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SITE-WORK DATE ID/SIG.COMMENTS OWNEN BUT-DER DTiI.CARATION
<br />I hcr$y nrrn uflh. FMh! rll Frrury ltd I D .xcri!'l fmm lfi. A',rod,F Lkcn* lrs rd
<br />'lE
<br />lolltrwing Eae,n I SG 7r.l l I
<br />EusnEs .d Pmfcrnon Cod.) Any Cny or Cooily $hich Etons r Fni ro sn{tu1, .nd, intmx. d.mnnh or qun y
<br />nrudrc. Firi i,, itr is rmr,.ko Eqlircs rh. llplalnt for {.hFmirto fiLa !3n d rlarcmnr rhrrlro.slr k li(.nEd numiltl
<br />nr rlE F)vi.i,n{ of t C.ntrrd i Latn*d Irw tcr!'Ird L CollmEin3 f,ili S.clbn 7(Ill o( Diviri,n ll .f rlr Burinc$ .nd
<br />Pbrc$ionr C.d.).r rhal tE or shc n.x.nrl rh.Efrom dn ft h$h tor rL llkscn cenrrion Any rhlnrion of S.d hn 70115 hydny
<br />{'plt.nr ntr . Fmn $bttr rlE rt'rlic.nr k, ! ciril pcmlty or B mE rhr. fiv. hundrcd doll r ($5m)
<br />tq, s 0*6 ot rtE Ford), or m,.mpr'ycs w h wotcr rs rhcr ek.onll..$1i,,.. *illdo rrt eorlfn d. ntBlE i1mr
<br />n drd.d r ofi.En ld sL (Sa 7o.t4, aurir( rnd FrDldionr cd. Th. G'.rdr\ h.nr l,r d- nn {rly ro.. orEr ol
<br />rhc pnDcn, wh, tlikt or i'rq'n)Ei rh.Er. ,xl wh, d(xi ikh M hiDrll.r h.r{lf.r rhn,uah ht or h.. oun.q'l,F.s.
<br />FovrLd th.r sh inyFwlls E rn ndldol (oflod for -L lt h.ffi, dr tliun* inlnEr irEld*rhDofi)td
<br />uf coni,lcrntr di O*nd Bxild.r will hrE rh. hfthn nf pnnine rtu rE or rlE did mr ld! N rtroE dE FIEry ft, rlr FrFt ol
<br />-1.
<br />f o*F nfrhc I'rIEny. an,cr.luri!.|,cont(r'nE wirh lrccn{al c.ntdck)r rr) con{rucl rlt pn,rcrlSc 70.l,l. Bu{Nl!
<br />lnl thftsin C(iL I h. Co.r&1nir La.nq liw i(r ml frrly b an .*ftr nt lroFdy rho hrlds .r im[ov.\ thcK)n.
<br />rDd rho conracrr ttr \uch nm]ccr r sirh tr (i'nrm$,n \, lic.n{tl Ni\!dn( tr)th.(l'dr!.1,tr \ Lt.trr ll*I
<br />r[r"',r",r".X-
<br />lrlg.aiiuMs
<br />I lrrrhl rlrtrrtrtrJcr trtrrlrtof ttrurtorr!n rlk i'llo*nt dc.hnrt r
<br />-l
<br />htrv. ard $ill minraii s Ccn,aKrr. or Conrd n) Scl!- lneurc fn eorkcB .otrlltn\lr ion. !r pflrvit.d lor by Ssli,n lrm .f llr
<br />trtry Gn - r[l,E FrfnmE ot t,E q,rt fq $hin i,E Fnir tr r\kd
<br />_l turr .d *rll rornriin *orld{ oqrnrd K!. in\urre.. sr rEtuRd ht Sdl hn l7rr() ot ihc bb.r (ixL, l rhcpatumrn.cof
<br />rh. sork for *hi.h rhir Frmn i tu{. My *mtsl d,n{Enerin insurrLr .rtr ulF kynun*Ere
<br />l l ..nify rh.' F rlE rsf,,tur. or rrE *ork ri* *hrh rh'\ F nn h is$cd. I rh.ll ml .ml,by otry FR,n r lny m.nkr
<br />$ 6 r, titrnf, rubjdr ro rlE *..kcn' lor{En*lion Luq ol C.lil'ornir rrrl raN rhr if I rlsukl b.<om rubF.r ro lt
<br />wo*6 d!r{$$rrr tmvnbn. ol s.dhn lrur ol r lE Lrh.r (idc. l {ull. todhB h mnpry with rhoc lmvtion\
<br />r unh$ful .rn shrll \utFr .n cnlploFr t' dimiEl FEls onl
<br />ldd i,,n to rhc .on otconFn$rhn. d!nEt.! !r r.vilcd ln, lll.,t-
<br />.l II \)'(..tr.,'*r, ft.
<br />DTCIIAAIIQ!
<br />) Ih.Eb,urf"muhLrp.n]ry(rFriuylhdlmlNn<nu.rFori.i)noICh+r69($mEdan8rilhSdbnTGxJrorDirirb.l
<br />' ol rh. Buvm* ril Pn,l.rnonr Codc. anl on lr.n!. \ D tull l'tr( un .fi(r
<br />!:0!$auCIu!.LEB!M.aqEB(I
<br />I h.i6y rmrn unlc, Fnlly orF4ry rh,r rhr. ii. conetuli,n Lnd'n8 a8cm, ntrlllc Fra.mNc orrtF sotk lor *hich
<br />'hn lErmir is
<br />isru.d Is.!. lln7. Civ C I
<br />IJnlcr\ N.nr _
<br />AITI.ISA LIIESJAAIII]I
<br />IL,L*ytrliimrnd( fctr'lry ul tr.!trry orc ofrhc h'lk'sir8 Ltlanri(trs
<br />t)tnhliri'n P(mil( AstE\lot Norirjllri(,h Fcd.ElRCEUlnrtr,hr (l,ilc J1). Pr 6)
<br />RcquNr t. .r ol Mriliali.n
<br />lcdilyrhd rh. fcdcral rAu)&rrs rc[u rntu\hc(osrcnx,vulu.trorrntlill'lcI'rhi\trojd
<br />trq.Lrr,ryrh{ I hlvc rcall rhi\ r rri(,n nl {rr. dr}i rh. Jhn. hritrnuri(,r i\ (ure..r ll8k!r,,.onIl!s hrllCir\
<br />onliEmcr Md S!!r.liwr Ekliu l iuns.on(ru(iiinr I hcrcht rurhDc rcFrktrt.riv.r.l lhis CilyuNl Coonry
<br />rlxr. n. Ltrr.ti tr,ltnv htr trtrI{!r
<br />ADDIi{nt ur A,16r sigeruE 6^J".*r-**,rn*,,!
<br />,6
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Ereclion Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framinq
<br />lnsu lation/Enerqy
<br />Drywall
<br />Ext./lnl. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Beport
<br />Engineer Final Report
<br />Flood Zone Certif
<br />FINAL l"lql9 ;(-.,/u ,/Z4t a.r €4l,tt ..{,1<4o.7 ICertilicate of Occu pancy
<br />Notes Remarks, Etc I (,4,rL AI
<br />-+
<br />BUILDING- INSPECTOR RECORD
<br />l.trdc.s Add,.s,
<br />-
<br />fY\ I
<br />l--
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