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SITE.WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />Sublloor/Vent/l nsulation
<br />Boof Sheathinq lpLt t/h/q)
<br />Shear Wall l_v
<br />Framinq
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />lvlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />lr
<br />FINAL 1\a ,?,,\Da*c"
<br />Certilicate ol Occupancy
<br />Notes, Remarks, Etc
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<br />uR Dt:t,(',\t{aTlo\
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<br />8ur'rc$ .
<br />'ht6
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<br />{Mu.. Fs b rt !on., rl$ EquE, rlx q"i.. nn rkh Fmr ro lilc r rsr.l {i.ftd rnd h. or slE 6 [c.nr..i ,,ulvnr
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<br />__I. r' ow or rtr rtuFny, or my cmployer y h w.Ecr !r lh.n sob q,mFnsrl ion. wil dd rlt wdt r,,l dE qtutE s d
<br />dcnldl or otf.rd ntr ub (Sa ?0L, trustr$ .n t Pnt,.sDn! CoL: Tll clr*&nr\ tNns llv d<B dr {rly b rn 0*6 ol
<br />rh.fn,Fn, ph,trLls r nF)rr rh.Fr. dr.l *hl dlE\ tsh url him*ll or h.dll or rhmuSh hr It h.r trsn crg'byes.
<br />Fovr.ll rh.i suh lirn,wEr ! N n rroJol q oridd (n ut ll h'M, !h. t!$Dg d ryn'Emnl L1 3rtl *irhin "ft Fd
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<br />orl Pt\rh\tn (itk: Th. Conlrel,tr s l-.cn$ tl* &Es sn lprly b d u*tr olln,n ny wh(, hurlds ot mPnrvc! dcr.on.
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<br />I n.r.mni u.rtr S(Irx
<br />"ffiffi*
<br />, I h.r.hy rffrm u .r lEBlry ol FJury om ol r tultrwry &.lMrNE:
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<br />trtrr C,rL. Iir rlE Frfo|rllh. of rlE e,rt nx *hEh llE Fmr !r ErEtl
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<br />I hrw .Bl wrll rht.in pork6 $riEtrqlion o$rrE.. r. rcqu&J t, Sd (,n ITID dr rh. l:htr Cirr., ntr ltu ldnr ncc.f
<br />work ror whlh lh! Ilcrmir N iituJ M, workcr .onlrner[n inlantu. rftr .nl ,Dlry nun*fl {.:
<br />54_\]te Fv-.Z\ -.t_
<br />,.rn,.*, Qa\.\ o 8\ ,.n^.ol-tl 2o La--
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<br />vr $ b lEntu rubFrr k, rlE srt6r $qEnrnr)h L*r olCnrlomn..il +r thd if I rh'ull lE om $b].!l rollr
<br />worl6\ uomFmrtnr pNvBion. o, S(lDn l?uJ ol rtE L.ttr Onc. l nrll, fonh* h coiloly rnh lhoE |h rsrD!
<br />WALNING: Fllurc k, q@ $ 6 snFnrdxr.lErtc rs unhwlll a snlu utirr tn .nfnty.r ro mrl Fulrs ..d
<br />(oil lin.i uF l. om hudBn lhruun drnbt (lloo.00)r, '. rllnir ro t,r .o< of ontiNrron. JmScr 8 ,m\rt.{ r rrE*ka"-?-q -? I nL.-lo A lcq ^ l-.. tr
<br />!l!I}$j1-!LLr-8,!lu!!!n!.!8!u.1^
<br />Ihri.htrlftflun'lc.Fnrlryol p.rjury rhnrI r l(ctr*d un,cr F'vr\ tr'n ol Chrprcr 9 (lonrnEk S! hSc\rrm'7(XXlrof lh^(n:l
<br />.l ih( tlun'k\\JnJ llol.sr nC,klr, a,ll n,r li(n{ A r h'llntr!! .Iccr
<br />L 31 lo2oCl
<br />cqlslB!.Icllll!.rEliutsci{iEM1
<br />I h.E$y llrtm un Lr Fnllr, il lcrJury rtur rhsc is r rotrrhrtt,n Lilo! 1!.^_y ft, Ih. F.fo|lra. ol rlE qxk ntr *{Eh ihir Frn it
<br />riskJ 15&. XIr7. Crr. C.)
<br />AP&ICANI.OECIdBATqB
<br />I Hry rtlm unLr lrehy.r Frrury oft ol rhc loll'sr! d.rLori'trs:
<br />I).mru,n P.rmr'tuh. or Noxrdxr tqLr.l R.8!Lr$n! (T[k4{), Pd6)
<br />_R..tural l.trcr or ud,ri.rrfl
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<br />ify rh.l Ih.rrc ttur.mla.lnr !n n.rc th.r rhc.h,E info.lurbn B l:tllEr I rird L,.$n{r, snh.I C y dCdun!,
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<br />r mn!r,m,l nRrFny (tr nrFl.n
<br />lppli.rnl or ,\E nl SiEEluE
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<br />t 3- zq- z(
<br />BUILDING. INSPECTOB RECORD
<br />UFER Ground
<br />Brown Coat
<br />Flood Zone Certil.
<br />$:21-:-2)-
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