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SITE.WORK DATE ID/SIG.COMMENTS OWNEi BUILDEN DELCARATION
<br />I h.rchy !firfl ond6 ncdlry ol ttrrury rhrl I m cr.npr nom rtE G)nrECloF l.kcns lis lor lh. follo*h8 En,n (Sft 70:tl J
<br />Bu.im( .d Pn'ac(bi Cd.) Ary Cny or Coudy shah r.qulcr ! Fni ro o.(rlEl- ths. iItt,o\t- &ml6h .r EFt tny
<br />(Mlrc. I'ir b nt irffi.. rt$ RquiB rlE .poltrm lor ss_h rEmr ro nk . ri8ftd sld.lml lld h. rlt ir lr.ncn purud
<br />r. rrE Fovisionr ol r Conr8ritr\ l-icn{d lrs (( h+rcJ 9, (i,nnEftina sirh Salion 7lrD of Dirnhn :l ol rlE Au\iErr c.d
<br />Prctr\bn\ Cod.),r rhrr lE.r rh. i! crcnv't rhcElion aRl lhc h.rn lor rlE alk!4, crcnlrrn'n Any viobt b. ot S.cthn 70:l I 5 hy.ny
<br />.nrlk. for r F mir ul'Fli r& .prlk..r k, i civil tErhy ol n m'E rtun rlv. hondrql dr'l!6(JJUrI
<br />-!.
<br />.r o*Er of l|l. rrlFny. in ny .mplotr.r *irh P.8!r 6 lh.t q,L .on{Entdio.- sill tlo ilr qdt .rn tlE rrdr k mr
<br />inrcd.rt Dr ofl.rd lor sk ( Se ?044, Burirtr rnd PmL$hn! Co{h 'l-lE c.brMols Ltc.{ liv di*. B .prly ro !. o*ffi ol
<br />rlE F,Fny *lD hildr d ilFnB ilEla trd srb &n uh qrr h'melr or lEclt 6r itmulh hk ot ls own.trr,hFcr'
<br />pftrvid.d rhd uh nqrrlrtrdr G ri ncrd.d q oftEi fr Et ll hffi, th. h{illi! d irrrerrEn i $5 *ahr (E Fr
<br />nr d,q'Erhtr ihc ovm alirl.r rill lIE llE h!&n oI Enrii, lll lE r JE dn d hild d itI.DE dE F{Ery to lr F,FE ol
<br />-1,
<br />.. owE or rlr prtrtEiy. h cr(tu\irly colrdha *irh lii.€r! onrxtuu 1., otrinal rrE F.F (Se 7O4,l.llriE!
<br />.rn D!&sim Cd.: Tt Co.kdoir L..nB L.r dcr mr.prly ro D 086 or,mFiy rrr buikr or idIFB ih.,ftn.
<br />.nd who q'drds Lr ruch Imj.rls ,'rh r Conhdonr) ltlnqat punM t' rlr Codmnr ! Lt.n. Lr*)
<br />I .m.rcmpr unLr Sa8,n
<br />Drr. ()*n.r
<br />woR(r"ILa col\lr'r]:Ns^'rl(lN
<br />D[CI.A8A.I]IJN
<br />I h.r.l,r.mnnu ( !'cnrlryol Frjur!oft.olrh. nnl)tr'n3 d{tk!rtrN
<br />-l
<br />haw !t *rU mitrrah ! ('.n ir*n. .r Cun*nr t, s.lr.lnsurc tu *ork6l $,!Ensli.n. !r F,il.d lot by Sdrii,. 17fl) oa rh.
<br />Llhn dn . ln rlE Frforndc D, ih. solt nr {tah
<br />'h. IEmil t hrucd
<br />kl uw rna vrtt mlnrrin "orLn coqxnuri,. rN.rt.. $ r.rlultd by Sarsn l?m of rrt t lor (ii., r.r ir Ffre or
<br />rlE wort ror *hth lht F nit i. nskn My 6rda d,rqE.dbn iirut!re di, 'd Jnlky nun$.r c
<br />l..d yrhd in rrr lEni,rmrccof lhceork fo.*hkh rhn Fnnir ar isu.d.l $!ll ml .q'li,y lny Fra,n in.trylMmr
<br />g' .. ro h.om .ulr<r ro rlE q,t6'snlindbn brr or C,linmr .'n rsG rh, it I .hr!l'l trirB .uhFl lo llr
<br />*n ai' NriE.srion pml irirn( of sdiin l7m or rh. lilu cirl.. I {Ell- r.nh*nh @tiplt *nh l,n. |nrvsio6
<br />ItARNIN(: I'r,lnr h {.trn tr.rkc^ trq{n\rttrtr,..\.n!r s trnLr{rul.rtnll sul'Fr .n cnphrrr b aininll lrmlB md
<br />rivil firr( u! nr n huntlrcl rh,'usud d.ll!^ rll(Xr.(xr)). ii l,l idr ol.onlxn\rrn,n, da $!cs or Inolntcd ntr rhc
<br />sdrl,n 1076 of rh. Iior ('dL. inrcE( &l trrorry
<br />trl.(l \R r I lr)\
<br />I Hly.ltrnu8t FMx, or Fiury fic I m liBr.d unrlr Fvirih or oq{d 9 (oImils *nh s..ri,n 7m) of Dinhr l
<br />.t llE BusiEs !n ProrBioB CorL, rd my lic6- i( in tull foR en cfier
<br />t", .",,,yy'/"f7
<br />A{krirsd:l(D7.(r cr
<br />A!EL[ANI.ELI.A8AI![
<br />I rr'Lt'y ,trm ulLr Foalr, ol Fri,r, ox or ltt folk,r itr! dc.lnnr..\
<br />D.m,lirbn Pcrmn! Arh.n.r Ndiaklr.n lnlcrlRc3uLrfn\ (Ttrk{r. Pad6)
<br />koquncd lrrrrrof Norli. Dtr
<br />I .niry rhd tlr f.d.r.l EslLrioN Eardins r+-tx rcmvrl tr ftx .t{,lt.t'L lo $n pFFd
<br />I (.'rirvrhJ I l \rrrn(l rl'Arft),{ i'nrnrrrn FeDtrc(r l4r( t).omtlywirh illC[yutrd(.unry
<br />orJtrEtu.i.nd sr.r. trwr EliinS ro hnildinS rcl't surktriz. r.t'.€nrdi!.r ofrhn Ciy and Counryb cnrr dF,n rh
<br />.h ! nrnrirftd nn)Itny tu nrlEdir.IruFEl
<br />Appli.xnl or AAtnl SiE Hlu
<br />Loql<
<br />e/t/r
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq
<br />lnsulation/Eneroy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Itr'lasonry
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />/* q A$aA-/ d .22-0 f?-c-<J 7
<br />FINAL /bz>--/p/)!-<- z n
<br />Certilicate of Occupancy
<br />Notes, Remarks, Etc
<br />BUILDING- INSPECTOR RECORD
<br />Crtr:-
<br />CIIBSISIJIJIIIII.EDIIi!.AGEACI
<br />I lEEh) llIrm unlq rEBlry o, rErrfty rhn rlErt h r dr{Mirn tndba .!.ry ror rh. Ffi'lllltr. of rlE e tur rti.h rhis Fmi ir
<br />lr .ir Adil($
<br />UFER Ground
<br />Pool Fence
<br />Flood Zone Certif .
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