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SITE.WORK DATE tD/stG.COMMENTS OWNI:R BT'II,DER DEI-CARAIION
<br />I tEtt'y rnnm undcr lEfllh! ()r Fqury lnd I d cr.q'r fn,m rrE Conrtur.N' Lrcnc lrr ntr rlx nnk'*ins (!so (tt7oll 5
<br />tlutirc\r !,n Pols\ion CqL, Any C y or (i'!dy shrh r.!!n.\ ! Fmn h (n<Ml. .lls. iryon. &nrlirh ur ftFn sy
<br />(turnr.. Fu k, it nium., al$ rrtuft\ tt* +pl.mr l({ .e h pcmt to nt . lisEn {okftnr lhrr rE nr th. s lhtntd puroanl
<br />h rlE Frlilirnr or rlE Contrrlq \ l,irnqd l r* rclufl.r 9, conftmi.! r h ss' i,. ,llxr .f l)ivri'. .1 of rlt Bulimri rnd
<br />Enr.si,nr C,xl ) or rhj h ,, rh. ii .r.nv! rlEr.f,nm !.d rlE t8i. for llE lllcscd csqiln Any ri,l,!irorStlrr ?0.ll5bylny
<br />rt'rlrrd ntr r F.mir iubr{r r tlr lflplEr.r lo ! r,e rt n Blr y .l mr dft rh:n lir. hunlrctl d{nhr1 ( llrrl
<br />l.sro*rcrolrtFl,.Irny.orny.nlo['Blf,dhNr3.\NttFnqrbotr{En{rnn.srll&,rhs(ilrn]rttiulwndr
<br />inrcni.rl or ofl.r.rl lor sh ISN.7()'I4. Bu(im( rnd l" llsi.m Cnlc l1E Cnnttrtn \ Lr.nk l:* rfif,r nrylyt'lnoemrof
<br />rh. nnrFiy r}r' tnild\ or iqro\s rlra.r'n, nl wh, dr \E*h trrt hnnrclfor h.rclfor lhouth hr or hs o*n..rnl))tc.-
<br />l,n,vnld r har uch inrln'rcnEdr N n'r inrcrlal or ottcd itr qlc Il tn*tvs, llr htril]i.8 or in{hftdrnr i\ v'll *irhin nm Jtr
<br />or conulriqr rhc olmr Buiuo *ill h!v. rh. hord.n orl['v,ne th! hc or shc dil , huiklor tltn,lc 'hc,rn,tdy
<br />tu rtr pur,rt ol
<br />l. x\owRroIrh.pn'|xnt. i,.rrl$^clyrotrrr.t rr qih lr.cn\.d Nnh ^ ni .otr! n'.r rlf,' tn rj..r lS,a 7l).9. ttu{trc!\
<br />rrrl lhn!\\r{Codcr Th.Cotrkrcroi\ I.r..{.1ru (1..\ n r Jt)n1yni Jn.*n.rofp(rtkdvBho htrrl,l\or nrlnxc\ rhcr.on.
<br />]fl,| *rr'.ontrr*lnr\u.ht'()lL(rswhn(nnr'Nnn(\rlf,cn{JDur{rrtrrk)rhc(idutr\1f,.n{lr'+r
<br />I Jr.r.trlnr untl.r Sccri,n
<br />l).rr
<br />1ll,l3lir&ulx8Ers.uDrDl(riU/UIaI
<br />! hr,.h) J,ltrtrrunJc' F-nrlrvol F'lun ,,rt.i'r rlk l"1l',r n! 'i.1lJirr6
<br />-l
<br />hlrc rl r ill roinlli" a Ccnifrrr. .I Con€n! h s.lt ln\xr. for $ olkda drn{Enst{r. !\ tio\ild ldl,ysd1x,nl]mof r}t
<br />I ihtr Cdc. t,
<br />'h. rErfornrh--. .l
<br />'hc
<br />trrd loi shin rlE pcrlnn k n\kd
<br />llrcrkl*ilLnHnrin{orlo'(rt(\rrtoirto,nrfer!cqtirci6r_SccrionlTlxrflrhclrht(irl..l((rh.ndnrmatccoi
<br />,mrt.^ con{f,trs.ln'n insuaNe.arier sxlF'li.y nunh.r ft
<br />lla -\a1lL]1c\7t'1 (.1 ,\I?)
