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BUILDING. INSPECTOR RECORD SITE.WORK DATE ID/SIG.COMMENTS OWNEN BUILDER DELCARATION I ffiy tlrm un& podty of Fjury rhn I m sdt)r 6Dm lh. Co r..106 La.M b* ror ln. follo*itra l8r (SE.7O] li B6iB &n Profdion cod.): an, Cnt or Coliy $hth r.qui6 . FEi ro @druct. .!8. Ee.oq dablilh o, n .t ay rtr!du., Fior ro n! isueq lb rcquiE rlE +pliqr for sch Fdh lo nE. rslrd nro6r tt lEor dE ! lic6!.d FBld ro rh. F$vi!io6 oa $. Com.&ror't Li..tu d Llu (ChrB6 9, Commins wnh S*lior 7000 of Divilioi 3 of lhc Bulind ad Pof6ioN Cod.) or rhn lr * r! ir d@pr rha6oi &d rh. hGB hr 0E rlceod aolllior ,{,, tbhio, of S.dbn 7oll.5 !y iy .Drlt d for . pa6d sbrd. d. .ppl'o!l ro . ovil FflI, of 6r mE lll., fiE tuxH &,lE {$m) [(Z!: - "** r*" **y. o, my oployE mrh w.ad s rh.t ek onpoldior. win e rh. M*.d trE rMrE t rcro"rJoa * ono.a r.l .t ri. roi.l. s*;* -a P'"ft"ri.B Co.L: Ttr Co,r'xrm! Licd* L.w &d mt.ody to e olt6 oa llEFoFly rtE hlldor i,ryoâ‚¬tt@G rn *h &Eidrrqt hnellor hd*lfor (tro.8h h! ts om aqb]c. provi<Ld rh.r r.h inFovalEb c ,Er iddicl o&rd 6r .t l[ how. ih. bi]d"s tr i,qDrsEr n nB *inb ft )d olcoEpLrio^ tE 0'^T6 D{ildE will hlw tlr hdi ofFovi,u rlln tt o. ih. drd ml tuild or nFpw t FDFry 6r dE FrpoFof l. 6 oqG oarh. F.Fry. 6 qchBiv.ly .od.ding *nh lt6.d .o d6 'o coldncl rh. FDJer (Sd 7044. BllllB .d Prtrtuih Cod.: Thc Cont.nois Liccn& L.w do6 mr lpply ro u omd of t opdt, *ho buildr or ihprc!6lhqon, ed who 6i[di for sh Fojdr win. ConrGo(r) lt.nr.d p{r*Erl lo lh. Co'rrEbr'r l.kce Lrw). I s .rcmp Nda Scriotr ( ".,,, tf n lz. za _*-4 !tL! L t!!\ r r( D I h*by .fim uDds poalty of psjuD- oE o f rh. fdlo$ rr d.cltrarioB I lI.!. &rl will midrh . CalifE.rc of Co!6r to S.lf-lEur. hr wrtd @nF!rio.. s Fovid.d for b S-rion l7m of 1h. Ubor C.de ad tlE FfM. of th. mrt fc rtin EFnn iris!.d. -l hav. ed will oainum work6 codF lnion iB(anc.. s r.qun.d hy sftrion 1?00 of lh. L.bor Codc. lor llE psfollrl4c of rhc *orl lor $hth thn roni t iq.d M, world omF8aion imurmc ffi6 rd polty nuhbq e Policy Nunbq - -.. - tirptG 4t <,0 rr'a i" rx p.r.M. or Ero'l ro, snrlrhi! FEn n e.4I rh,I @r @pby$yFe.,,oytr:lllE--= 6 ro b6G suba.l lo rh< *o*a coDpoBdDo LB of cdifomq .d lgE $.1 irl dbuH bcotu 3ubci lo rlE e&6 comp@rdion previlioa ofsario! 1700 oatt lrbor Codq I ihdl fonhwilh 6nply wirh thos prDvilbN. WAmlNG: FnhE lo E@ wl6 @dF!dh. dvEra. i3 uLwtul- ed .h.ll obir1 e orpbF to ciBirl po.ni. &d .ivil 616 !p ro oE hud,ld rhoBld &llrt (llm.ooo). in lldirion lo {r coi ol @EF!.rio'! drD.aâ‚¬ ! F.vn.d for tn sdrion 10?6 of inc Ubr Code in'6d drd ibrEy s f6 7/zt / z- ,-t lrl ( l.\R\llrr\ t h6cby .mrf, und6 pduty of Fju.y lhli I d liGs.d @&r Flvirion of chlprs 9 (coMcins wirh sdbn 7000) of Diyi3io! l ol th. BciIB dd PDf*ioB Cod., ad fr, lru& i. in tull h@ !d dr{t colualcuo!.rElDllslcElcr I hdrt'.ffm u!d6 Fultr of prjlr, '.. tbc ir. @nrrudior lsdioS.8dy for tlt F6ffi. of 6. wl b, *'ltth lhi! FDi i ieEd (sc 1097. cir. c.) L.,xla r Nlm: - AfIUCABI.DECIJAAII()! I hauir rffm undd po.ll, oi Ftury on. of rh. follo{ ing dcl-alioro: l}mubn Pdi3'Arh6rc Norific.lon F.dd.] RcsuLlbN (Tnb {0. P.n6} _RcquiEd L.lld ol I',rotifi.dion I cd'ly fill rh. LrlsJ r.suldioE r.ssdus sb6lN rorcvd e. ior qPliabL ro rh6 PtF -l .drra, rht! I ha!. Ed tnis rpplE.r.n !d Irt. $d lh. .bov. inaornnion it co,d I lgc lo onply wnh rll Cny .nd ( ounly .i rh,r ('it ntr(t (i,unrt ().nrr uEln rhr 4 t/ulz<2. Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground v SLAB Floor Subf loorA/enUl nsulation Roof Sheathinq Shear Wall Framinq lnsulation/Energy Drywall Ext./lnt. Lath Brown Coat Masonry Pool Fence T-Bar Handicap Req Deputy Final Report Enqineer Final Report Flood Zone Certif. FINAL 6-1.2t 1 *Q+L Certificate of Occupancy Notes, Remarks, Etc. *