|
BUILDING- INSPECTOR RECOBD
<br />SITE-WOBK DATE ID/SIG.
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUlnsulalion
<br />Rool Sheathing
<br />Shear Wall
<br />Framing
<br />lnsu lation/Enerqy
<br />Drv!vall
<br />Ext./lnt. Lath
<br />Brown Coal
<br />Masonry
<br />T-Bar
<br />H andicap Req
<br />De puty Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />FINAL
<br />Certificate ol Occu pancy
<br />OWNET BUII.DET DELCARATION
<br />I h.rchy arftrm uBLr FDlly, F0ury lhi I s.r.ny{ hlr6 rh. Codr.rrE' l-.o{ tr* lnr r& li l)*ins E.rr (S.. r0}l i
<br />au m( rit Pfuf.r\p. (ii.): An, C y or Q,unly uhf,h EquRr r Fd to dinrtur, .lrd, 'nt"6E, &n)l*h or Ep.r uy
<br />nMluE, F,k, r 6!nr(t. dlo rqu@\ rlE rr'rL. tuqhFm lo riL. s8Fl nrcEnr rhIho.dEslr.nel e.d
<br />ro rh. F)v!n,ns of tlE CbnlrklM 3 LEn<J trw lcfirfl.r 9. CoheEus *uh Seri)n 7(|r0 ol Oiviron I ol tlr Burmss .kj
<br />Pft,f.rlin! c(rl.) q th.r h. q sh. s .r.mpt llEEiion dnl rh. h.$ for rh. .lkf.J .r. trrh Arrr$LrFrofSd0nT)Jl5 by&y
<br />rt{'l$nr rd r IEmr subtdk rlE {tlud r, . civrl FMhy of D'l mE rh.n trv. hundEd dolt-r ($m r.
<br />-1,
<br />I omr of rlE Fsl.nr. ( hycn 'll|Fct w h w.Bc. ar ih.r oL u'qEtr..ron. vll io lh wt.n 0r ntuJw 6 mr
<br />lr.nlol dofiaEd rrr .h lsa.?o,r4. au.Es.nd Pn,r.ssns ctrL: llr co rarn r Lrm kw dc nd +ply lo u owEr or
<br />ItE InJEny wtF h{ s.r fltnE.llrl!4 !n wh ll- rh qxt hm€ll or h.r-lf dr lhtuu8h tr ( &r ou.r{,by6.
<br />I'ru,ii.r rnd rNh uqrrm tenn ir.nLl txoiftrd rr sl Ii ho*.r. rh. t! rue d u$*dd nr d*ithqmFrof.onol'e E oemr auir.kr wdl h,E ilt llntn or Frvuu th.r lE or srE Jil mr h]i! r i,ImE dE FrrEr] ftr rlE Fqs..r
<br />_ l, $ own.r or rh. !n,p.dy. I'n.rrluriv.l, .odrnrr8 $ h lkcnE,l (onlri.r)F h .ondru.i rlI F)Fr (Se ?044, B!.tr$
<br />ul lhnsrrr Oilc: lhc aonlrkld r Lr.nrc I-.w dds no! {pl! !' doemr.l Fol.n, rL, huildr or lhrmEt ihcr$n,
<br />rnJ *h, (rrBt iti rkh InF.rt rrth. Conrnen'i, lr.n{d tllrd n, rlr Ci)dr k*-rt-r.n{Ij*)
<br />-l
<br />imcr.mpr undcr Sel
<br />lcraf,Ef,s.g&ItllsAlla!
<br />DEctAEAIlq!
