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SITE-WORK DATE tD/stG.COMMENTS OWNIIR al rlll)l:R DI.ILCA l{ATION
<br />I h.Eby affrnr trtrd.r D.n&lry o, p.rflry rh.l I o .$,rl'r fDm rh. (ronturoR LicM t.* f(n ilt lollosinr t.5n lsa.'7011.5
<br />Buii..rs Ii Proltsion C.d.r: any Cny or Counrt vhich Equn s ' Fmr nr 6nlMr, rlrd, irproE. d.nnirh .r Ep.r. oy
<br />ntur@. pnr!, i[ rw.rlsEq!6rlErr rd r,y $h Fmt r, lil r r*fd rr.ftd rhdlEq{r!li!.el Fltld
<br />ro (hc Imvihtr\ .r rlE Conrdri l.enEd lr* rouFd 9. ComrE'n8 *{h S<r.n 7fir) or l)ivirbn I orrlr ANies rnd
<br />Prol.sDN(lxLrdrhrr EnllE !.r.n+rtE fron rd rlE h.!! nrilE rlk!.J.r.trqrn AryrnlrrionolSerDnT0ll.Sby.ny
<br />trIplicrr for r r,trh subJ..rs rlE loplicrnrrorovilp.uhy.lnormr.rhrnriv.hundrddolhh(l5rlr).
<br />_L s .wEr .t rlE IrtEdy, m my.moht!.s lirh e.a.r a rh.n ek orrIEd$4 *illdo rlt xrl rd tnM@k d
<br />irftbl volT.EJ f(r qL (Sd.?(xa, Buii6\ Dd Eofaih Cq!.: TIE C. r81triLjancllrJGd.pdyhrowof
<br />tlr Fr+6r, wl$ h{rrh ( iqrcE thaq Ud rho &s *h urt hielf o, lrelr q rEuSh h6 q h.. ou.rpbFa
<br />F.yi.d thrr 3uh rprlwtucdir.d.dnoltut sL ll tMF, tlEt{illirtc rFErd it$ld *.hnft )d.fdtphia ! owE Bollla *nl ltE E hln&. oa P.otil{ rtd rE or tE lil fl, hoitl or irFtrw it F[Fr, fr, rll FrFe of
<br />-I.
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<br />rn hD6sr CqL Th. Coddol! Lr.ne t s d{xr d .n ly b u ovE oI rroFdy wlD blildt ounFrwr ilE6tr
<br />rrld *tF c.drdi lq ruch F'rdr qh r Coddd, lalr.d Fr!6 t' rE Cdd '' t&e t r).
<br />I lmer.mnr !'ik Sersn Ir &Pc.n|rnn\r.rrnr
<br />uatf[&Lcaul:IdtAtlox
<br />lECI.AEAIIo!
<br />I h.rhy .llLn unds p.uiv of F,!fr or of rh. rdltr* ot d.cbnid
<br />I h.v. !d w'll nEd.in t C.n,f..r. of CoEd 16 S.lr-lNE fr urtc' lrl't{rEdrn. I F vi!.d lor I'y SfrtE. 1?00 of ttE
<br />l-ahr Codc. lor irt F,rormt. oI
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<br />*Dlk lq *hi.h r tE Foir i i\su.d
<br />_l hlw rn *rll mi lin vod.6 .!np.B.rirn in !h8., rs Equiel hy Scr.n 3100.f rlr bt r Co&.lor ill F tIffi of
<br />'lr wt l( *hrn rh! Fd ir iull My *qto orrEdion iN(re Mir rn Fu.y mrtE n:
<br />Policy Numt.r:-lirpiE.
<br />I cdify rh.r in rtr p..fmE ol rlE sort fc *h.h rhs Frmir ir lrEil. I rhll d .!elo, s, F@r ir x, llw
<br />- B b lEor oltd t tE 610 dirp.Mi.. L*r.f C.lifon!- !i {r lha if Ltuld tE m -bi.d ro rlt
<br />u)rla! or4turM pEwbb ol Saisn lr@ ol rll Lhd cdL, l itdt. rdh*-h.!trp! enh iEr povitB
<br />WAINIICT FrllE ro r@ qrt r'on+ans.n orrt. n lri.wtul. rrn .hI $bid D apb).r h ml FEtir.!d
<br />civil li(s up io oc hmdr.d rt6u{nd d6lle3 (!fil,lxxD. in ldirirrh io rlr coe or.onrr.Mron, d.d8.. u pmyn.d lor rh.
<br />S.cr n,n 1076 ol rlE ljtdr crodc, hr.En lnd dbry , fEs,
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<br />I h.rby .lli.m n,ljd ,iMhy .f !.,jury rhd I im lieMd uidd F.tirih .I (lrt{6 I (c.mE*iry wnh Sdrn ?omr .r Divnh l
<br />ol th. Burims and PBL$ioro ccL ald my rE.rt. ! in tull for rd.fi.ct.
<br />cQltIBUCUOljrN)tflliJGtiSCr
<br />I h.rby lrrtu unld tEsly of tE ily rhi rhft s ! or{R1r). Errlu rr!(y lDr rh. F.IMld. ol rlE e I tur *hi.h rhis Fnnjl i
<br />tr$.d (Sd.1197, C'r C)
<br />AIIIISANLDECTdS6IIA!
<br />I Hylfmu rd p.trt, ofFl,r.y * of r lolbrtrt daLd.nr:
<br />D.mlnion Pqnill^rbde frdrrE rin tu Jtl Rcallris (TiL 40, Pd6,
<br />-R.qui,qi
<br />t n6 olN.d,hle
<br />-l.eniiyrhlrrEr.d.rrlrSu[ii,nxFg']'ngrh.(!!rnr)ulrr.nor,'
<br />rlnJhFtuil'i\pr)r{
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<br />cdrf, tlu t h.E R-l th! .r?li.rion .n d. 6.r ll' rbov. ilforn i.'n n r@r I {rE lo {tplr *iln rll cl, rid cod,
<br />ddiML.6 ul Srd. bB Eli! ro hrldlt8 cotfurM !n ,Eby.ulrrE Ep.lidrB ol ftr C., rn Cedy ro da uloi it
<br />,rv. rdi'En pn,Fy f6 idFdior FrFs
<br />P. ilE EElDrl ):-
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUlnsulation r\
<br />Roof Sheathinq '-$ -z-7n h.urd\JwKL riTllctt!
<br />Shear Wall
<br />Framinq
<br />lnsulation/Eneroy
<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 Cerlif .
<br />l^
<br />FINAL q//,/7O --'tz 6t4
<br />Certilicate of Occu an
<br />Notes, Remarks, Etc.
<br />BUILDING. INSPECTOR RECORD
<br />Rev.08'O/'2015
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