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BUILDING. INSPECTOR RECOBD <br />SITE.WORK DATE ID/SIG.COMMENTS <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />Subf loor/VenVlnsulation <br />Roof Sheathing <br />Shear Wall <br />Framinq <br />lnsulationi Enerqy <br />Drywall <br />Ext./lnt. Lath <br />Brown Coat <br />Masonry <br />Pool Fence ( <br />T-Bar I <br />Handicap Req t/ <br />Depuly Final Reporl <br />Engineer Final Reporl <br />Flood Zone Certif . <br />I .t ,1,^2 <br />FINAL 7,<9 <br />Certiticate of Occupancy <br />Notes, Remarks, Etc. <br />, <br />OWNER BUILDEI DELCATATION <br />I h.r.hy r nm oBLr FMlry ol Fr,lry rM I d .topr ,nn ilE CddrkkB' Irne Lr n{ lh nnh}b3 r..e)n (5...)011.5 <br />Bxsh.ss rd P(n sk,n Cdi.): A.y Cny or Cou y qhrh rcquiB r Fmt n' (Nrruu. .lr.r. nrpn'k. &mlish o, ttE, B, <br />iurm, rnrr. rrt urn.h-....l$ Grlir! rh. +l'tEeni td.kfi Fmr nr lik r ruEd sl.rcmnl rhrt lIor,E ! lilrtrEl I'u$onl <br />t, rh. Jnv(DN of dE Conr-kr's l-...*d Uq (Ch.|ls q, C.llwBhB *nh Sarion nll) of Divuirn I dl !h. Blnris d <br />Pnr.sn,nrCodc)orrh.rlrors}l.tcr.ry lh.rcfn,nrnlrt b.$ ld rh. .lk8.d .kn{iirn Any vx,blln.f Se'$n ?o-11 ,ty.ry <br />Illrll(rd n, , Fmr bFB rtr .rl'lErn' b . .itn Fn.lrr or not mrc thu lilc hunlr.n dollr {'J{x)) <br />l. rr owncrolih. FoFny, u ny cngloyes wirh vs3cs.! rtrr $L otrrFNlIn, * ldr rlr *qt rn ilE nturG ! n <br />lr.nLal or of,.eJ ,{r e,. (Se.7(x4, Bunmsr rnd Pmf.$h.i Cnl.: Trr Ci,nut(tr s tr.nE tlu d.cs n.r amly n' u owE. rl <br />rfi. F{dy *h' tlrl1! or irln)Fr rtd6( rn vh' dB rh *'lt hhrl or ll*,f o, itm)qh hr !r lEr owr.ry'!!ycs. <br />F)vrl.drhrlsulhhlmErnisEnnhlcnjcjo,oottrlt.dcIf.hlwcRr,tlEhiriinS,trrryntt8diralli*riin,Eyc{ol.r,InLtrl! UEo*E lru lr*dhr*DEhmlnorF)m80ulErslEdri h{ll, MtrrrmE hc rntEly l[lh.,'urFcof <br />I Mcr.hnr un!.r SccrDn-, B &PC rorrhn Eafl. <br />lllBA!8el&Urj!$rlQd <br />PE{:IJEAIIA! <br />I lEr.hy ,iltn un'lcr tEuhyoi Flory oM ofrh.loll,wr! &a llrrionr: <br />'11m'nrJn.(.n',rr(ol(nn{trrr,S.lr-In(rcn,*orko!lornFnertsr.rslrovhl.Jl,trhyS(rrrr7lx,o,rhcrh. F1f(,frtuc dl rh. rork li'r *hrh rhc IEtrtl il r!u.J <br />ll mi.r.n w.rldr comFnr.ri,n rBur.tu., .1 rcnurcn 6, Sdrrn tTcD of trr Lhor Cod.. for tlE FrfimE. ot <br />ir n\nr*. cd.. dd F,lxy numbcr e: <br />_Erl'!ct lzl+, 7 <br />_l !.n',i rhrr r rh.Fd rmtu.orrhc worl l'tr whEhlhrIr nn r rsu.n- I firll tur cmphyrnyFri,f, r.rym,nmr <br />vr slo tEoE rubFl xr rlE e,{tsi otr{l,eti'n L*rorcrl'ron!. thl.8R rhd n I $ou! lE oE rubFr l(' rh. <br />woltcr' comFnsrri(,n ln,vBi,tu ol S&tion !7ft1or <br />'h. <br />L.htr CcL.I $,lL nnnvih.r,ry,|, rnh rrDr FvBi'nr <br />WARNINC: I ur !i' sE srr.tr eohtEnr.rkln dxftEc i! unl.w6rl. u,i \h.ll hitr o.hfk'y.t k, dillnl FMI.i.nl <br />0v, fiftr !p !' .ft hunlr.i rhou{d dolL^ rllm.ul)), rn r!'ron ro rti oi ot cohlr6.Lo., de3.s ts rovk]al ntr llE <br />Sefu'n !076 .l lhc L.ttr Co!c, int.rcsi !n! florrcy \b"'V/t rt <br />ul![&u!l! <br />I h.Eby rrrm ulld Fmlly ol !.r,ury th.t I m lrqG] unlr F]tlbn or (tFd 9 t$nmhr! vnh Serrh nID) .l DrNNn l <br />or rh. ausft$ .n! lhra$ios G,,lc. {d hy li..rq ir h luu forc .Al cfl.lr <br />I h.^bv.linn !d.a ltelryoI Frrur, rhrr rlft r r.rrnMlDn lcturr8.3cB_y ntr tlr Isl,'trrre..f rh. *( ntr whth rh( Ffrr B <br />rxu.J (s.!. 10e7, Civ C.l <br />k'ncis NaB <br />- <br />.inc-r. I rld n, dn{ yqnnruCny. clilnry <br />clr.s.nhlv.r ol rhr C y rnd ( ounry b cnrd rF)n rrr <br />A'JEI <br />SLAB Floor <br />l. $ owEr ol rh. I'.Fny- rh.r(lrulrly $nr&ro3 qnh lr.nsJ Nnuf,r.nt, curttu.i rlr F,Fl(s.. 704{, austrs <br />url Pn,t s\id C*Lr Th. Contrrcntr'r L,..nr lrw d,rr ml.ntly ro d o*ncr oI nrolEny *b lto,[i or 'mpn'v.r rh.rd,tr <br />il wh, c. nchtu $(hlr,Fls*irha O)nrsbnt lf,cnrJ llllrunr L,!h.Cont.cl'(Lf,.n$ Lawi. <br />C1a <br />APPLICAI{T DF(-I ARATION <br />I hd6, ,rm unlo p.dX, ol Fr,trt oE of rlE lolbwDf lcLr.l rnr: <br />D.mniion P.rBih-Arb.rror f&,riri.rion F<i.nl R.!!Lri,n! (Tnlc,r0, Prn6) <br />_R.quu.al L.rrcr ot t*r -r:llr <br />,on?/4e/_