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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNER BUILOER DELCARATION
<br />I na.!y lIfm u.&r FEly oapdrury |hi I d qrqr tth rh. Cod*r6 LilE t s 6r tlE folbwra.l6o (Sc 70ll.t
<br />Buind ad Prclsbn Co&) An, Cny or Cody whih 'tqui6 . Fd to codM, drq. iqrov.. &tuli'h or l9.. e,
<br />nruclB Fnr lo ir! i!s@.. ako r<!ur6 rh.49liilr lor sch Frtr ro 6lc. lis.cd xdc@r $rl h. or t'c a lt.tr!.d p@dr
<br />b lh. FDvisioN of llE Co.rErols Li.d!.d Lrw (Chrpra 9, Comtring wilh Sarion 7000 olDivirio. ! olrh. auilB sd
<br />PFfdbs Co&) tr rh.r lr or tlE i q.r,E thdlilh .d th. bGit lor E dLs.d qdFb Ary rDlrioo ol S6ti.n ?01 I 5 by &,
<br />,pgicm for . panit sbiru rtE rptli.&r ro . ovil Flrly of.or eE tta 6vc hurir.d &U6 ( $m)
<br />_.1. s orG of th. FoFry. s my opLlE wirh *!s6 a th.ir Fb codp<B{l{n. viU {b tL wt ad dr !^dE i! mr
<br />i.'dlal oroltc.d for nL (Iia 7o{4, BuiB !d PrDa<iod cod. TIE C.tuoa! tile t w rh€ ml +1, b e orE of
<br />rh. Fpqt r ho hril& @ lnFDlc tlEr^ !d wlh .,c sn w,t tiElt or h€*lf or tlmugh ho q hq 6s arlolG.
<br />prcvid.d lh8l 3uch imp.DtffiB e d iildddoronad tor sL. r[ hotrw. th. hrildilB or imFoEEn i!$ldwnhhon.16
<br />ofontplcbl! 0E ()*rq a{Ida eil h.E 0E hdo ofFlli.g thd lE or slE dil Bt hilj or i,q.Dw dc FDFty hr tlE FIFE of
<br />L a ous ofltc Fopsry, M .xcluiv.ly contkiry wnh licd!.d cool,a.loE ro co6lru.1 ttr pioj€1 {sc. ?044. I\BdB
<br />ad Piotsbn Cod. Tn Cont..to t.icffi L!* 1106 mr .r,Fly lo e owns oaproDdy *ho build! or inprovg lhqmn.
<br />dd *ho codrtt! for iu.h Fi(r sh. Codr*ro(!) li.. r.d Fc@r b dE Cotudd s L@ trv,
<br />I m.xdpr u.da Sario.
<br />troaxEa!:(artfEriii rlaN
<br />DllCl.8AIlQ!
<br />I hsct y affro unds p.nolty of psjury on. ol th. nnh*ints dal{.tioN:
<br />_l h.E.rd *ill Eid.i!. Cdiiftd. of CotE! ro Sdt-lru. for wrtd o,pqub( 6 FriLd tor by Scrio! 17@ of rL
<br />ldor Code for llE Ffot'lle. of llE *ort ror *tkh llE Fnn a iscd.
<br />I hrw rld vill @inuin so,l6 cooFadion ilsec, a r.qud hy sdion l7m of th. trhor Cod.. lor rh. pdfolll@. of
<br />thc &ri f( *t.h fti! Fn( it sad My wdt6 @nFlrion u!l,lt. 6b .d lolat ounbq e.
<br />--l cdirylhd in th.Frormlncc oflhc work for whthlhis tcEil ir i$u.d.l sh.ll nol flploy lny pq$n in My o@d
<br />s a ro baom iubjer ro rh. mrta'.oniposdio. l,n of Cdiaomia ud {r fi! it I lholld haom rubjEl lo tlE
<br />wt6 oEFurlion Flvti,E of Sdion lr@ ol llE t t { Co& I i.lL fonhvnh otrply uill |nox FortioE
<br />WARNING: F.il,a io tq. $sld onpdii'. @ro+. it u,LstuL !i ndl r!,.d a drpbF b sitri.d F.li. tn
<br />civil li..s up ro o.. hm&ql rnoMd d.l!d (1100,000). i. &Bnion ro $. .o, 6f comFMrio.. d!bl36 a prcvid.d lor rlE
<br />Sdion 3076 of lh. t$d Coda intdlJ xi ntorrEy'r f6.
<br />llcEttED-corraaLroa
<br />D[CIJ8A:I]o!
<br />I hq.by .fim ur'& Fdt, oI Fju.y fir I m li.rr!.d udd.. Fovirb. otct pllr 9 (6,1tlEatr{ snh Sdb! 70m) of Diriibd l
<br />of !fi. B6i,B ad P,Df6i,B Cod.. rn sy ftd i! i. tull aorc -d clTtd.
<br />coNsrntrnoN r-r\Dl l: acft(a
<br />I h6rt,.farE ultdd po.t,ofpnju.yfid tE b.orrrrudbo ladio3 tary tutf,cFfctr,lEoftt E br *,trn thir FEi i
<br />i!!u.d (se. 109?, civ c.).
<br />Lndai Nm.:
<br />-
<br />AITUCAM.DISJAAUq!
<br />I hclby .fiiD !.d6 Frhy of Fjuy oc of rh. aolb*iig (bL..lbG:
<br />Drdohion Pmn!-Artdor No(ifi.lion FGd6d R.suhtio.! (TnI.40, FarO)
<br />_Rcquir.d L-drd of Nirifidir
<br />I.diry rhd rh. i.d6dl Esrl,tioB Erdding 6h<k)r rmo\rlec not rprlicdbl. to lhB prejdr
<br />_- I cdiry rht I h^r rBl rhi' .pglt tion rd sln. r,'r 6. rtEE infoEri,n ! cndr I .sre lo .!,ltiy wirh .{ Cny lrd Counry
<br />ordic dld Sr.r. Ls cklB ro b.ddins core$rF( r'd lErby.l,no@ rq6. ra6 of6ir Cny dld CourIy ro @16 rpo.,.
<br />aborc Mri.n d prepqly for iEp€lior purpos.
<br />Appli..nl or AEqrl shn.lur(
<br />PcmhR nrme lp.ln0:
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subfloor/VenVlnsulation
<br />Roof Sheathing 1T$VL bn4,'14 7
<br />Shear Wall I
<br />Framing
<br />lnsulation/Energy
<br />Drywa ll
<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 Report
<br />Flood Zone Certif .
<br />lt
<br />FINAL Ttqa l\w
<br />Notes, Remarks, Etc.
<br />Set Backs
<br />Certificate of Occupancv
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