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BUILDING. INSPECTOR RECORD SITE-WORK rD/srG.COMMENTS OWNER BUI LDER DI]L('A N"AIION I hd.tt .rrf, undd Fn.h) or Frorr rhd I m .rmF frlm lh. (hdrrioc' l.t.e tr* lor rh. folhriry ra$n lSR 70!l ! BNinBs ltd P.ol*6n (odc) An! ( ity or Counly qh'ch r.qutrF a Fnir h (onrtud. .h6, impi.r.. &molBh or tsntr , nru(1u.. rmrx' ns Buft.. ft. fttuirB ih.4Dl'.d lar ru.h Fmir k' lil.. riBr.d (armr rh,i L o.3h. 6 licd*d ludmr !o !h. FdishN of th Conlr.clor s l.ic.nFJ L.* (Cnipl6 s. (omnfl.'ns $irh s.c!.n 7(roo of Divrnrn I otlh. BunnN and ProfNnns Corj.) or rhd n orrh. !doF rhs.6om tnd lh. hcs6 aor rh.tlk8.n.(6dhn An) rrhtrnols<cliJnT0ll tb tnv alth.d lor r Ff,i iubj<t !h. 6ppli..nl ki r il p.Mh v o f not morc lhn l-rv. hu.dr.d doll$ ($500) l. s.sEollh. FoFny. or rv.n,plorduilh{a!B$rhcirc,hcon,$sn\..uilldo!h.so*mdltEsln!1E.!R,l mrlddl or DlI6.d for$k(s6 7$l-l.Ii6ilK 6d Prol6i'B (-o{. Ih.(i' dors I r* li$ d.6 tun 4,tlr- ros.trMof rn rnFn! $ h. hril& or imp..\ 6 llEotr {'d q'ho d6 l$h $ul hms.ll or h6.lf or rhmo3h hn or ha tn dlplo}c. Forildl rhar ruch imF.rd3d n indid d oltud fr sk lL l$*6d, th. tuildi.a or iiprorffi 6 $U u iih'a on. \6 of$rrpkrbr rlE O$( It![ir * l h!r. rh. hnld or pru\ mg thn h. or sh. dxl nor htrir.l or iqror! th. Fopdy (n lhc IlrF{ ot l. a osE of rh. thFd). m .r.l8tr.l! ..drdinS * nh hc66.n .onlrdoN to cotrlruci llE tm]tcl (56 r(X,1, Ilnn6r .nd Pirt*ir ( od. I h. (i'nlretoi! Lic.ns. Llw do6 not arrlr b u otr ns or propqry sho buld! or 'mp{o \ 6 rh(6., snd rip.od'.drrorruchFDj.(s$nh.c.ddnnrllidaaiN6drorh.(tntr..ioiiLicGli\c) I m.rdd un 16 S(t.n r/s lt1 DES.ABAIIA! I h6d, amnn undd r6.hy of,EJUD.rc{tlhc rolhsrry d.{, arnN I ha\c el *rllnminr.'n, ( d'fi<nc6l(ir@r ro S.lt ldnc for tr0116' romFKri.n. 6 Fotidcj li)r h) Sdnn l7(xrolrh. lrbor (-odc to rhc FlonMc. of rh. trod Ir rvhEh ih. FNr u i$u.d I h.r. rid *illm.i.r!in wo 6 comp.Nlion iButonc..6 Eqtrncd by Sdnrn l7(().rlh. t t'oi (i,L, nn ih. t-fomtrc. of rh. $r,t a6r $hi.h rhis Fmil ir isld Mr *flld onlFMion 6uru.6ir rn Fli() numh< dr l..niO rhd in rlE Ffolmft. orrlE rork ror *h(h rhis Fnn is Be.d I {ull6l @tkry tny Fsn in ry mMnd m 6ro b..om subj.n to th. worl6 rcmFnsarion hq of(.lifom6..nd rgc rhd ift shru tE otr rob,.cr h rr. w*a smFsxhr Fovilio6 of s.diin !7@.t rh. t.bor Cod., I dull. fodhr nh omFlr wilh lhos pmriltrN WARNINC: Flilurc ro Bur. $ortd onFndhn (ordra. ir unls ful. ad rh.!l sbFl o otprord tu dimiMl pdlti.r d .nrl n.6 xtl ro ok hund,.n rhoo$BJ d.lllc (lloo,(xro), in .dni'n k, lhc cct rl co k,n, dr r!.( rs f'fliiLJ i,n rhc satn t076 ofrh. t:htr(o{.. inr66 and liloru} s I hd!t'! !fii.n und.r pdulry or p.'jury lh,l I n I'ca<d und.r Fovirio. olClBp'd e (.om,hmcinB *ilh s.dkrr TUn)) orl)I\tnr \ of rh. Burind and lmfsFnr Codc. arj my lr# 6 in tull forc. rn.fi.d (a!$f,x(rallE8!MSli[l.(. I holtry attm undq Fmhy .r Fj!ry rh, rhd. i! ! oretuc1i.n Lid,U .Sdy ror th. Ff(rl1rltrG or ifi. {ot firr { hkh rhis Fri ir is.d {sd 109'7, civ c ) AIIII(AIUTES.dBAIIO! I holt't .fm udir p6.hy ot pqruN oN ofrlr folk n Ds &cleri i,.i Dcnrliion Pmirr-Alb6ros Nolifictrtioo !.d(01 R*uhtio.s ('lnt 40. Pano) Rcqutr.{ tdtd o I Nolifxilhn I cdr ' Iy lhd rh. f.doal r.*ul oB (!dd'n! dh6r.s r@r rl tu. nor etlrahl. ro thE rmjdl IcsiifylhalIhav.rc6dlhdlprlic.liona.d atclh l& atF!. rafofrdro. d.otr41 I4raro(ompb $'lhlll('tr) nJ c.unr) ordiBx6 !"d Srd. tiur Ebr'q-! r. hildDs co,rrruurE rn h6.1D ! ['rn. r.Fslltn6 of rhis ( ity d ( ounrr lo dld trF,. rh. il$c mrk,n.rl pn,pd! tu rnsp.dkJn Applicrtrl or A96l Signr(urr <H)ENA L*\ rft[tt Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Subf loor/VenUl nsulation Roof Sheathing Shear Wall Framing lns u lation/Energ y Drywa ll Ext./lnt. Lath Brown Coat Masonry Pool Fence T-Bar Handicap Req. Deputy Final Report Engineer Final Report FINAL e/2zllt -1/^/slt s) Certificate of Occupancy t t -, \_/ Notes, Remarks, Etc DATE I Flood Zone Certif. I B &r( nv lhn r.Mn/)..| rlxltt ^X4^j-,