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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNER BUILDIiI DET.CARATION
<br />I nd*, .lTm r&kr pdEl'y oaFJury rhc I m d F 600 E C. rrloB L..@ rrs aor rlE fouo$ft8 'a$n (S6.70:ll.J ,
<br />Itu!863 ad Profsion Cod.) Any Ciry or Cou y whth tqri6 ! Fnil to on,ruct, !ha, inprcvq damlish or EFr oy ',
<br />3rtucrue Fior to ! inu4., ato rc{uir6 $c applicel for such pdr.n !o 61. ! rirn.d ndordtr rhd lE or rlE i lic6B.d p6u.in '
<br />to llE FovtioN ofdr ConE&loar Licssd L.w (Cn!S6 9. Colmeir8 $nh Sdrio! 7000 olD'vn{n I of rh. SsiB ad
<br />Pmf6ioc Co&) or rhd lE M iE i! acnF thd.trlD dd rlE b.!t fot dx alLgod adnFion. A,r, vi,hio. of Sdbn 701 I t b, ey
<br />arrk.r for . Fnn $bj.tr! rL .r?lker b r.iril pd yof mr mcrh& 6v. hu.(H dolla (t5m).
<br />l. a ow of rh. FoFly. d my trplo,€ qnh $rs6 a rhcn $h 6mFG.t'on. sill do tlE "$I nd rE !trrEic B tu'
<br />inrdj.d or oFs.d fot rlc 1Sd.?044. B$DB Dd Proa*bN Cod. Tt ConrrElois l-t6& Lrw &6 not 4'ply ro m ohq of
<br />rh. Flrigry who hild! or i!,F!v6 tlEFc !d who do6 ruch wlt niE.llor hEelt or llFush his or hs oq d!rloy6,
<br />providd rhar su.h inFoffi e mr idaLd orol&d for sI. l( howd. tlE blilliir 6. irqr*._.mn n $E ehnin or ra
<br />of.orplibl\ rlE OqE Aonda wil lw. tl! hrd.' otprcvi,{ l,( lE or dE did Er hild m ilsoE rh. FoFty tor dr FrF.. of
<br />I, a own6 of rlE Fopdrn m d.l6'rl, coddins *nh I'c€Bt.otu&ro6 !o @trrtu i rrE F.jdr (sc ?0{,1. &@6
<br />.nl Plli.se Cod. Th. ConlE toit l.'cd€ ljp tto6 mt ipply lo d omd of ptup61y vho blik s or inprev6 ths@n.
<br />and who conhcr! for ch Foj.ft wiih r Co.rDdo,l, licau.d pd@r lo rh. Conradofs LiccM lr*)
<br />I m.rdF u.dd Scrion _.8 &PC h,fiBlle..
<br />D.t. OrE:
<br />laaf,E8s:lAlrrEBtADq!DISJAAIIQ!
<br />I h6.by .rm und6 t6ahy of pdju.y orc ofrl'. followi,8 delnrioB
<br />I n v. E d will ruint.b . CqrilErc of CoMr ro S.lf-lNlE tm srt6 orF!.rhn, 6 FDvid.d tu. by Seriotr l?00 oafi.
<br />I ibor Co<lq aor th. pafollMc o atlE Eit for *hi.h lh. Fh, i! isu.d
<br />S hr\..rd E'll m.h,i lo*e' .onp.M6n lsi,l8., s r.qunqj !y Scro. lTOo of E t Dor Co{t . fo, rtr Ffollrs. of
<br />th. mA lor *h(h !h4 Ffrr 6 e.d M) *0.16 ontpoE rn ,M. .,r {d Flsy.dbd G
<br />c-t,, Tlziv€LAnS PMP6^- C.ISV{LTY C O ^^?,Ni c h^4U\L( ,L
<br />t"tt,x"_*, \) bSLglgbj ?l zt K,,,,- q | | I 2-o2 L
<br />l9.or,ry rr,.r . rr" p..f.*. olrlr s'orl for *hih rh! FBn r eEd- I .l!ll 6r dtrploy &, Fen 6 6y -e$ 6tob@@st*t1lotlEh 6 orqElaioi hq otc.lifomi/\ dd reE rh. irl3lblld b6oft.!bjd to dt
<br />sn6'orpoBdio.provi.ioBofsdio6lT00ot$.t !., Codc. l .h.ll fonhsth.ondr wnh rhor FD6ioN.
<br />\TARNING: F.ilu. lo su. wrka comF@rio. @vd!. i! unLwtul. Md shrll subjel e @doF io oimin l Ftrlria od
<br />civil find up io oE hundr.d lnoMd d.rllm (llm,ooo), in addnion io fi..or of conp.Naliotr d,Mgd B Flva.d for rh.
<br />Sa'ion 1076 or'h.lih.r Code hrcd {d dbdy s 'ks,+ga wnf1lGEly!^,,,0q/oJ lLo )- I
<br />Ltcr,Nsbt (oN rnact oR
<br />DEO.6EAIIA!
<br />I hftby,JIm ud6 p<nlhyofpdjury rhd I o lica&d undd ForBon ofch.pro 9 (.omocing lh s.<1ion 70iJ0) oiDivirion 1
<br />of rh. asins dd Pof<iocCod..ud nylic@ B in tull foG ana.n(r
<br />..*cn bczo c3bctotr*- o*!*y 1b35YC
<br />I os /o 11p] I CN 0NeE94lo.1
<br />I nalq .rm mdd Ftshy of Fjlry thr IEC ir r odtucrbn lqxliru .e@y for th. Ffoll@. of lh. wrt 6r *iih fiit Fhi i]
<br />e.d(sc. 1097, civ c.).
<br />tfttl(ANfDEclaaAua!
<br />I hod, rrm unda FrXy or pajuy onc of rh. folbvins d..Ljlbc:
<br />Ir.mlirDn P.Tnv^rh6lc Nolificaion l.ds.l RcsuLIioB (Tdl. tlo. P[l6)
<br />Rqurtd l.ls otNori6.di,
<br />I cEtiry lhlr th. f.ds.l reuhlioN ESadinE abBlN roovd e nol appltlblc lo lhi! ,mj6l
<br />]aI c6rry'ha I tE. rdj lh! lpplirlFr.rd n.rc lhsl r.t v. bloridbi a coF6l I .sE ro @Eply wih .ll City.!d Cou y
<br />ndfur6 !d Sld. L.s Eh"B lo hrldus conocrFtr dl hatuy ,!l'oriu rcF6drE6 of ltn Cny .!d Cou.ry ro 6rq r4on rtr
<br />$or.n6r6n d FoF, for
<br />,\pt,Uc*[ or gml Sitn.tur.
<br />fr\Ctt!q 4
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUlnsulation
<br />Roof Sheathing
<br />Shear Wall //\
<br />Framing Pztif D*(:rll
<br />lnsulation/Enelrgy \a1
<br />Drywall E-n-a Mh.h
<br />Ext./lnt. Lath \7
<br />Brown Coat
<br />Masonry
<br />Pool Fence 7\,
<br />T-Bar 7--tr2--a VIL:f.S
<br />Handicap Req.<-t \Y
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />.A
<br />FINAL -7-2/-al YIL\I
<br />Certificate of Occu n
<br />Notes, Remarks, Etc.
<br />9-\g-A; Fixmtub cK
<br />-,.oslo1l7.0zl
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