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BUILDING. INSPECTOR BECORD
<br />SITE.WOHK DATE ID/SIG.COMMENTS OWNER BI'ILDET DELCAIATION
<br />I h.mb, arrn und.r p.n.lry or Frrury ih, I m.ftftpl liDm lrE C.nlrclm Li.trE L.u for llE folk*inr u5r lsc{ 7011.5
<br />Busirc$ ud PDfcsion Cod.): Any Ciry or Counry whth EqliEt ! Frmir ro mnntocl altcr, ioorow. &mllih or EFir e,
<br />rlcnm, Frr lo nr L51ju.. it$ r.qliEs tlE rl,pliul for uh IEdi lo nh. ri86n nd.moI rh,l rE o, nE i! lt.n-d Pur:ld
<br />b rlE Fsrn! or dE Conhrd! Li.nrd t w (Chrrtd 9, ColtErins * Salit. r(xD of Divilbn I or ft. 8uliEs .,!d
<br />P,n6'ir.i Co<k) d thrr lE d di i!.!cr+ rlElnon!d E b.iis td rlE rlk8.d .Eqri,n. Any virhlbn or Scrb. ?01I J hy u,
<br />{,Flic.nt ror r Fmil subidr rh. .pplianr to . civrl p€rn, ol ml mE $$ fivc hutrdEd {blLn (tJ@),
<br />-1.
<br />sr ouE of rhc nmll.ny, D ny .mnlotr{s enh eeB.1 {r rltn $k onlltn$rion, *ill &r rlE wk ul rh. {ElE is ft(
<br />i.r.nal o. of.r.d lor sb 1Se.7044, BusiE$ id Pr.f.sioN Col.: Th. ConlEld r Li.n* L,* &Et mr rprly ro e o*F o(
<br />rlE FbFn, wlr, hildr or intm6 irmtr an *b d(B rrn k)lt hin€lf or h.&lfor dmuah his ( ts o*r.rlployc.
<br />pmvii.d rh.r rEh ir{mwd! e ml ir.nLd d ofisld 6r sL ll hotG. tlE hrildiq m i,Fot!full i! rld tttin [E )g,
<br />ol @nDl1i4 rli O. rr Build.. wi[ lrr dE hrd.n of Forii€ th. !r d {r dit ltl hriu d irFE rlE FitEry fd dE FIFF or
<br />-1.
<br />&s osr. ot rh. IroFny. rn .r.lusivcly coohd h8 wilh lianrd codr.cioB ro conlrdcr rlE Foj.rr (56 ?O14, BNrm(
<br />.rrl Prlt !i{ Cdi.: Th. Cohldroir Licn( lr* ddr mr rpply ro n owRr or proFn y srb bril& or imrrcws rh.rcon.
<br />.nd utm L! dr rd sh rmi\1r vith r Co ra:ro(r) lhnsd pusulr ro rlE Co rrrq\ Lire trw)
<br />I r crcmpr udi.r Se'i)n D & PC n, rhn rca$n.
<br />t.lc: O*n.r:
<br />woRKrust()nlPl.,tsAT(rN
<br />DECIAIAIION
<br />I herct'y .mrn !n&r tEdky ol Flury om ol rlE (,ll*in3 rL.LrdFN
<br />-t
<br />n rc r,t will minrain r C.nirErl. of Conrnr ro S.lllNE lor wt6' or{lnnrion. E prDvirtn rd hy serion 3700 or rr*
<br />Libor Cod.. tu
<br />'h.
<br />pcno.Mc or rlE wort for which lh. Fmil i. issucn.
<br />_l haE.d srll minrrin wort. corryrcnsti,n nru6r.. G 'rguiEn by Salion l7(x, oa rh. t hor Co&, fo.lL Ff(llrr1.N of
<br />lh. wt ftr rhih rh! Fmr i! i.Ld My sct6 &ntE6dion inru,u! @ir rn rbliy nunirE e,*, SLh Coqrt iu|'
<br />,"-t*J-
<br />I ftnilr rhi in rr. FrforrN ori,E wort rq *hih rnL Frnir i3 i!ru.d. I srull mr .npb, sy F$n in.ny trum.
<br />- a lo h.om rubF lo tlr $!t6'of,FNlbn Ls of Cnifomn. .!'d rrE lh.l ir l {ouu b6om {bFl ro llE
<br />h*6 of,{En..rrr p,ovBbrs of S.clbn llm of 0E L.ts Cd.. I rldl ,onh*nh mnlply wirh lhoi lfttni,N,
<br />WARNINC: Frilu,. ro sE *ml6 @trqE8nbn owrs. ir lnL*tul rn<l dBll {bFr u crplo}4. ro 6inin l Fuiir. dd
<br />civil fims ur ro orc hundEn rhouiud dollss (llOO,O00). in addnion b $. cosr of.onrFnqrion. drm8.i .. pbvid.d ln rlE::a/',tf
<br />l:IrAKUllll
<br />I hcrcby afilrm u ls Fnilry ol Frlury rhd I rm liensl urxls Imvntu.of Chaplq 9lcomftmin8 wirh Sc{ ii,n 70@} ol Divnhn l
<br />ol rhc Borimr\ lnd Pofc*ioor Cod., ,ld ny li.cn* it h ruu fr,rc. drl.flirr.
<br />CiIIEBICTOffIEDACICEUCI
<br />I Edry.,Irmlndd Frlyofr.r'ryrhd rhn i.r 6ntub. Ldina rlEry fd rlE Ffm oltlEwi lor rtit thn Fnl it
<br />iisrd lsa. lO)7, Civ. C.)
<br />AfIUCANLDECIJIAIIO!
<br />I ho*y rtrm ual€r FMhy or Fliry oE ol rlE aollo*ing &.Lr.]ioni:
<br />Dcmlirhn P$nns-Ashc(or Noriiic{io. F.ddll R.8u hrio.r (Tirk 40. Prn6)
<br />-RcquiEd
<br />Itrr.r of No{ifr.rion
<br />I diry rh,
<br />'lE
<br />foLnl F8ul4i,B Eg.dn8 albc{Ds rcmr.l e m' .ppli.bL b
<br />'ht Ford.
<br />I diay rhrr I luvc Ed lhii rFll..lion $n nar. rh.r rh. lbow innnrElion i! corE{i I r3re ro @mply eaui .u Cny.d C.unry
<br />ordiEft.! rn Sr!r. L.ws EhrinS ro boi[ins con rudion, !n h.Eby !ur,Di& EprEEtrr.riwr o,lhn Ciry..J C.unryro.nrd llbn rlE
<br />nlr)vc rtritrnr.,l frutrnyld r
<br />".-U* -..,rnr,,2 Iu
<br />7/4?,
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathino
<br />Shear Wall
<br />Framino 4lzslz,
<br />lnsu lation/Energy tl
<br />Drywall r
<br />Ext./lnt. Lath
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Fleq
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif
<br />FINAL 112". L,
<br />Certiticate ot Occupancy | 'l
<br />Notes, Remarks, Etc I
<br />UFER Ground
<br />J)?-
<br />Brown Coal
<br />,hK
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