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BUILOING- INSPECTOR RECORD SITE-WORK DATE ID/SIG.COMMENTS O\f NER BUILDET DEU ANANON I hscby .mm und.r Fdry ot Fjur-v rhd I d .rflpr fi!'n rlE ( ont..r@ Lt.nE lrw ror rlE lotowrlg E=Ltja iClJ 5 BuiB d Pmr6nn Co<!c)r Any Cny or Coun, whrch (qui6 ! fEnd ro coNtu.1. rlr.. inprove danolth or re.! ey nMdq Fir ro irr illrre..to EqdB rh..ppltot for $.h pann kr fiL r !is..d rldffi! lhn lt o, .h. ! lico$d poe.fl rb rlE Flirio6 ot rIE conrrEr '! Lk N.d h* (Oqr6 9, Comcin8 *hh Sdbn ,00o of Divnion I of lh. BdlB dd PmadioN Cod.) or drr lE or rh. k q@pl rhddrom rnd tlE t lir for rh. rlks.d .tdrFhn Any r iohrion of SGiion 7011.5 bImy +plicel for r Fhrr rlbjal3 rhc .prli.er lo a civrl pcn.ty of mr mr. rhr. tiv. hu.dral d.lla (1t00) _1. 6 o1l@ of rh. Fnpqry, or nt 6pLr6 $nh *186 B rlEn sL on'pdldbc *iU & th. wt .d dE rtuE . d itdrd.d or ofi.rd for nk {SE 704.1, Bui'B ud Pbfdioc Cod.: Th. conlr.clr'! I.ic.e Lrw &6 rct.pPly ro o.m.f th. FDFry * ho hild d inslq oEE o. r'd *,lb dâ‚¬ sh 6t hrell or lE*laor tlrousi hir or lE o*n dplorâ‚¬, p.ovilal lh, ruh i6F!vs!E! E rbr irsd.d r olEEd 6. {L lt I'oE . iE tuldila 6 i4.@d ir $ld wihn oR }6 oaonplii,!llr OsG aliEn wil h.\! dE hrd6 6l Foving $i t or !t!. did ml hrild or imFov. dr. FoFry lb. th. F4o*of _L 6 o{G 6lrh. F.Fry. o .rcluiv.ly ro Ecrins wnfi lica!.d conr6.loB ro cdaitu.r llE FoJ.d (Sd. 7044, &!itr dd hDkin Co&: Tn. Com.rcrM , Li..G k* d6 rcr @9ly ro m oqE of FoFd, who brild! ot inFov6 lhd6n, ed who .o r!.1! for ruch FDiert pnh . Co r&1o(r liq!.d p6u,r b rlE (odr.crd r lid& tn) I d .xaB udc Sdi)n-. A & P C ror lhi! len D.t.r Ou6l wo*rRs'aoirrDns TroN DECIAIAIIAB I ffiy lmm unds pdrlty of pgjury oG of lh. f.Uo*ins &clrdirB _l h,v. rld will minr.in r Cqriarcd. orconht lo Sclf-lns@ lor edcl 6nrp6{liol\ ! F.viLd 6r b, Scrion !r00 oflh. t !o. Codc. lir '& pqfi]|rtE. oath. mrt ad *tth tfi. Fnn b isu.d. -l hlE &d will mlidnn wo*.rr' comrdlsl irn iNurm.. 6 E{uirdi by sal ii!! l70o of lt L,hor Co& ft'r th. Ff(fu. ot rlr Nrl fd xnah fiis p6nn u is.d My w(k6r omp.rud'on Nure. cmi6 !d r.licy numbs e: -.-11,1-4 l-,(^:.-( . \ A-rrA l0ooo')'1G o q -l cdiayrhd in rh.F6me. ofrlE wo* ,or which rhi. p.rnir is i$u.d, I !n!llnol oploy ey ps$n in ey renr e arob<!E$b6rrorhc* 16'@rp@rion h*rolcdifom^ i +rrhd if I dFuld t<od ot*i1rotlE wod6r comFeti.n rrcvatios of S6lk)n 1700 of rh. tlbor code I JEll. fmlhs'nh .onply tr'nh llri Fovi.ioG WAnxNCr F.ilw ro su. wuld onFBnion ovosc 15 unhstuL od thrll luhj.d s on loF lo simir,l FEhE ed cnrl nn6 up ro om h$drcl lh.Btd doud (tl(x).mo,. 'n ton. d&u*6 6 Fo\rl.d for lt. rt!' (i\lc 'nrq6rud anohct s li6 27 I DECIJSAIIQtr I ,ryLJ lrm unds p6dly of Fjuy 0r I 6 ticEel u'<16 FDririoi ol(-rufl6 9 (onffiin8 wnh S6lion ?00o) of Div.ion l oa th. BBilB.rd Prcfshc ( o&. .n my kav ir h tull forc !d.ftur . cl o I b l2-o 1-1 tl'z-+f r i ,.,,.,...ts ca! auquo!..LElDldq.AcEr(} I h6.by .ftm urdd pailhy of Fjury rhd thE. ie ! odrucli.n ladiry rydy for lh. psfotu ofrh. *.rt 6r rfikh lhi pqBn a i$cd(Sa.lo9t, Ci C.) l,ndd t Nm. - attucalr.lll(,JaallQN Lrd*r .,fm u.d6 pda[y ol pajury .E o I th. folh$in8 rL.hmhN l).molnn,n P6mnr-Asb6ros Norifiotion Fdidll R.8uldioN ( lillc.l0. Pd6) R.qun.d tatdof NdiaE lbn -l cdrS rhd llr tud r.suhrrE Eslirn! 6160rrcm\il rr N iptl.lbk ro rhs Fmd 3-4.-iry,r,,rr'....a'r'urml'.dNnaldns,.rharncabolro.oftuNnn.or.rrIereroondy*hill(iry..dcounry mdruN6.rd Srarc ljrs ELri,a ro t{i!d (6 oIr[r ( [yud(iunr]ro srd ut,nrh. ahrvc narioftd prcpdy fo. iBFdhn J::::ffi"TS .r/" p l. Lia- .>/ q Forms/Steel/Holdowns Erection Pads UFER Ground SLAB FIoor Subf loor/VenVl nsulation Roof Sheathing Shear Wall Fram ing lnsulation/Energy Drywall Ext./lnt. Lath Masonry Pool Fence T-Bar Handicap Req Deputy Final Report Engineer Final Report Flood Zone Certif a il FINAL Certificate of Occu n Notes, Remarks Etc Set Backs Brown Coat .**za