny *'hrh r.qut6 ! Fn lo sneod. .n6 mrrcv.. {toliei o. .qri ur srtudu.. Fior b n! isud... nL. râ‚¬qui,6 lhc applicMl ao. ru.h p.mi lo nl. . lun d itImhl lhin h. or rh. t li.dtd PuGulm lo rh. FovirirE ot llt ConrrtlM't Lic6*d L.n (Ch.prd 9. ComctrE *nh Setb. 7m0 ol DirLio. 1 oarh' Bnrind 'nd PtofsioN Co&) or rh.r lE d :nG s salpl lhd nom dld rlE b6k tor rlE ilLs.d ad4rin Atv vnhb. of lclion 70! I t U) .nv r!llic&( for . !.mil llbjâ‚¬cr3 thc applic.m ro t .iril pdlty of nol 6orc rha liv. hun&d dotl6 (1500) l- B @G of itE FtrFy, d m) mphlc $ih "ta6 s rlEir ek orp.rdio.. *i[ do llE s<rl !n rh rirlG - E{ iddd.d .r ofi6.d ftr uL (Sc,7044. BuriB ud ProfdioB C.d.:'In Gftrloit La.E l.w &E nol igtlv lo r orffi ol th.FoFry wlF hrirl d i!F.!c thsbi. .d wh. dE sh wt hitu.lf or h6*laor thmult ti! or hd oM @Plovd. proriLd fi.! $ch im,,oEErt E d irdid.d d ofiad 6t rL rr- h{!t, r t! .iiB d irFsn&r ir ild sihn q }d ofstrpliion. rlE Ouc Bdld6 ll lE!llt hnrlt.fF.!i,B fii tEott djd br h,ld G i,p.trEdE FoFrv ftr EIi FEof l. B ouE of llE F!!qt), m.r.l8s.l! .odr(,ls snh li.qsd.odMoE L onrru.l . F.i< (S< 704-1, &6ir iid hDi6s Cod. Th. Conrftloi! Li..nr Lt* &6 nor .tPl, lo d oMd o f rbp.nv rho blild! or impbvd rh66n, ud who Nrtr..i' tor o.h Fjdtt *ilh . Coflrxlo(3) lras.d Ptl,uI to lhc Cofi.cin t Ltou tt*) I m.r.nfl undd Sdrcn O.n6 \r oRrcRs' coit Pts\ i^flor DIig,AAAUA! I hdrl1J'amrm undq r@lrlof Fiufr on..l tht lollo\inr &{ltruinr3 I hi!. rn * ill m.inilin . Ccn rff,d. of ( oigl lo SdflEUE lor mrl6 .omFEdn)n 6 FD!*Li fot t'v sEli,n l7m o t lh. t tv Co&, for thc rEfollM. of rhc *brl for whi.h lh. Poni! i i$u.d I h&r.nd uill roinr.n *0116 oiFBlrion i6l)ffi., s r.qurd t, Sdhn !7OO ortlE bborCo&.6tllE FfolrrM. of rhc wrt fd *hi.h lhs Fnn ir iscd. My tr 116 comFlr.tion idum.. cans dd polkv iunbr e.: P.licyNunbg - - ErPnB I cdrry rhd i. tlE Ffotuc of lh. worl lor whrh thn Frn 6 i.u.n I irll ml dplo) uI F$n in dv ioF $ s ro b6om. subjcl lo U. $nk6' comFnqion l.$ ol Cllifomi.. ud lgc lhlt if I 3h.!ld b.toh. $bi(l 'o rlE *0lt6' shFBdio. t'o\i!68 of Sclion !?Oo otlh. L,bor code I Jull. fo(h$irh or4ry wnh ln i Fo\ irbN \* n]TING Fnhft h cw r.rt6 (mFErhn 6rEr*. i uL*tul !n idl {l'jtl - dt+bF lo oiiiol Ff,lid d cNn amd up ro on nundrcd lho@d ihll6 (llOo,OOO), in .<ldni6tr ro lh. con ot conFBdion. rbrosd d F vd'd f'r rh' sdion 1076 ofrh.l,tn,Cod., inrddl ud dlotrE, r aG I hdlty .rm o& Frty of FrJuy lh! I n U..G.d t.& Ftrri'in .r(lEFd 9 {@n1ll6iDe $ifi S.trnn 7000, 6' Dir Eirn r of thc B*iB !d PmfdioE Co&. .td hy lic@ ! in tull forc rtd rlt .l 1t7f<Z7 CONSTRUCTION LENNI{C AGrNCY I hortr .rm u..kr pady orFiu.y llr rlEr L . otdMbn lddta .8d} lot llE FtirlG. or $. *ql ir, stth rta Fni i nru.d (s( 1097. ci! c). APPLICAIYT DECLAIIATION I hod,y .ffr uo<,.r Frhl of FluD' oe of th. followi.S tld lrdioB Dmolilion PdmiB-artEror Notiliclt ion F.d6tl Rcsultrionr (Titlc 40. Pdn6) R.quild ldE oI tlotifr.rb. I carity thi lnc f..l6J rcsuLlit6 Estding .ltdot roovll e ft'l 4?li.ftl. lo lhi! Fni6r I cdiry rhd I l!v. rdd thi! .rrlttrhn !d i!r. lhd fi. .tnt. infordi,n is c6*1. I .g.c lo @ndy wnh rI Cnt ad C.ffiy odirN6;d fu1. bwr Eldit lo toiBnU .odntlio.. !d hd.by .dhoriz EFenal!6 o atni! Cnv dd Coubly to 61. upon ll! !tr\c lErirnql F.Fn, \>.,,dAe ]h o-/ /o* lU t / / Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor SubfloorA/enUl nsulation Roof Sheathinq 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 Certificate of Occupancy Notes, Remarks, Etc. COMMENTS -,. /O-q- (-l ,."**.n*,f .L5 ^"bs-lJ