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BUILDING. INSPECTOR RECORD
<br />SITE.WORK COMMENTS OWNER BUILDDR DEITARAIION
<br />I h6.b amlm urd6 F.ahy of p<jurt ltul I d .r F from ln. cotudoB' LicN Llv lor $c rolbwins l@o (S.q7o:ll.t
<br />BN6d !d ProfBi)n co&): Any Cnt or (-ody *nEh r.qoic a pamn to connrud. slld. unFor., dr@lln or ltp.r uy
<br />rltudu. Fsr to nr isNq .ko Equc lhc 4dkd tor such pdll to nk. $slEl ,cmt lh, lE or JE it licsE d pusunl
<br />ro rhc FovEn,G ot tlE Cont&roar l-s.nral tls (ah.prq c, CoMos vnh Sdb. 7000 of Divsion I of thc t BiB ad
<br />Prof.s$tu Cod.) or thd h. oi 3lE i q6pr rhEciio ad ttrb6; for tn..lLgdl.rdFion AryvDLli.nolscliotT0ll.tbtoy
<br />arplic&t lo. a Ff,ir $bcri lh. $?li.mr t a civ il poahy ol nor mr. thd fiv. hutr<t.d &lld (l5m)
<br />l, 6 o"rE of rhc pr$Fty, o. my mplotd *nh w+6 ar rlEn $b ssFEni'n, rrll rb rh. sdt ad $. n ulr it Nl
<br />,dddal or ofi.rd aor xlc (Sc ?0fi,ItuiBod P6l6!irB cod.: In Coflr*1oi3ljcce Irw<rrd.or 6pPlyto eow of
<br />rh.FDpoiy whd hril&.r in{mE lh@r !n \ h dE sh wt him.laor h.*lfor
<br />'hrouBh
<br />hn ot tE oE 4Pby..3,
<br />Fovllal rh,t $ch imFovdEr! e ml s'd.d or o,lb.d for sle Il ho*oa. rlE bUdn'g or inrF.vdr.d L! $B *rhi. w !a
<br />ol.otrlplr@ rlt olrc B!iH6I hr\t rt! hnkn ofp'olu* !h, rE o. ih. dn d hild or irF.otr dr Flrdry 61 0. Flro.of
<br />l- 6 orrd of rh. Frrdy, m.r.l6i!.b .o rdins rnh licdE n co.'lB1o6lo o&<tud rh. Fojd (S* ?04.1. tsGus
<br />Mn ftoE$M Co&:1hc Conrrxrorr Lt.@ Lrs rtoB m! rFrly 16 M om6 of lmpdy who bundl or 6pova lhd@n,
<br />dd sho NdBl! for tuh FoFi wirh r CodEdonr licoB.d p6urn brb.Conrd.ri Lkru lts)
<br />I @.rog lndd sGrion ,It &P.C lorlh6 r6$n
<br />Ortrr'- $oRIiE[s coaiPttrs i'oN
<br />Dicldf,alloli
<br />I hschy a,fim u.dd FBh, olp-Jut orcolrn. folloaltt3 d6lslnoB:
<br />- I hrE drJ tr rll mri.!a'n r c.n rncar. olconst lo S.lr'lNrc tor sorkd soF$, io[ a prodt d for 6, salhn 1700 ol lh.
<br />I lbor Coil., for rhc pgrolr@cc of rh. wo.I lor *tth th. Fmn i isal
<br />I h.ve and will ruinlsh *ort6 onp.nsll ion ruuffi.. 6 r.nu&d b, Sdm 1?00 of th. L{h.. Cod.. rd th. FIQlrre. ol
<br />rh. qorl for *hth lh! Fhn i! isrd. My *o d .uDoE r,oo imum.. (aiE ad polty numba a.
<br />c"i,.r?,i1. a'..,1 1 -..,- -. -.-
<br />11:1 2e.&Jhcy Nunbq 1o <l :-AlZ ! !1!:l
<br />I cdiryrhd in rlE Ftr'llrffi. orrlE rort tu*h'chth'! psmd ts so.d.l rh.llml6Ployey ps$n i, uytu6
<br />5 al! b.o@ lut <r lo rh.h*d compddion Ls of( drlomi& rd.srlh.l if I lhouB bdoft subrEt ro rrE
<br />u'orl6 smFer'on tmvisroN of Sdioo 1700ofth.litor (ode I JEll. fonh$ (h oq)ly wih
<br />'ho* Pror610B.
<br />waRNlltc lolu. b suc sort6'cotrrFsdan ovrssc ir bhwtul, ed ih,ll sub.d d mptoF ro aini!.I FrfB &d
<br />cilil lin.r up ro on. hundEd tlDusd d{ll6 (1100.000}. m rdJibn ro rh.ror. ddnssd a p.Nrldl l rh.
<br />sdrirln 1076 otrh.linrold. 'nrEd d'nl
<br />",'.,41.>/>t
<br />DlCld8AIo!
<br />I h@by rrtrm un& psdly of Fjur) lh.l I D liGs.d u lq lottn olch,t{6 e G!flnmcirg s(h S<li,n 70.J0) ol Dirilhn l
<br />ot llr &Bind d Pr.f6ioB Cod., !,n my lk* B in fuU for. ul.,Id.
<br />l(@clA$ lal =P5+
<br />o"" -lAfolzt "*'
<br />r ,.*. x,.toj 7:a oa lo
<br />t onsrlur.ttor LrtotrctaceNcl
<br />I hdcr'y !{Im und6 pdDny or pajury rh! rhe B a mn rucrion L"dins asdy for tlrldaoll'e. olrlEutl tu ]tfth thi lEsn B
<br />if,ru.d (s( 1097, civ. c )
<br />APPI ICANT DECI ARATION
<br />I h6dD 6lt-m !ftld ,6!lry of FJur' on of rhc follo{ins d..l,.rEN
<br />l)onolnon Pdmirs-AitEtos Norilic.tN. F.d€.1 R+uhtiiN (l nlc.l0. Pd6)
<br />R.quElj ldt6 of Mnitu.l.n
<br />I .dlb thd th. f.ddnlr.suLhoB rcssdiry 6b6ror rtuv.l d. mr +dk5bk ro ths l(J.d
<br />I cd il,! fi! I hsvc rca! rhn applaar on lrl nd. rhd rh. ahor. mfomain
<br />ordilrm6 ed Srar. L.s5 cldilu ro boildinr cordru.rion dd h6$y rdh.r,c
<br />n uoncrt I lsrr b smpt wnh dl ciry rid Co[ry
<br />r.F6ddiv6 ollhn Ci, .rd Co! y ro .nrr lron Ur- -," 1L,-41,-'--
<br />Set Backs
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subfloor/VenVl nsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framing
<br />lnsulation/Enerqy
<br />Drywa ll
<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 />Flood Zone Certif
<br />5"'l-ah-rq.";F ?LY,V b'q-2)r),L\t)
<br />FINAL 6-c I tr,w\t)\
<br />Certificate of Occupancy
<br />Noles, Remarks, Etc
<br />J DATE ID/SIG. i
<br />Forms/Steel/Holdowns I
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