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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS O1VNER BUTrI'Ei DEl'ARATION
<br />I h6.by.lIm un& Fdry ol Fju,.r 'h. I fr d6!F 6!m $. Corr.soB ti.dg ljw aor dE follosin{ r@, (Sd.?01r.,
<br />BB,na r.d Prof*ioi Codc) Any Cny or Cour[y whnh ,.quc i Frir ro @rrtud. ato. inprovc darclirh or tq.r uy
<br />-tide Fbrro irs isl,lft,.L E+liE
<br />'rE 4plrE for sch FDn ro 6Lr3@.dd6mr firllortEitli.d.d ,l,rrd
<br />ro llE FevlioB oa lrE ConrE u 3 Li.a!.d t w (Ch!f,d 9. Com*ng wnh S<iion ?000 of DivirbD I of ln. auila &d
<br />Prcr*io Co&) or th.r lEordE it crdpi lhstntrm dd fic b.sis for tlE dL8.d qn/br. Aryvioldionofsdhn?011.5byu,
<br />_ lgrl(d for. Fn tubrdr ln. .rphcrd ro . or il Friy of mr mE rhd fir. hudld doll4itioor
<br />' lJ .L)
<br />-:++ a ow of lh. FUFty. d ny srghyc qh w.a6 s lt.n,E @mp6Eihn. *i[ & ll, wt td tlE erlE ir mr
<br />ddi.d .r ofiq6.l atr.L (Sc 7ol14. &d,6 Dd FlLsba Cod., TlE Comrrort trqG Ln d6 d {tl, lo D o*E of
<br />rht rrDFty wlE Ulild or inpoE tlEEr dd wll. dc ru.h w him!.laor n laor
<br />'hmu8n
<br />hir or lE ow.npLyd,
<br />F!vii.<t thn Mn irqmE .d! rc d iidrr., dolH 6. eL. lL lb"l€, tlE hrilding d i{ rqrE ir$ldvitnm rc
<br />of cotrpkinl llE ()srs tuildc *in h.v. dE hdd ofFoliie nti hc o, !h. d( @l build or in'FDw thc ,rDFty tor tt Frpos of
<br />-1,
<br />a oM6 otrt€ Fopdy. m.klurv.lt conrdl.{ eirh lE.Md.odrdon t'.odtu.r t,E Frjd (Se 70{4, q!in6
<br />.,n A!lai.. Co& Th. Co.k-lor'! 1.i.6* Irw &6 @r rpflr ro 6 oss olFoFry who b{ikl or iipov6 rhqar!.
<br />d who conrrss lor such Fljat wnh. co
<br />-l
<br />@ .rcnpl urdd S6lion-
<br />hcms.! purswr tu rhc ( o radoisLrcMt r)
<br /><^,, 4'2'7-2 t
<br />PECIIBAIII}!
<br />I hd.by rrtrm onds ,.nrxy of rojurt onc otlh. follo*ins ddl&arioB:
<br />I h,v. drl { ill mi rin . Cdifor. of Co.sr lo SclalBur. for erkd onpsadion, a Fvit d for by Sdrion l7O0 of th.
<br />l,b.r c.d., for $. p€lo@c. of rh. *orr fo' whtt llE r,6an a Eu.d
<br />,I harc .nd will hlrntlin wo.t63 compddtion iN!Mc., a Equircd by Serion l?00 oaih. L.bor C.d.. for ih. Ftol:llE. ot .
<br />lh. trut ttr *'h*n thb Fnn ir isrd M, sorl6 .omFuiod 6urmc 6ir !d polk, nu6bd c
<br />Poliq Numbs:-. - ErpnB:ao-
<br />!.tLlcolify 'h{ in th. FfolM. of rh. *ort for *hi.h tht Fmi n 6u.d. I slull dor dlploy uy pqsn i! Dy meE
<br />s ! to b@r stiu ro th. *!rt d'gnFlrbn LB orcrlafo6i...rd qE th. if I iDcld balG $tir.d ro rlt
<br />6itd'@rpaob!Flvbio6ofsdtio!1700oft trbo. clda I .lull ronh*nh @od, wnh &oc D.ovi!b6
<br />$ARNINC fsilurc tu Eu. wo 6J comp.Mrio.sh6ll 3ubler s mFlora ro siniMl FDii. &d
<br />ctrrl fin6 up lo oE hutd,.d rhorsrl dolla (rl of corrFMion. d!r!r6 6 pro\ij.d lor th.
<br />sslNn 110T6olllE l,htrCodq inlrd ud
<br />(,.q-zq -Lt
<br />It( F.NSID ( ()NI',t{,t( tI)R
<br />lug.!&u!o}
<br />I h@by lrm und( potrhy o f p6jlry fid I m liEE d un.Lr Frvllbn of Chdpla 0 (onrccing wnh Sd ior 7000) of Dililion l
<br />of ln. B6i,B ri PrnasioB Co<!. ard 6, lr@ . i. tull foc dd.rd.
<br />COIiIA]JCIIANITBIITC.dCIN(I
<br />I ha.t, llIm u.JG FEII o f tsJur, rhll rhqc ! a codructi,n LndmB alfty tor rh. Flolrr@. or rh. q o lu}h(hthEFnn 6
<br />a&.d (Sd 1097. Civ C).
<br />LndB r No.:
<br />-
<br />dITj.ICAILDECIJIAIIA
<br />I halby rlfm ur<la FuXy ot Fju.y oc ol th. tollo*i.s d<LdioB:
<br />Dcmohion Pmnr-tuheto! Noxficslion l.dml R.3uLt ioN (1 nl. 40, P.n6)
<br />Rcqurcd I,itd of Nolr,icdbn
<br />a!6ros rnDr al e mr .prli.abt ro thir Fijcl
<br />.thd
<br />'h.
<br />dorc hlonMlFn i!cn.r I!3r@oE ly u,nh lll Cny.d Coul}
<br />d hg.by aurhortc rcp.MraivB oIthir C'ryud Counrylo
<br />-z/
<br />ab.v. m6ro,.d pNId! aor
<br />\ P.milN nrmr (prn l:
<br />1., urt
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground t
<br />SLAB Floor
<br />Subfloor/VenUl nsulatron
<br />Roof Sheathino
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />FINAL ?-/a'a ll-ts a41oSaru
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />tlrl b
<br />Brown Coat
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