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BUIL ING. INSPECTOR RECORD SITE-WORK DATE ID/SIG.COMMENTS Set Backs Forms/Sleel/Holdowns Erection Pads UFER Ground SLAB Floor Subfloor/VenUl nsulation Roof Sheathing Shear Wall Framing ln su lation/Ene rgy Drywall I Ext./lnt. Lath Brown Coal Masonry Pool Fence lr rl l,}tll+y'lv yfT-Bar Handicap Req I Deputy Final Report Engineer Final Report Flood Zone Certif . FINAL Certificate of Occupancy NQteq, Remarks, Etc v. OWNER AUILDEN Df, ICAR/l'TIOI\ I hd.tt lftm u.dd F hrof p6JU.y iht I m.!nF lion rl! Codr&ro6 l-tmrl,sforllEtollorns@n(Sd70rl5 BNr.* drd Pr.{4rior Co<lc) Ant Cily., Counly *hich r.qui6 5 pann lo cotrnrucl. !hE. imFo\.. {tmolish or EFr !.) nrudue Fiorro ir! !$uocc..l$ r.qun6lh. appli. ! aor rrch Fmn lo frL ! ri8n.d (dmdl thd h. or shc is licos.d purludl !o rhâ‚¬ Foviriod of llE (o racloi! l-icdi.d lrr lchrprd 9, (bmmtri.8 *ith S{lion 7000 ofDivnnii 1oflh. aurinRt !.d fto fsrns Co&) or rhrr tE or ihc a sdt{ rhd.from ed rh. ii6i! aor th. .lksd .rdF ro. A., rirbrn,tr ofs.a:rrn 70ll 5 N nnt q'rlic&l foraFd( rulrdt. rh. rr?lkrd ro r .ivil F tr ornor frtrclhs nr. hur&.n doll6l l5(x)) l.so$n6ofrh.FoFn!.ord!dnph)6qirhut!6srh-,r,LonFMFn.{rll6ll!\qtdi$.rMr.bml mr(dd or o|IF.d to, !k {sc 701,1, Buli.s Md Proa6nnr (id.' l ic Co ricloal l tak b* 66 nor 4'pl! r. o\nqol rh. rnrpdy wno hrild!.r iqm!6lh6rn. ud lho do6 srch r!* hrfrs.!f or h.rulf or lhrcugh hie or hs om mplotc, prcv .drh such mlirvmG e frx mta&n o oirdld fo.sL l[ ho\66.rh.hildi.*or inp,lvqmr tg,Hs hnon.ldt o[$,rq)kio^ tlE (\.6 Bukt.r *rtl h:\! rrr tlnla olFnnt rhd lE or shc di] ml tuu dr inrFt\r ln.In)Fl, f( lrE ptlr-s r l. 6 o$E of rh. Fopsl]. h cr.lGn.lr codidss \ hh l(mr.d codkoB lo .odrud tlE Imi{ I S( 1(sl. &lslt6 hd Phfsi* Cod. t h. (-ont&ror s l. rc6r. l,!r doâ‚¬ ml .aTh lo an o\rnd orltoFnt sho blildr o. impr.r G rhdon. ind who onlr.dr l$ suct Foj.ni * ih n ( .d6d6n sl li6E d Fluml tortc(tarr.(.4s Li..M L{) I m.\dno undd Sd'oo .B&P('idrhisr@n r).r. (r*nd llQf,lills.sQilffils^IlaNDr:gi8Allo! I hdchyaflimundd FBlry 6f pdJU,r- .n. orrh. nnhq int ndlo.!tr'n.. I h!!. dd *,ill niinr.in d ( fii6.dc oi (ilnffil ro s.lf-Itrlxr. hrr $ orkc' conposnn'h. 6 Ftvirl3l lor by Sdion 1700 o r rh. l.bo. ( odâ‚¬. for th. Faomdc orlh. *olt frtr *tth th. Fmd i! i$o.d I h.r. ind n ill h.'d,i, *.rt6' omp.Mhn iM.. s Equ!.d q_ sdli,n l1rU.rrh. L.bor Cod.. tor lh. Floffi. ol rh. *o* for \nth th! Fnn b isr.d My \st6' omFrErNn 'Mdc @ir &!d Filat Nmba rc l.diryrhn in rh. Ffol1rlm.of rlE sorl fo. $htnrhir FE. itr isu.4 l.h.ll mr dph!.n) Fvrn !n.n! n6ffi $ s ro b...ft abd h rh. ulrlsr'mtFltion lsr! orc.hfom( .td .gr lht if I lrhub tt .m stid ro llE $0116' onllE ri,i llnn 6io6 ofS.nFn r?00.frhc llhor (id.,I slull. fdhq{fi c,ntl} wnhrh.rlrolnnN *ARNINC lIl '. r, sru'. \orldr (('l lin.s uf t, otr. hrnir.d rhoisitri .ll srhtd M dplo'61{' $ninal pdBh6 dnl I hch) rmm uarls lh.hyolFjrt rhd I !n licct6cd und6 rro\ rsioi orch,fl. e Icumnrtrins qirh s.cl(r 7om) olDnrion t .r rh.Businds d PmldiDnscod.. Md nr! l(ds. is in loll turcc eftl.ITd 0D/rE 10)+|]1_Z L ?r ( ()\stRt( II)ir I l Nl)lf\(i (;l,l(\ I hftby dlj n utuls ,.nlhy of p.rjury tha lh6. i! ! coNtudi'n kndins .sdcy lor lh. dfome.. .f th. qork fin *hich lhi! Fmir ir isun (s< 109?,(i! ( ) AFet rcdtr nF( LARA'noit I h6i, allm undcr Fflahy of rnjury onc nr lh. nnlo{ins dcl,it ioN D.nshbn PmiB-Arb6ro! Norific no r.dsll R.ruLrF({Inl..l0. Pd6) R.q!t.d Inr. or |{iifxdion 6b.sos rmo\01.'. nor alf,lrc.bl. t' rh! t)nrNi rlr\c nnndnn n.ond I ltlrelo compl] *ih all ('ir].nd (,)unr\ .nd ( ourtro ard lrrn rh. pl+l )+ TlUrrZt I I I I lis />/J t//l//z/l Wz. I .rrI I'rAI ttltrd+ /"f (). /;