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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS O\TNER BUILDf, R DEL('ARATION
<br />I hsrby anid undd p.n lly of pcrJUD_ rhd I m .ropl tum !fi. Cof,lr&1o6 LicN La$ for lh. foUovirs ragrn lss 70.r L
<br />Boi.6s ad ProlBion aod.): Any Ciry or Counry *hich r.qun6 a pdnir lo sBrtud, ah6, inph!., danolirh or ,:tu My
<br />srudo... Fror to ns isuec.. also tulutrd rhc arplictur tor such tsmit k, fi|. a 3ign.d srd@ot ltut hc or stu n licdial pBus,rt
<br />ro rhc pr.viebN of $. Conto.br3 L(.nrd t s (Chdpr6 9. Colmtr uB srlh Salior 7000 ot Dn iion ! oa rh. EGies ed
<br />PmasioB Cod.) or thd lE o. nr ii .rmpl tha.fron drl lh. b6is ror lh. .ll.s.d .r@g ion. Any rioldion ofsdion 7l)11 5 by ey
<br />lp?li€nr for . pdnn subrds rhc arpli.dr io . .iral p@ll, r f nor mr. rhr n\ c l'Un lrql dollrrs (tt00)-
<br />l.so{f,6.lihcImFny.ornrydnpkryGMlhwaldsli.nFL$'nl.!.rio..$ilddrh.*{lItd'h.*Mu!$Rn
<br />oroddl orofscdlorelc(sd7or4,Busind d ProfNionr coJe Tnc (irnr&lu s l]car law dd nor tpPl' 6 M d*nd oa
<br />thc F!p61y *ho borl&or iqhiv6 rlEEr. dd sho d(B rch wo,t hinB.lf orh*laorrtNush hir or hdowndpk,t.6.
<br />pror d.n tnal $.h inFo\.6Ml' m ml i,ndxLd ofiqql lor eL. lf, hoM, fi. tlildin3 or irpotrc as sld wilhin on. )d
<br />oaco,ekriotr lh.Osnd B{its \ hlE rlE hrd6 ofprovins $i h. or sh. drl ml t{'U or oFow $c FDFy fo! dE prrosol
<br />l. as o* ns orrh. pnrp.ny. rn .(.lust elr conradfr $ n li.ded conri.k)n h (Nrud rn |, (r(r (s( 70t.1, Ilc$6r
<br />itrd lh)f6sirr (i'dc: l'h. Co.kiclors I (cnse I aw doN troi ,prly t' u .Nnc o r tmlht *ho boil.jr or imprev.s lhsdrn.
<br />nnd \ho cofinrts f(tr strch p'()($ sih . cont &trls)li(d*d puBmnr i,,(E( onl.ackn s l,iccnsc L.w)
<br />I e.r.'np undd sdton
<br />Drrc osrcr
<br />\\r)R(Ins' ('ol\i PENs,n nor
<br />DTq.AAAIIOT
<br />I lrr.t! rlfrnrtrndd ltnrLtyolpsjuy.n.orlh€ foll$rnu d(le ons
<br />I h.v. ast *ill mainr.in . Cdif{sr oacolgr ro s.lllsur. lor *ort6 conpoadid. s FDvkkd for b, s6rbn !7o0 .f lh.
<br />llt.r Cod.. lor th. Ffolll@. otrh. {ort lor {nkh rlE Fmn ir is.d
<br />l hrv. md s n l m!'main \ ork6s' co,nncEalion irur!n(., d r.itutr.d ht S(rn)n 1700 ol rft l.alrr (idc. lor th. nqn)nnDc. of
<br />!h. *o'l lor *l'(hlhtsFn EEu.d M'\orl6s'.omrdid'onNUiM(.csrcudpolic
<br />(md *-+<- CaUI 6,.$crfr-A 1t,^,,,,n^*eL!7/o/ ,rpu6
<br />1C,
<br />3-g'z<'L Z
<br />I c6lia) rhal in llE pstomncc oflh.sork ror shth rhi. Fmh i. Lrsuot.I slull ml mplo! my pqsn inuy m nd
<br />$ !r ro bcdflc subl(r Id rh. so*6d (omFMion h\$ olcallom'e ud a*rc lhal if I shuld b..omc aobjdr to rh.
<br />lvorrm.onrpos0rionpmvilions.lS6tnrtrITcrOoirhcIihorCodoIs\all,nrnhs'lhconplywilhrhrspbviioB.
<br />\r,\RlIll(; IiLltr'( r, s(..u,( \\i'ld\ (nnxrMltr,n (n\.'rrc s unh\1tr shall slbicl m Ennlo}lr lo ciminll ljsElr6 &d
<br />cilil finG up lo otrc hun&.d lhousnd doll,B (5 oI co,np.Mrnnr, dnrorB s rrorid.n tur rhc
<br />SdFr 10?6 of rh. bbr Cod. i sd ed dro'6i3 fc
<br />oZ\
<br />I hdcby afll6 undq t mhtolp.rjlry rhd I an licm*d ufldr p'lrision olChapldI (co'nnocr.s with Sdion 7000)ofOivhion l
<br />ot lhc llusrKand lror6oB Codc, a, 6] lic.e's m lull foi..,nd.lTar
<br />r**."* K - .
<br />n,,. 5z>C ^2e4,.*,6 a
<br />CAINIBIICIIANITIDIIG.6CIBCI
<br />I ha!t! lmrn lndd FBIy of Fjury rhd thd. it a @Ertud idn laiin! .!*, ror ifi. Ffffi. otthc $o* to, q hich lhb Fni i,
<br />issud(S< 1097. Cit C,.
<br />ATELICAILDESAEAUIA
<br />I hdtbv !$in !nd.r D6t.hy of pdjuiy o* ofrlE follo*i,8 (kcbrnioc:
<br />Daroftion Pdn!-Ast6los tlorifr.db. F.d6al LgulrlhN (Tnb 40. P.n6)
<br />Rcqut.d tllrd olNolificdioi
<br />-l
<br />cdriry rhr fi. f.dd.l (guldioB r.gdnB dbdo! @vrl r. mt sgrlic.bl. ro rhir proi(.
<br />/ t *iry ru t t "* '-a rm" opglt bn.d n,lc $r. rlE.bov. inrordion botrBr.I lsc ro oiply wnh t[ ciy Dd counry
<br />o.dmnis d sratc I!trs rcld13 1., tu'ld o,! dd ho.bta hort. rqrMldn 6 of 'hb(iry ud Counryro dr6 ulnn lh.
<br />iLr.moron.d lk)lxny lor
<br />A[pli.rnt or ,\Bcnl Shnnlur.
<br />I(nirenrnk (prn t: z-e So4 Ea t^
<br />5-Ze ^zaz /
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUl nsulation
<br />Roof Sheathinq --o
<br />Shear Wall I b/t7/r)ffant
<br />Framinq ({/7/2/efu//
<br />ln s u latio n/E ne rgy
<br />Drywall I r'rye{0turu rd
<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 />Flgod Zorle Certif tt /2warub/2214 O?ty'tn VfrV.a6vFINALVs/)r -M:zd
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />ME
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