<br />I hcr.hy,llumunJcr FnallyoiFr,lrytrE irlE ftnlr*or Lklld.rrunrl
<br />_lh.Ernw lmhr r c'd'f..k or Cons.nr ro Sclahror for krl.a lxi{ndion, .r Frvrbl tu h, Saron ]7m of rrE
<br />llhx CdL. rM rh Fnolm. dr rlf hll ad *hih 0E Fmd i! niEJ
<br />_ I hrv. rnJ *nl Mi.rri. wo.lm corqEnuri,n msur.R.. $ Equtr.J hy Sdr i'n J7U) of rtr tih, Cor.. lor rlE F frr|l1lM ol
<br />rlE qrk td vhrh rhl\ Fmn u .irdt My *ort6 coqrn!.r0n rnsurB. ce.r rn F)l.y mhtE e
<br />c*, tl,qzrico.r 7 uric,.
<br />v,,LSOtbclJ lirItrc.I Zc
<br />-l..nrlyrh.r
<br />m rh. p.rldrBrc rrlEuorkl*vhxhrhtrlErn tr rru.J.I rhall ft chpk)y rny ti.N,n m tny lMrr
<br />s' rs b tEg,B {q.rr ro rM wstdi $,|Fnd bn L*t ol Cllfom4 ard .3e ihd il I thrtt hc$m rubr.r l,' rh.
<br />wortc .of,{Ensron Frv.i,.! or Sdi,n .!7(n oi rn ljhn C{rL. I nElL nnhw[n Lnrply *ilh rnE FDvrn.s
<br />WAININC: F{luE ls Burc H,*cu oqrn{tln cdv.E!. r unberul, :nl rh.ll rlhj.ir D mfloy.r t, ffml FEIS ri
<br />r lu.r ulr , om tu,n.c'l lh'uslri JoU.B (t1(x),U,0), '. rrrl bn b !h. on of Lon{En{hoh. dltr8.r .r ltova.n for rM
<br />rh. I2hrc.ic. hr.({.n].rbmy "-ibtl(r l
<br />L(lilst[r9sr&Klaxlul:l4l&u&!
<br />I h.Ehy dltm uD.,.r p.nrlty of Fjury lhi t m lEnrJ unJd F)vrsu of Cl[orcr g llrrlrrtjmina *rrh S-1rr nn)) df Drvnn'n .l
<br />ol rlr AuriR$ .nd Pn,a.ri,nr Ci,J.. drr my lrcn( s o tull tunr .rn .liar.
<br />ctd q19)rA
<br />t\/za / rc,
<br />CONSINUCTIOIT I,F'NI)IN(: AGENCY
<br />I h.nby dtuh u*Lr Fn lry ol FrI!, rh, rlrE ir . .r'nrtrulr rn bn lry q.ey for rtE Frfim. of lh. qrt lor wnri rhr IEmt s
<br />,rreJ (S<..{D7. C'v C.)
<br />APPLICAMT DECI-/ITATION
<br />I hftiy rtrm unJ.r Fn.lry oa F.rrry oE o, tn. nnbrirs &t l!.ronsl
<br />D.ml!sn P.rhjrlArlE{or Ndilirrrr F-lc6l Rqulrrrns (ldL40, Pd6l
<br />_R.q0in.i lrrr( ol fltrl..alrn
<br />I L.nrly th. lr f.d(.|rc8{hr.ni EgrJnS xh.nus En,vd rc n qDlI kn,rhtFrFr
<br />PJI d,ry rlr.r I h.vc EaJ ri! .rTlrrri,n ail (.r. rhi rh. .t v. rbmr[n F .omr LsE n, (mrty ,rn .I (ir y .,n c,ury
<br />oiinaMr u'j S!.rc L.!r rcLrur8 ro hu lh8o.{I*-ri,n. ril V'htr,. rr.\.nrrnlcr or rhl C , rd (i,unry (, .nrd uF n rll
<br />atx,v. Bnromd poFnt lif, Dr
<br />L
<br />^ic
<br />(
<br />I
<br />COMMENTS
<br />Pool Fence
<br />Notes, Remarks, Etc.
<br />f)rv n ,' ,' , \./ a.i .- t
<br />I
|