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BUILDING- INSPECTOR RECOBD
<br />SITE.WOBK DATE OWNER AUILI}ER DI]LCAIiATION
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<br />{ .tuc. l,(nlo rrs lss'rncc rl$ rcqutcs rhc atplc r lnr \uch lrlmi n' lilc r \ilned urcntnr rh3i lr r stk L\ hccnkd turNrinr
<br />n, rhc pi,vsi{'n\ ol rlE Cont{kn's l-'c.n*d tjw (Chafl.rr), Con rR r! w h S(ri(nr ?(X,0 .l l)lviion .l oi rhc llusi'rcs\ rnJ
<br />Pnn.ssn,h\ Codc)or rlur Ik or sh. 1\ .rcmfl thrlclr.nr rnd the bd{s ntr r[c ullc8e,]crcmpnon Any vr)ldtordfS.rron 7{l1l 5 hyany
<br />ipnlrr n, a pcmrr \uhjcrts rh. amh.rnr n, rc,v,l[l.ultyofnor horclhrn llvc hundrcddollds (i5N).
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<br />rh. pn,Fny wlr, htril'lsor improks rh6G)n. rRl whi, '1,f,! \uehwlrl(l,dscll orh$\.ll !tr rhx\'Sh h$.r hcr owo cnll"yccs,
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<br />ofr.nlrkik& llr Ow.cr Au Jd rnl ltrvc 6. hldcn oI ptuuU rlrl hc or she ',1n,r huiu or irntr'vc rhc pfl,Fiy ntr rh. Ntak ol
<br />l. r\"*ncrolrh.p&p.ny, rm.r.lu\iv.lyront,.rin! * hli.cD\cJronr(r$n'(otrnn(rrlrtn"F.r(Sc.7(X-r.lluuc\!
<br />rt t\ncsbn C.{1. Th. Coftar!,'s Li(chc t-aq J.cs nor aflrly h r owmr ol lln'r.r ry *l'd hu,[s or
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<br />I amcrcmpr u.lcr Sc.ri)n-
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<br />DTCLAAAI,IQN
<br />I h.r.hy rlirnunJ( Fnrlrtol lc4uryonc otlhc li)ll',um! Jcclu{ri()ns:
<br />ofl havc nlwll mrirh,. C.nnildcorConsctrrlosclrlnsurc lttr*o,kcn .onFner0n. a\ Illlrkr.'l r.rbysceri,n 1?00 ol rh.
<br />lrxr Orl.. li,r rlr lcrlorhrn( ol Ih. sl* ntr whrh lh. pclm ! issucd
<br />_l hrvc ntul w'll nrnflr workcr s' L mP.nsridn iDstrt(c. ir rcqntcl hyS..ii,r.l7il)olrh. IlhorG)dc, Lrrhc Jirtnnanrc I
<br />rh. vork,,rwhichrhtr tl(nn ,s r\icd My work.r! $nrPcn\iu.n tnntrrn(crrtrf,r rBl I[l(] nofrh.td.:
<br />APalUCtat tAtqLrY co,4 A-f
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<br />I (.nni rhlt ir lhc!.rn)rmlNcol lhc w r[ hr wh'.|rhtr p.flni r i\sE],I shallnor. rtn,ynny F-.non trrinyImtrmr
<br />(, 11tr, h.d,BshFd r,dr{ori.r\ (otup.n\au.tr lr*s nl C{l'Irn'r, id rlnc rhli rl lnn,ul'l Biom sth)c.t brh.
<br />workcri.onrl.nsnrirt'r,r'$otrs l S.Lr(r lTtDol rhe uli{ (:,xlc.l shrll.lonh*irh.ohlly w hrh){'tR,vsitrN
<br />W^RNIN(; Ii' !n r' !(r( u.rl.r\ ({nBrn rtri q'v('!. \ trn n'rll \ulJrrr Jtr cnun.y{ r'.nnnMl n nrhr\ !l
<br />,'v'l lrr\ trt n, !rr l[trrl'.,1 r1,,tr^]trrl rlL'lltr\ rlllri,.rrxr) tr, rlllI n$rnnr. ditrDlc\ r{ fl)viJql tlr rhc r
<br />5(rrtr'n 1(r?6!n rhc lihr(iil.. inrcrc{ rnJr(onrcy s lcc\
<br />I h.(by alliitu uftlf l^_trdtyol p.ljury ih.l I m lMnsn unlcr !('ri\n,n olChspr.r 9 (.onmNtrr! qirh Sc(rd]7m0) ul OlvNr$ l
<br />ot rlr Brril\.nnd Pnncss.rNC.!., i[] my lscns. Ls r lullnk! nlc,lc.r
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<br />t=t.(4 ,ot€f I 2L Y f tlnEl1
<br />laIEI!!!! Ti.LEIDlliCrll:lICE
<br />I hckhy illim unJcr p.mlryol n riury rl,r du. n r on{nrrxr lt,ildrS rlcn(y ntr rhc l.rtornlnrc ol rhc *o!k lir qh'rh rl,N F.ni 's(srJ l Scc. .rlrJ?, Cir. C )
<br />lxoJ.rr Nrm:
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<br />I lrrhy iltunrrnLlcr lrrndlry oL perlury onc ol ih.l,,llow'n! Jc.lalhon\:
<br />l)cnn,l'rrn, P.rnn( Ash(nos Nori,i(rlotr F.d$rl R.!uhrtrini ( r b 40. Pfil,)
<br />R.qntrcd L.llc!.1 Nolili lidn
<br />l.cnrlyrhd rhc tn.rrl rcluLri,)tr\ r.e&li ! r\h.(o\ur)vnlftc tr.r n|)ln(rblc r, rh1\ nn)lc.r
<br />a'(.c,hly llrt I lNc rc.d llns opplulrinarrl rli,r. it,l,)rmirtr, ^ !!inr.r I r!N!)(! nl,ly$(h,,lLCLry.nLl('ntriy
<br />ordn fl..\ in(lsrrr. l.r$\ '.Lrry n, h il'ln,!ulltrtrr. rcnrc*ni/lrvesor rh^C y ffit C,)utrry !r .hrcr ut llr
<br />trtx,vc rmnr(nnl pn)ncny 1,tr trxFrrk)n
<br />ADplic.nto. A!rntSiInalun
<br />lt rt '
<br />/,c1.,
<br />Set Backs
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framinq
<br />lnsulation/Enerqy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Ivlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Report
<br />t\b
<br />FINAL 1 L1 L Dlwr )/
<br />Certif icate of Occupancy
<br />Notes, Remarks, Etc
<br />tD/slG.COMMENTS
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />Flood Zone Certif .
<br />n^,", y'zo 1.r
<br />trn,lci' AJ,lrc$:
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