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BUILDING- INSPECTOR RECORD <br />SITE-WORK DATE ID/SIG.COMMENTS <br />Set Backs <br />Forms/Steel/Holdowns <br />UFER Ground <br />SLAB Floor <br />S u bf loor/Ve nUln s u lation <br />Roof Sheathing <br />Shear Wall <br />Framing <br />ln s u latio n/E nerg y <br />Drywall <br />Ext./lnt. Lath <br />Brown Coat <br />Masonry <br />Pool Fence <br />T-Bar <br />Handicap Req. <br />Deputy Final Report <br />Engineer Final Reporl <br />Flood Zone Certif <br />FINAL <br />Certificate of Occupancy <br />Notes, Remarks, Etc <br />O$NER BI]ILI'Ef, DELCARATION <br />I h@by .rm und6 pquXy of poury lhd I m qdB tDn rh. conl[.ldr Lic.M trw ft'r tlt aolktwng r&n (s.. 7ql I 5 <br />Bso{ ald Prol6!6n C.d.)r any Cily or Coud, whth ..qui6 . Fnil lo Ntrrrucl. .lla, ioprov., &tFlith or qln dy <br />dMc Fi, ro irt isuse .l& EquiG rlr ?9lk&r for ruch Fnn ro 6L r riS..n rnaDd lhd lE or rt - lic6!.d F,.rd <br />h 0E FlairioB of E CoDr.rd', !En&d L.tr ((tuprs 9. CoMdins *nh S<rir 7Go of Divkio. I of ltE B6i!6 d <br />PmfdbB Co&) d rhr li or rlE u don9l Udifrom aid dE bGa tor rlE.lk8.d ddp(iln. Any vioLriot of s<r!n 701My uy <br />@tlicinl for i dEn rubjdr! rh. .pplicer ro ! ciril l!@n, of ror mr. fia liv. hun&.d &lle (t500) <br />fufio orm nrrhc gqary. d mr mphyd *nfi u!a6 6 tho, nhtumFd.n. " &rlEktltn rf'(l(.d <br />,I;d.d qoftocd i, $l(S< 7u4. &lG&d Prof6i,E(-rn TlEcon,tdd't tioe trr do6.or tpdyh &otrFof <br />It FoFty *'lD hil! 6 irrrod llEEil. nn who d6 Bn slt hi,!.tl6r lErlf or rhrc!8) hit m lE os arPlotG <br />prolid.d th6i Mh imFb\drEa n d ilndrd.d or.tu ror rL I[ lbrw.lrE tlildilR q iqio\tl1d i sld slhin oE ]E <br />ofcomplaio.. lhc Ownq Bullda vil havc rh. hda ofFDvnU thi h. d !h. dn nol ttrild or inprDv. lhc FoFly for E Frroe oa <br />-1. <br />sow of rh. FoFr, m a.hsiEly cori'-b8 *ith lkd!.d colnrriGlo ollriud tlE Foitr (Sa ?044. Bui6 <br />rd hDkir Co&: Th. cotu.dd r LtGc L.w &6 mr +ply to @ o*M of propaly vho boildr or iE mE thdan, <br />md {ho conr.dr aor suct F!r€l! wnh ! Cofferorl3) ltd.d puRun ro rh. cMhcln r Lk.ru L!w). <br />4 <br />_l @.rdfl un.ld s*lio <br />,"" 6rl.,a1:+q <br />DECIASAIIq! <br />I hc.hy rmnn u.dd Fiahy ol pEjury on. otlh. folh$ inr d(tu nrN <br />-l <br />h$c ed $ill niIrli. . Cdifrd. otcoNd b sdf-lw [r wI6 mFdixl' d FDrit d for by Sa:li,n ]700 of lh. <br />Llhn Co<k fo. rlr Ff()ll1'.c otoE elt for *tkt rh. Fnh i! ie.d <br />-l <br />hdv. a6d sill maintair wolt.n .otrrp.Mtioi iNursnc.. s rlquircd by sd io6 :1700 of rh. t,hor Codc. for th. pdfommc. df <br />rh. sort for which fin p€nir ir isld My Mrr6r mmFsdntr iNurdcc.rir en polty nuntE r.: <br />6fldairy rrrn nr* xrrom. ortlE sorl rq *'hEh thn Fnr n is.rr.l.tullmr aDphr oy F$. r &] i1ilE <br />-tl 6'0b6omsbdro't srtd odF.rbD hs. ofc.lifom( rrd .8E rhr ill iEutl heoB stirr b E <br />w d' ohFE rio. Fovirird of S6rb. 1700 of $. Lrtd ('6&. t Crll. fdhwnh mmply *nn lhor FovirirE <br />ltrARNINC: Faild. lo s.<@ E.!a' onFMi.n 616.S. i rk$tul ad d'dl rubid u @!hF lo oimin l pqEXB dd <br />c'vil fin€r ut k, o.. hun&.d thous dollds (t100.000). h fulditii n ro lhc c.{ fr kn,. d.m4.s i$ t''.\ d.d ln' rh. <br />sdi6n :1076 of rh. hbr Code hrcd ed lnoEv ! <br />lrr!L\&ulQ] <br />I hd.b, .mm !nd6 Fndly of Fjury lhd I d liGs.d und6 Foeirion oaftq E s (.omtri.s qith Sall,. ?fix,r) o I Divinrn l <br />or 'h. <br />B6inB.nd PiofBio6 co&, {d my lk.M ir in full for.. an.UB'1 <br />qqISIAJJC]IA!J.I!DIiG.AGI!(} <br />I hs.l,y lttm und6 Fndrry of Fjury rh, th.. n . codrud irn Lndins .socy lor lh. pcf.,m. o I rh. worl ft. *hich lh6 Fn'l . <br />ir!ud (S(.1097. ( iv C.). <br />a.S8flcArut!c!68aua! <br />I lEdv lem n|.r r6.ty of Fjury oc ot rlE follo*ing deLr ioc <br />D.trnlnon Pamnr.Arb.cor Norifici ion F.ddal Rcsuhr bN (Tdlc .lo. Pd6) <br />-R.qun.{ <br />ldrs of tlorifi.rio. <br />I cdliry rh,i rh. r.ddrl r.!ub n,N r.A&dinr rnEtos En'vil & ml apDlrlbl. ro rhis pml<1 <br />G#**:;xlI h.r. r6d rhi'.rolr!.n !d d.i.iht rh.$oE 'n6rdion i!.md I lara to .oq)ly u irh tll ( dt .nd Cou ) <br />!r. l,*! chr{ ro t{illi.g @,rntu.rir( a.d lw.ht qr*fldit6ofrh*( ymd Court to otq ulxh rlt <br />altr. nmrion.J n6tdy lor Elfflqr puno!6 ,/ <br />n,o'-"t * n* r *^,,fud* <br />,*^,* ",*0n",4ip4 ClE / fl <br />,,,,A/:22- /? <br />I <br />Erection Pads <br />-",0t -+1-' l1 <br />f-------T------