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SITE.WORK DATE ID/SIG.CCMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loorA/enUl nsulation
<br />Roof Sheathing I 1A
<br />*TltulqrShear Wall lutzllT 140 I
<br />Framing ,l
<br />lnsulation/Energy
<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 />Enqineer Final Report
<br />Flood Zone Certif
<br />,,-\
<br />FINAL /241?ZC /t.1/"-,.?r< Z)7')
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />OWNER BUILDEI DEItr(' R TION
<br />I hd.!t ,ftm u.& FMlry of Frury rhn I 6 66F &ci rl'. Co,nr&r6 Ltoe b* for tlE 6lbwins
<br />BBira .d Profdion Co&): Any Chy or Cod, whi.h Equt6 . Fhn ro codM, d. mFoE d.mlth or
<br />rtrudu.. Fior to "r Buua. al$ r.quu6 rhc qDlrdr lor su.h Fnn to lil. a ,sn d ${od th,l L .r JE a lic.6.<t
<br />lo th. FovirioB ol ltE C.ntraclo.s Lic.n$d ljw (Chrfld 9. Conmo.in* with Sdtion 7000 ol Divtion I oflhc Bui.d
<br />Prcld66 Cod.,6.lhrr lr or 3n. s qcmri $6.lion ud rhc b6!6 tn lh. llLs.d dopdon A., vrhrio6.isclion 7011 t by
<br />.pplrd lor a p.mn subJd. rh. appli.er ro 6dlnp.nrluof.or mor.rhd n!. hufldr.d dollB (l5Lro)
<br />l. B o\ E ol tlr FDpary. or m, dph,6 r'nh sls6 a rlE $L otrrFlrEt! *iU & tlt $qt r, 0E rr'dE . 6r
<br />naid trotrdGl6. rl. (s< 70{4. &!ilE 6d Prof6bB cllc TIE codrsoli kde t^ dod d Slt to a o"G or
<br />th. FF.! *lF hr L d in+r€ tlE@ !n who dGrdr u4rt hnE lfo, hd-lfor dmugr! ha ha os atpk!6.
<br />ForkLd fid tEt inForqrd! e Dr i'rroi.d r otu 6r r]. lr. horw. rlE h,ildi'g tr irFeEEr L ,ld vithnr G )s
<br />of .onpLrb.r tlE O*c Bu dd will h!6 dr hdr otFovitE rhd lE ihc dil hl hild or irpnE UE FoFt, b.llEF posof
<br />L a of,r6 of rfi. Fopdr, m .xclG'v.I, conr&1i.g wirh licaEcd codndoE nr .siirud rh. Fojar (SE ?044. BGh6
<br />.d Eokin Cn& Tn. Conlr*lors l,ic.E lrr &,6 ml r!?ly lo e os'nF of FoFly $ho buld! or inpmv6 ttoar...d rho 6 d! for.kh Fojrr3 $nh ! c6d8to4r) lidB dpoBdbrh.codddsLkdeIl*)
<br />I m.ro uBld Sdion .a &PC lo. rhi ren
<br />Drrc Orncr r!3[talrauf]rt .tla!
<br />|2!ELTXAUA!
<br />I rucb) ri]jrtr utrJ.r po[ltv ! I pd]un on. olrhc nnb]irs dccltralons
<br />Ihrvcaiwill i .n r Cdifrlrc of Cotgr ro S.lf-l'se for Ert6 omFtdioc a FDrid.d for bysalbn 1700 of llE
<br />lior C.dc fd tlE FblllEC ofrh. h* atr
<br />"nEh rE paBh ir 6ua,
<br />I h,v..d q,ill mrulri. *0116 comF6.lion rlMffi.. a rcquu.d hr Sclnr 1700 of lhc t,bor Co&, for llE Ff(ffi. of
<br />rh. sorl for { l*h rhn pGhi' i! is,cd. tty * 0116 6mp.
<br />,.n*'1Qr7. Cj]\5+Lafr4 zaA
<br />t (aii rhd in rlE Ffollrm. oa$. $o tu $hrhdi!Fon i! i$a! I nul m' aploy &r F$. inetffi
<br />s a!ob..om$bcllorh.ro 6 @,pes.IF. h"!ofcdift'mia !d !*r lhd rf I JDuld btoft ot irl lo llE
<br />$!rt6' ompd@ion FlvnfB ofs..rio. ! 700 oflh. L.tor Cod., LEll. fonhs h mndy w(h lh6r FoiFB.
<br />WARNING ti'lu. ro cE. ErI ' co.+..dFr F!6rg. i! ub$tul. ..d .hrll rubj.( M atb)d h
<br />.'r,l fin6 !p kJ on. hundrGl rhollgd dollds (llm,0ooi, in add tr,n r) rh. tor .fco
<br />l,.hr(odc, id6d rd dn)n _! s
<br />r)t ( I \R \ I lr)\
<br />I lErty slIm u'xlr FrXy of Fpry rh. I e licEi.d u!d6 Fovirir of Ci.pr6 9 {collffiur8 *{h S6dbn 70@) ot Dnnon l
<br />of llE BGiB rd PrcldbB Cod., !d ny lie ir b 6lll foE !n dId
<br />l,o
<br />v4oV0 or-icrycrs,-lCEJ4
<br />cqllrausrloll.EdDuc-acldcx
<br />I hdrt.v.ffm u.dd parnyof Fraylhr rhdt !.or!tudb. btdi'E.a4t forrlE Fftlffi of Ewt6r*tthrhi!F ii
<br />ir$.d (SE. !097, Civ. C.)
<br />AIIT.T(3dLIECTAaAIIO!
<br />I hcrby rtrr6 u.<hr Frhy olFj'ry oe ol lh. followins deLr.rioB
<br />Oqtuliirn P@fi'^.!dd NorifrdDn F.dd.l R.suld.B (f nb{O, P!1o)
<br />&qun.d I!16of No{ifdbn
<br />I (cn't fid rh. Lddd r.sulllioB credns nthdld @oql d. nor amli..blc !o rhis tmrd
<br />fomdion ir corxr. I lge lo enpl, with rll Cir! and Counry
<br />iorc @tion d lr.F! lor 'ffh{fi
<br />BUILDING- INSPECTOR RECORD
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