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SITE-WORK DATE ID/SIG.COMMENTS OWNEI DUILDER DEI-{'AR TION
<br />I h6.6y ifim unds phrlry ot pajury fid I h .rdpl fmrn lh. Co,{r..ros tkru Lw tor tlE folbu ing rd. (Se 701L
<br />Buin6r drd Prol6tio. Cod.): A.y (ily or Counly wfith rcqun6 a Fnil ro oldrud. .lld. imrrevq .Lmlith or q.! !v
<br />nruciur( r loh! trtr.. &o r.qoi6lh. +9lt! for r.h Fmn to fik.tigttdnn.l6r rhd lEor rlt a lt.B.d Fr.sd
<br />ro rlE Forirhd of rlr Co rsroi! Lk.B.d 1,8 (Ct Fa 9. Co@itrg u'nfi Sdion 7(xr ol Dili.b. ! of rrE EdilB ed
<br />Pro66.bN Cod.) or rtd lE d dE L ddF lhd.nsm !d ttE b..ir fo. lh. .lks.d .rdplFi Ary riohlhn of s..thn 7011, bv ut
<br />rpplicd for ! FEn 3ubi*r! rh. rrpltd ro !.ivil F nt.fml mr.lh!,llr. nun&.d dolld (1500)
<br />-1.
<br />B 0*6 oadE F.Fn!. d my dploys wnh us6 s |lEir $L c.mFBdio! *ill do ilE w. dd tlE rn(e i mi
<br />idcr,.d d.fi(.d 6r d. ( Sd '704,{. DBiB od PtladiB Co&: TIE Codrdd s Lt.r I rq d,6 d {,ilt to o ouE of
<br />rh.FFry *lb tdl& d nrrm16 tlEE( -d * ho .tE rxn sril hiElf or hd-lf .r rlnilah hi a lE o\n mphlG.
<br />FoviLd lt l .u.h inF.rffir c d iidr,.d rotutd ft,6l. Il ho{6s- llE hrilding n illm\dE n it sld $ irhin nm tc
<br />of.onFkior tlE (){ns Blildo "ill lus rlE t rkn ofFtrtin! lni lt q Jt dA d hild tr itrlFo\! th. FbFl, for ltE FuFi ol
<br />l. B oufu ordE F+a!t. m dduiEh co'rElins s ilh lcc.d .odt-oE lo N'dnrl rlE F.i< (SE 7N1. &.IB
<br />dn hoa.irco&r Jt Co *roi3 l-ta* L.rdc mr qrly lo e 0116 olFoFny sho bu'ld! or imF.\6 rh66n
<br />ud who (lllrd! fr sh FoJdl! wnh . Co' n<lo{!l li!&d PoBu,n l.lhc Conr.doa. t -k.M L.* )
<br />I 0 .x.mr' undd sar nrn
<br />D.r. ()ind
<br />noR(FRS (',Oiltrl\saIl(l:\
<br />DLl;lIa^IIA!
<br />I hq.by ofinr undd I,lndlr).Itcjrry onc.flhc aollo\ns d(l,.rioG:
<br />-l
<br />lB. rd will uiir.i.. CdifEtl. of CoMl lo S.lll6{G lor wla omPosiiotr t ForrLd fo. h! Sdiin 1,00 ol E
<br />llt r Cod.. tor rlr Ff(,t1rl.e of E rut fd trtth lh. Fta . !$dl
<br />Ihrv..nd*illmdim.in$orld.omFdtri.n!murtn....!r.qutdh\s(r.I7(xlorIh.I.hor(od..fitrrh.Ffodfficof
<br />on insursnr..in6 mdpolicy nu'nbs &.
<br />€ zb^\ b-Qn
<br />l.diftlh in lh. Fformtc olrhc{ork aor *ni.h lhir lErmil i! i!.u.d.Ishrllnol mphy iny pag,. in any nBnn6
<br />o B ro t .oft etixl rc rlE mrld' omrEEr h. LE .t (tlifomb. dld ryc lh, if I trsuld tt om sbjal ro lli
<br />Nlt6' o(FE rbn FnBhB otsErhn l7(jo olrrr t.kv ( o&. I filL tfih*nn @nply !nh rhos Fo\lFd
<br />\f,ARxt G: Fnlr to sc wt6' omFdbn 6\q4. ir unhsful !n ih.ll st!.tl & dighJc b aimEll Fdi: &d
<br />.ivil lin6 !p ro oR nun&.d thouerd dollN (ttm,om), in lddni.n lo lhc.or ol conp.B.liotr d!ug6 r Fo\ilcd for lhc
<br />Prz,.doILllcllllDioNrx lf!r8
<br />DECIjAAIIA!
<br />I hdt, dlm uidd Fntll, .f Fjury lhd Li li6!.d unda F.\'ithn of ( hqr6 9 {snr.o. inB rirh S.nrn 7([[l) 'r Ditirid I
<br />oa th. BuinB end Pmt<ioBCodc, d mr licce i! in lulllo.c.od.rat
<br />c-\o
<br />-c\ -l&
<br />c\
<br />,.r-3 I
<br />F It
<br />(ONSTNUCTION LT-\DIAC (:ENCI'
<br />I hc.b, rrm u.& Frny oI Fiu,y lhr $@ ! . .iEt!.lbn ladi'B .Str, f.r llE Ffffic of llE $n tu stihlhit Fbi a
<br />is.d (s6 1097. ci! cl.
<br />Lnds t Ne.:
<br />AIIUI;ANLIECIJMITO!
<br />I hcrt, rltm u..Lr p6.h y ot Fjury on. of rh. i.llo$ ing {k<lu.l ioE:
<br />D.moliio. PrmiB-Albdro! Notili@tion F.ddrl R.guhrn'n! ('rillc 40, Pfi6)
<br />-R.qur.r,
<br />trrd of r&{ifribr
<br />I cd ily rhd !h. f.d(it r.suhrnd E8-ding sbci.t r.m\ tl &. mr ryPli.bk lo ths Ir.Fr
<br />6-,rr,r', r r,"*,-a,r,u lpplkdrior ed,.,.rhd rh..ts!. hr.m!r'n !
<br />(odlled.d sld. tr*r ELilt ro h,ld'ns coluru.rotr tn hftb r(tF(. r
<br />rotr I.!rc k!.omnly\virh ill( iry.nd ( ounly
<br />ofrhi! Cn, ad ( ounit ro drd l4on llE
<br />.tFv. mfirirkn prcFny ror BFdion
<br />\ppri(, r o' \EHrr Si*nrrtrrr i
<br />I'crmil.. nimc(Drinl):($#
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulalion
<br />Roof Sheathing
<br />Shear Wall
<br />Framinq
<br />lnsulation/Eneroy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />FINAL
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc.
<br />+
<br />I \
<br />BUILDING. INSPECTOR RECORD
<br />q
<br />o
<br />Set Backs
<br />Flood Zone Certif.
<br />Ot1[)rt\d{ 111-
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