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BUILDING- INSPECTOR RECOBD
<br />SITE.WORK DATE
<br />Set Backs
<br />Ereclion Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lns u lation/ Energ y
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />Handicap Req
<br />Depuly Final Report
<br />Engineer Final Report
<br />Flood Zone Certif .
<br />FINAL ZlzTlrc /,1, /x/u
<br />Certilicale ot Occupancy
<br />Notes, Remarks, Etc.
<br />I
<br />Ol0NER AUII-DET DET-('ATATION
<br />I h.mhy .rlirm unJ.r !.n.Iy of F jury lh.l I m .rcmnl hom th. Conrr&hF Li(cnrc uo f( rh. tulhwh8 rcrqn (S..70.11 I
<br />AulUFt .,n Prurc$r'. CftL) A.y C y or (i{ y ehrh Equci r F,nr ro e,nnB-r, .]rd, rrtroE. &mlLrh o. EF! ,y
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<br />t, rh. rn'vN$n. or lh. Corka.nri l.r.trBl L!* (Ct!pl.r 9. OrmmE'nE * h Ssri,n 70m Dr D'vFir I ol rlr BxriF(...ti
<br />Pnrac$ion! Coi.) or rhrr & dr rh. ii.rcmrr th.rcln,mdd lh. hrrir n,r rh..lksd crcm r,tr. Any vi'lironorSornn 70:lL5 by.t
<br />.mhrnr L. r p.md iuhFG llE l|'f!lr..l io ..rvrl FMll y.f r mrcrlEfikhu r.J JdlI! (s50o).
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<br />d.toi.d M olt.dt ntr srh (Se.7044. Busfts rnd Pmlc$$n! (iic Thc Conirr(n'! I-f,..!c kwtll$ n(, rpplr l'r !nowmrol
<br />rh.In,Fn, w,rr hiLlt or nrtrF! rlrB'n. lrl *lr' dEsh ktrt hmr.lfor h.Mllorrhnlsh hi! or h.r own.nPl,,t.!.
<br />F)yrrdl ih.r s(h uqnrwdr & d{ dmL{ nolldEJ k qL Il.lDEc.th.h lraixdFrxftdtr$Urthortr)c{
<br />orcorqfttrs, rh ovftr Bu Lr ril h.E lhc hnknorFDvq rtEl lr ntdnI h!!dothE0EFfd]forllrFqs.ol
<br />t, a\ owEr ofrlr F{Edr, e.rchNy.ly.odr&ruS vrh l!.nkJ eodrr('F k,.$n{d(r rlE !n'Fl (Se. 7(x.1. Bulms
<br />ul Pr{:.!EceL Tri C.o mtr'r I-..n( tir ddr mr.mlttu s.wrcrollnFny *lI, bu'[rot r0oEt lh.ron-
<br />rnd {h ddtui! f ruhF,r.rr* h. ConrEr(n l.lnsj p{l.rl[r rorll codarr\ L.cnr Lr*).
<br />I am.rcmt{ utu1.. Sc(on
<br />wonx-tffi
<br />DECLAAAIIA!
<br />I h.(ht r uButoLr Fdlr, of Frjlry ox olllr nnbwiry d(lr,rr{ns:
<br />-l
<br />hlk Bl w'll tulntr r C.nf.d. of ConGd t' S.r- ln.uE |,f, *rrt(r Latrp.nrri,tr B FolrLJ f by S-l.n 1700 ol rlr
<br />ljtxtr CitL, tu rh. Fnolrrrl@ ol rrr s,k fo. wh.h rh. Fnn n Ks.n
<br />)el hrv. rDJ w rll Not.m mrlcF rohF nr.rrr mu,rm.. I knou€J h, Strxn 170(l dl r& L.titr (ixL. for rh. Ftlolrfr. ol
<br />ilr stk ntr rhrh rh. Fm. ,r Fsrl My *rf,ln\ rltfxnqln o.unnc (drr .i F'L y nuhlH d
<br />i"*"S*!o|'t N,"+\ G5 Cro
<br />",*:t{,lo5g 4cr ,$, q i3o/ tq
<br />_l r.d'l!rhar rrh. rxrlormE.ol rhc wort,'f, uhf,hlhr p.rn r Fru..l,l.h!U nn.nphy.nyFmn htnyEnftr
<br />q' .s kr t(rnE suhr(r kr rhc kr.lcr' $np.nd n'n lrw3 .r Cd'romf, rd l88. rh.i rr I sh,u!.| h.com subjct n, lrr
<br />u'rl..' Li,r{Ens.r$. pn'yili,nr ol Sdrir l?U} of rh. t2hr (ixll, I shr[ tunh* h .l'r{'ly wirh rh,< Fov8.n!.
<br />WARNINC: FlhR r, (m krtcr'lrllt{x.irrr llvoa( ! unL*luL 8! sh.ll {hF! s crqfi'F ro lful FalEr .
<br />('vrl lim! ut) b om hu r.n rli)uqnl 'jolls (tl(f,l.(tx,,. m rll on b th. (oc ol onIE.{i,n, drd3.5 .t th'vrLd ftr rM
<br />S.crx,n.1076 orrh.l,htr Cuic. rt.r.q lnd !lr'my'
<br />f,*,., l-3-1? nrr,,*,,
<br />"u#,
<br />LICEISSLIINIBASIAT
<br />DEI:IIEAIIA!
<br />I hcrchy dltrh odcr p.nalrydflEqurr rhrt I anr lMnkn u*Lr J'nrvn!'n ol ( hr {9t$nmncin8 w[h S.Lrrn 7ll(x)) of D,vskJn I
<br />.l llx lrurEs.n! Pnn.s&.r C'u1.. lri hyLcn( 6 in flll hrEr .fl, .tl..r
<br />4t"1j u1
<br />t- 3- t1 Pelcrsrab-
<br />CqlSIag ANUN0Alir[EX(a
<br />I hctohy sllrn und.r FMllyolpcrjury rh, rhcrc ! ! ondru.rr)n kBh! +.n(y l({ rh. tcrldmh-'c or rh. work ntr whf,h rh$ FYn s
<br />RrkJ rsd U97.Crv C r
<br />L.nl(irNrm:
<br />APPLIC-ANT IECL NATION
<br />I H'r.nim u Blcr F..lr, ol F.]!r, oB of rhc dl,wor ddl,trrriirs:
<br />o.nbhon Pcrm .Aih.nor Norili.{i'n Fcdcr.l R.3ulari,n! ('Iirl.4}, Pd6)
<br />_Rcqurd tJtr$or t.rfE Dn
<br />l..ri,lyrh, rh.lr(l.,rldtulrrr, ( 13drl'nt i\nno( krr,rilrr. n.r rPpl'.rhlL (, rl,^ |n"F_r
<br />I..nrl, rh, I h.E F.n rhir.p?lirt,n,n nnc ihi rlt:h,vc rtuImr.n s t$cr I r!ft t, ron?|, wih il Cly rrd Coui y
<br />.nlllreci .nl Srr. Lrrt ELrE! ro t 'ldo8 $n{t^*rhtr ,r, lrah} .untruc EF.rdrxkr oftnB c., !n Counr, ro.nd qbn rlr
<br />. thrrcm $rd pNrEny r(tr Drperru
<br />,irr,n*,&^
<br />T.
<br />tD/stG.COMMENTS
<br />Formsi Steel/Holdowns
<br />T-Bar
<br />I
<br />".,.' @l-3i
<br />ht ll:21D-
<br />=
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