SITE.WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns 2.1 - t7 J,l"!."(,a?D
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loorA/enVlnsulation
<br />Roof Sheathing 3lzt lt,l\1\, #3f Gp R-.,{,,-l-
<br />Shear Wall (/rr,/1'7 iltl/ i r.t y'Evi,w t* lvttll4
<br />Framinsd'5 hilb[i,DW
<br />lns u lation/Energ y r ltr(t7 ,'/&( /r)
<br />Drywall
<br />Ext.tlnt. Lath fu( 4a(-'o/1A/l?/ t.'r,eLf- rr* lln'ttu-A
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />n-&k{r.d ,lLq6/t7 l.D.bY
<br />FINAL rq "9lb s.at tLt4At <'
<br />Certificate of Occu pancy
<br />Notes Remarks, Etc
<br />-BUI ING. INSPECTOR RECORD
<br />or\ Nt:R al ll.t)r.R t)ut_( 1R \ I ()\
<br />I trchy nmnn undd p.allly ol p.rjury lhal I d. .r.mpl lmrn lh. Conka.lou Liffi liw for lhc rolbsiry r.aq\. \h r(rll 5
<br />Ittrrn6r ud P(f*'on Cod.) ny (\ry or Counly whth r.qutr6 a p-nn ro .onsrtuc(, alr6. improv.. danolish or Bet y
<br />slnrclu.. Fior ro n! isuDc.. .Lr. r.!un6 th. ippli.dl for soch Fnnir Io 6lc a shn.d stalmdr rhd hc or shc is hcer.d pursinr
<br />h rh. Forisi.6 of thc Coir8lor'r l-iccn*d Ir* (ChlprF 9. Conrndons \vith s..rion 7000 of Dnisio. I ol rhc lrBin* ed
<br />Pn'fd.n'n! ( .d.) or rh'l h.o,shc ts.rofl rhdctonMdrh.bot lor rh. .14.n .ranpl ion ny violdion of Sdbn 7011 5 br sn,
<br />apllic. for.Fmnsubj*srh..pplic.mto.cnilp.nrhy.lnormor€rhefiv.hundr.ddoll&s1t5(x)).
<br />L ai o*hn of rh. F.Fny, d ny mpkJyc *irh $aE6 s rh.ir el...nFeiion. rill(h rh. $ort sd lh.iMu. i! mr
<br />int6vi.d or o ll6ai for sL ( se.7o44. BBinc Md RtrfdioB Cod. Th. Conrodois Lica* t$' &6 nor aprly lo m ourr or
<br />rh. IrrtEly who hikk N nnFor6 rh6o.. ed s h. d(B sh ull{ hmrll or h@lf or rhtuuf,h hk or hd o\ n cnrpL! 6.
<br />provid.d rhrl !trct iDFovoEi. e mr hidxlcd or ollsln ao, eL lr, ho\'h E rrE h rinr o, in{ro\ ffir E $h tr irhin nn. ta
<br />ofcompLliotr lh. ()"rd B{ikj6 "iU h!r! lh. hrddr ofF.rug thd h. or slE dil ml hiH tr itrpmr. tl'c propqt} ior lhc pitrlx)s of
<br />l. Bo*E ofrh. Irlpdy. m.lclsnclyco rdns u'nh licff.d co.rBdoB ro ennrud 'ri Frjd (se 70.1.1. &6rns
<br />lrl Arftsin cod.: Th. co.tmroi! Li.6r. Il* do6 mr.r,plr ro so$n6 ofFoFny $ho buil& or impo6 rhq6..
<br />lnd qh. colrEr! fo. u.h F$F! unh r Co E rorl,ltds.d p!G@n rorh.Cofr&rtrsLceb$)
<br />lmcropt und.r Sahon
<br />",,, rLli?.-t-t6
<br />DECI.AEAIS!
<br />I hs.r,, lmm un{ts porhy of pqjuq-' oft onhc tolhu ins {k hrnio6:
<br />I h&. &n r rl! EFr.in ! CqritEc. ol Congl lo S.ltlerc for n o,t6 .otr+<Miotr 6 Fo\ id.d for b Sdi.n ]7qi ol $.
<br />libo. (ode tor
<br />'h. Ffolrlrm. or rh. ".rt for *hicn rfi. p6nn i! isu.d
<br />I lur. D<l *rll nlinrin $'0116 conFNrion iMft.. 6 rcquir.d bl Sclion lTm 6t'h. hb.r co&, for ih. Ffo.li:m. of
<br />lh. *!rL ro, *hih lhir Frnn n i$.d My \crl6 omFldirn itMe. cdnd et Fl4 numb.r m
<br />I cdrt rn.l i. th. pafolM.ol'h. sort for "hih rhb Fmn L! is.4 I sh.ll mr mrloy.ny F$n r Env nuE$ 6
<br />'o
<br />b.{otu rut .cr ro rh. $!.td onFldion her orc.hloma &d.{c rht ial .lbuld hdom tutid ro rlr
<br />tr rtd' .omFM'ion FrEioN of Sdb. l7o0 of rh. t t r cone I slEll. fdns nh 6nplr- $ nh rhs Frvaio6
<br />\TARNING Fnl@ ro su. uqld' omFuirn o\6.s. i3 unhrrul. d slull utid & osprolt ro oinin l Imxi! !.d
<br />.n lin6 uD lo oR hu lrd rrFuerd &,116 (t100.fiD). m r.ldilirn ro rh.conFMio.. {hrus6 B pro\il.d for !&
<br />Sdrx,n 1l)76 of rh.litv (irl.
<br />'ntdd dd
<br />AfuLa.+€
<br />olclJ8allqd
<br />I l6!b' .mm urd6 Frlly ot FJUr' lh, I m licqE d un&r Fortio. ol (l[pr. 9 (mnmi.8 $th Sdirn 7(x[, or D'rnrn !
<br />ol
<br />'h.
<br />B6i,B,rd Pr.i6ioE Co&, *l mr lt.N i in tull to@ !d.ftd
<br />CONSTNU(]TIOII LENDII{G AGENC|
<br />I hq.t y .llm und6 pc..Xy of Fjury lha thsc i! a .ortlNclbn l6drs !c*y lor ih. Ffoffi ot th. $ orl [)r ufiich rhi pqnir ir
<br />is.d(S< !0e7, civ c )
<br />ATIIICANLDECIjSAIIOT
<br />I \dq lfm undd po.h y or Fjur, on. ot th. hlhq ins ddlsral on3
<br />D.nolnion P.mils-Alb6lN Norificdion Fcd6.l R.8uhb {TnL40. Pan6)
<br />R.1un.d l!rd of Ndifr.dbn
<br />I c<lray rhd rh. f.d6al r+ul.lioN Esrdios Nt6ka roo\ al ec nor amlicabl. to lhis ,r.jd
<br />I .dr '[ rh'i I hr\. rod r hir sfi,li(arion lrd 3r.r. rhd rh. .tx)r. infomdion t coEd I rarE lo comply
<br />ud Counry ro dta uFn rlE
<br />'4u-2.
<br />I
<br />I
<br />Flood Zone Certif .
<br />A--'l
<br />,r/4-2.r"'r-,
<br />o'dd,.c6&d srrr.l.wr'.lddr ro h'ldrn! (.nntud'Fiatd.b) lurhorn.rGFMidtr6,
<br />rtn. 'norrn J propgly tor r6n.r'on,ru.I{h , J
<br />^pp,k.n,or^sm,shn.,ur.:
<br />( J'kz'zt*'
<br />r.rhhen,h.(p.hr): Dt;avl,++i Ne%E+)
|