<br />I rd'fy rhnr ii rh lxnarllm. nlrh. work r(tr *h.h rhii Frnril i\ i\\Ed. I rhtrll nor cn{ (,y rny ,l.R,n in rny rurcr
<br />!' 6btE.or.uhl.rr ro rlE *r'.t.6 {nryrnurr Uetol (slrtumir..nd +erh! if I lh'ull tEr.ft ruhFr (,rht
<br />r oltdr' .l,.!E.eri'tr I)(n irbn\ of S(ri,n 17ll)
<br />' 'l rh tjh, Gd.. I \h!ll. foni* i corrply *irh rhtr pn,!Ni,.s
<br />WARNITC fa,lum ro M *olt.F .r'mn nrarkr.orrm8c r unl,{tuL d rhdll \!hFr .n.ilrll!'!! x'.rmiu! FMlis lnd
<br />cNil 6ms !p b.m hundr.rt rlhu{d drlle (ll(r).(nr). r .ddirbn r. rrE.orr
<br />r":#", ''
<br />-,f EB 15 201
<br />I'EIIJE6III]N
<br />I h.Ebyrllir undcrlEnollyofpcrruryih l!rlnuyrlr' d Imrsir. ol Cn{trn 9lconrtft irrs wir h S.ct i,n TUXD of Divnrn :l
<br />nf rh.Ittrrncss {nd Pofc$ii'ns Codc. u my li.cn\c i\ in lull nne urntffc.r
<br />, L \ \un,r. l[) cr' ", e'.r .\)r
<br />!j1!!.11I.I1;.UQNIEMII!1iICT (]t
<br />I lrnhy i,lt'n uulcr lEulrl ol FrJn,y rhr, rlrac h !.trhrtulro !ndr3 rsctry for rh. FrturnulK. olrh uork f!" trhth rhn lEmir i{
<br />N{trd 15( :l( 7.cs c,
<br />tad.ii Addr.$: _
<br />AIILI!:AIiLIEIId8dIANI n+,, rmmrudu Fna[y ol Frjury om or rhc nnh*ins d(lurinF
<br />l).r,lirirn P.idik Asbcior Norill..rion l;.Jcrallt.!ul.li,n\ ('lirk 411. Pd6)
<br />R.qun d knfi oiNotificalion
<br />_l lrnrayrtlr rhcredrrulEsuldrii,nrftisrdo8nrh.norermrllrrcmrappltabhrorhtrft*.r
<br />rd;'Iy rhrr I h!\. Eld r hF 'nplrlr nn ud {!,c ,hd ,hc rlr'r inbrturi{rn ii . trer I !8re k, d,!{ y w h rrr c y .nd counry
<br />,:id;!Lc. rnd srrr. brs RErns r.lrrBhs (nn{rudrn rn tFeh, adrbna qtNnrd'v.r .I lhit (iy.nl (t,rnrr ro c.tr u,rn tlE
<br />xtxtr. nrnrtr)mJ l]n,pcny !n in\tnrxstlrFMr
<br />,trpllonl or AB.ni SiSMtuR
<br />S,"'.s*-u*-*,on*,, 12,4 \4 , L,(
<br />,",.ttEB r E ?0 1r
<br />Set Backs
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framinq 4t b/,t 9,Vt LlEit<g
<br />lnsu lation/Enerqy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lvlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif
<br />FINAL 3tq /r, .r.)d,-izMl
<br />Certilicate ol Occupancy
<br />Notes, Remarks, Etc.
<br />BUILDING. INSPECTOR BECORD
<br />:,FiB n€rt
<br />Fo rms/Stee l/ Ho ldown s
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