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SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDF.R DEI,('ARAIION
<br />I lEEhy rlltn urrl.r Fu!, ol Frtod ihn I D cr.'q)r ron rlr (-,) rar(n Ltoc l:v ttr rh. t,ll)*n3 Elcr (S.( 70!l t
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<br />Poli$,uns (nd.) .r lhll h. or xh€ t cx.dpr rhcr.lion!drhc t!!! tu rh.ruc!.d cxcnyron Anyv('l.l!'nolJ&*ri,n70ll5hyeny
<br />ltplitsi |.tr!p.m $,hF!h rh. ippl'clirt' r0vilt)tMlryof ndrfr,(rhln ltr! hu.lrd 'lollar(l5Ul)
<br />l. .i ohr or rlx rtDFrry. q nr.npbFr B'rh *+d as r,r{ rtk.rr{xn{D,. qIJo rlr *li.d rlr sNs 6 d{
<br />d6rldt d ollrRl t r .L lss.7(x4. 8u(trs .fij Prof6!.N Col.: Tlt O rlrq\ trtd b* dB nr {Plylouoft. of
<br />rh. FoFny *lr) llllrr tr rtmk3 rlIFf, rn *,,I' .IE (n k,t hm€lr or h.rlf or r]Nuth h! B lrr oh cq't'F.r,
<br />nrovrlat.hd .u.h n(mEmd3 c r{ lrchl roltml rq {t ll ll)ffi, rh. t!ll,l!r! ( lrF,Err.rr Lr 5ll *irho d F,
<br />or.o(phr^ rll os*r Bu '.lr
<br />yil hrE rlE hr{.n orFoEs lh.r lr ortlr dn br b ldrFoEdE,mIEl,fdtrl rFtor
<br />l, !sowmrdlrhc lln Fny. mcrclulkly.odrlcrus wirn Lr.hs.J rodr.doF k) con(ru( rlx nt*!i lS( 7044. Busft(
<br />aJri hukru C(xl.: l'h. Cd.Eroa r l-k n.. lrw d(. mt rJ'rrly r' r .*8 .( I'.r,p.n, wh' 6u' r .r tmPmv.i lhcrfl(
<br />.nd *lx, (ddturr (itr rEh lrtrrdt *rh r Conrstnr lirrktl Fu^D t!rlECo r*roi.ltrnE L.w)
<br />_l m.r.mtr unLr Sn1$n-. B &PC htrhs Eav,n
<br />I!ORXFRS' ('oMPITNS TION
<br />DEIIdSAIIA!
<br />I hcrchy rllnm trBl.r p.ulry ot P.rrury ok ot rhL n'llowing dtlarllt \
<br />I h.v. .rn *rll mmr.h . C.nrlirr. ol C,'nqnr k' S.U-lninR lor k,rt*a on{End o.. .t F$vti.tl ft, b, S&r M !7(x, dl rh.
<br />trhtr Cd., ftr lh. JEd,mr ol rlE *fi fi *rrrh rlE Frur ! ^.Fl
<br />_l h:N.rn*,1! mdrn *o.tcF' .nrqEnqr Dn nrur.m..8 Ertulrai lry Sdri).]7m df tlE trhtr Grrc, tu lrx Frft,lM-c oa
<br />rh. Mr* lor *h.h rh( Ftu ir n!d. My w.rtqr .a,qErsi,n rolu!.!dr 1n thlly nun*q e:5€
<br />"r,.r*,.*. 9)-3,29 a
<br />-l
<br />.tndt rh.r h ilr F.lolriu: ot rrr *ort l* *hxh rh,r |Frmn tr 6.8n. I ndl mr .trphy .ny FMn 6 at lMB
<br />rr I ro hcr'm ruhFr ro rlE s.t6' $rFnnlrr Lw< or c:lnom. .Bt rlr rld if I rh,uL, tE d rubFt ro tlE
<br />kd6 $nF.nrsn Fvlrb6 of Ser.n lrm dr rrE L.!{ CqL. I ndl fonn*rh ond, *rh rhE FlviinN.
<br />WAINING: F.rluE ro r.uE @lcd u,oFr{rr!.oh8c Lr unhwrul !n rh.ll rubFr o ci9hF, ft' dlliml IrErF.!rl(,v lincc un r,.m hudrc'l rh,u\!frt &,lhB illlX )), 6 d[hn (, rh. ror ol r,rgrn{rn'n. .Lm!( as I'ovn.al tu ih.
<br />)5 ItriG
<br />!2tl|rB!l]1D
<br />I lIEby .fttm unld FDxy or F iry rt I rn lEn<n url.' F r.r)n ol (lEF.r 9 (dnmLr3 wrh S&l!n 7000, dr t r(rr l
<br />ot tlr Buimi !n ProfelbB Ccl.. rn nv h.tr€ s h tu n'N .rl.llal
<br />ltr //1-
<br />I tm$y .rlirn udLr rEDly or FrF, rhr rhdr ( . 6dtur nn hnro, .ady f6 tlr Frfolfu! of rlE *rt lor riEh lha Fnr 6
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<br /> IPLICANT DECT-I T\TI(TN
<br />I Hry rllim undd Fn.hy ol rErrury oF ol rlE linb*rn! LktLnr k,.r
<br />Dcmlron P.m.G^th.qo! li.r"urDo,nj.El R.3uLroN (Trk 40. Pd5)
<br />R.qur.d tru.r .I &{firbn
<br />I c.nrl y rlHr rtu krl.rrl r.lulxrr)trs rrSuJ ,t r\ti {.\ hrr)vlll r( Nr rnt un[ n) rhis I)t!I( r
<br />I(cn',yrhirIl!,krcadrhs.pplrdkrol{d.thlrrh.rltlk1 I!3rer)e.molyw hrllcny.nJ(i,oniy
<br />or'lmNc{. Sr.rc liw! Elllrt h rllo!.onnrudrrtr dl h.Ehy lurtrrr. rcIrcsrl'trv$ ol rhtr C{y rnd Courylr'.nrcr uF'n rh.
<br />.h.\. md$rd F{rny ntr
<br />lppli. l o. Ardl Sirel
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />UFER Ground
<br />SLAB Floor I
<br />Subf loorivenVl nsulalion
<br />Roof Sheathing |PQJ-Pft-A UFT
<br />Shear Wall I
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coal
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />II
<br />FINAL uk ta f,f/l^/h/t\-1lsr/
<br />Certilicate ol Occupancy T- ' I t I
<br />Notes Remarks Etc
<br />3-z r -bo )111 P?2 A 4-L tvl I
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<br />N1,^/
<br />o r,/L IISL,1
<br />BUILDING. INSPECTOR RECORD
<br />ltlsqg
<br />,,*' :lC l[9
<br />Erection Pads
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