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SITE.WORK DATE COMMENTS OWNEi AUtI,DER DEI-CARATION
<br />I lErchy rrrtm ud( Fdk! rtt Frjury rh.l I s.tc'qtr hrh rlr Ciidh-.llx Lrcnrlr,ntrh.ri'lh*r!trq'nlsd?oll5
<br />aulmlt ril Pr.l6rnn CirL): A.y Cr! or C.Edy rhrh t!u!$ . Frrnt h d'n<ur ird. t.rq'ow, &D[rn ot EF, rny
<br /><urw, fnr b nr !sll&!. :ts EqlEilx {'tllidr fttr ruh rEmr ro lik, n3*rl (rc.mr th.r lE or rlr 6 lms! PUas
<br />k, rl* FolM,nr dl th. ConrEtni Lird.n Lr l(lsrrd 9. ColllmB--n! wdh Sdrr,n 7ml of Orvarrr !.f ih. RN'r( r
<br />Pn,r.ri&nr (ixL) ,r rhr lr d rlE n .(nF tlE lth.nlrlEtunr l rlttll3n.cnY'l,n A.y vithrr'n .f Scrrr 701I thy.n,
<br />rmlrrni nrr lEmn {hFh rh. {"iErnr h r.,t,lFMlry"l hn m'E th2n trvc hunJFJ J.nLtr ( Slm)
<br />l. 11 o*m' ol rl. rx{rlly. r nr cmll,ycc\ w h *rF.\ r\ rh(tr v'h onlt'cn\ikn,. w lJ. rh. *(f,t.nl rtr (Bim N fri
<br />mtnlftl fll lcrc.l ttr el( I SN.?01.1. Bnsm$ 3nJ l'n',.rnons (,rn: I lr Conttrrktr'! l.f,cn{ I rw ,lo+ noi qlllly k, an o$ncr ol
<br />rhcpn)irywlx,h,kl\ormfn'vc\rhcNr.irlwlr,(l(flflhu,*hn\.llorh.rscll Irhnn'lhh^,trlkrown.mnl'y.c\.
<br />lllv .(l rhrr !'rh 'mpn,lcnidr d. ftn trbrl. { dIqLrl rtr $L l l. lx)u.vcr. rlF tinln'q or mpnvrtrYd r\ nrll w h'n onc }t
<br />ol ('n{'Llrfl. rlr ( )wNr llril&r will h.( (lt hurlknnltn,vrn8 rlurlrot\h.Jd n lxtrLt dr triqntrt rh. Flrtr v 1,tr lh. pullrrc l
<br />l. r!o*Frol rlB F,Fny, m...Iu1'c.ly.odr!(ih! strh I'dntd.orrt tFr,('n{l**rrlr|n'Fi(Se7OL Bhmr
<br />Prft\$rCd. 1tc6 hk,'r l-k.nt L.r ntF r, .nply ro s ovM or Pn{rn y vh' tlurlli or I't{treEr rh.r<'n
<br />rEr (d rtnn.utFoFrr* h t(i,rrori,rlt lft^ed F^u.rr lotlE C)nrBror'! lr.r{ lr*)
<br />lv{ lKFtLs' ( ()ntIEl\sATloN
<br />UEII./\EAIION
<br />Ih.nhy rll , trtr,lrr Btralry.l lcrluq.rE.l rh.l',1[,s'nr JRlnrrr()n\
<br />lhrv.r'rlw,lln n Jn.Ccdilrrl.ol(in,\.nin'S.ll ltr{trc nt *dk.n uompct\rinn rs l'ov',l.,ll,t hyS..rt,n:trrX)!n tht
<br />l-Jhtr(irl. l,trrh. Ii'nmrf,.ollhc *oIk l(tr wh(hrht F-rn N '$trcJ
<br />- I hlR xfl, vrll .urnrin *o.t.r' onll).n\!rtr!. rnruoh., !r rc{urc'l ny S\..rR,n l7(1, ol rtr I rtxtr (ixk. ntr ! h. n rl rmmc .l
<br />ih. rork nr uhrh rh6Fmn F !s{hl My*o 6 (rr{*nuk'n rn$rrrc rr.r dn Fnry nunt r r.: ,
<br />I!. 'ltrhri ih. tHl'rmET ol rlx *trrk,rnshkh,h\Iritr,[ N Rn'cd.I \hxu hri.nr$)t.nv Iir('n 'nrnymanm,!) !rr)t$nnr itrhFr b rh. $1,rl.ts $hFniirNr lr*\ ol( rl'lom'r. rnJ a8rc. rh rl I \nn'Il t\(r'tu \uhi(r ftrrh.
<br />wD*ci\' s,n{xnqrkr I'n'rtrtrrns of s& r0n :l7tn .r rh. I rlitr (iil.. I \hill. bn ha h urnd! * ih rhr{ Pt'vr$r\.
<br />WARNIN(; l'irlur. n, s.urc worL^ .ompcnrdnrn (*ii3c r( trnhwlrl. 3n(l shrll nrh).er rI orfloFr I' on'n.l F,rrlrtr rl
<br />Ir lrlitr (,rt 'nr.r.nrrlltn ry\l.r1
<br />IEIIABAIIIN
<br />I lErhy ! nm udcr Fmly of Frilry rh, I m lr$tn uBl.t Fstrpn orc]Efl.r', (.nrch-.m3 wrh S&rnr,(rn) or r)'ttrnn :l
<br />or rlE an!ftr ril Pmr.si)m Cd. dl hv h6< r m lull lrrF nrl.lfar./o I
<br />C(TNSTRT]ETIIIN LFNt}ING ACENf I'
<br />I tu(he lrltrB un,lcr lItrilryol trrj$yrlEr rh.h t a (nn{n(l!'n Lkl!,8 r3ctrcy k* rh. llrLIrtr{rrr ol rlt work t vhth rhis l^-rn h
<br />rru (Scr .lrt)7 Crv C )
<br />afrlllANrllEcL{EAllllli
<br />I Hr,r dlnn uDl( Fnrly nl FrJUry oE ol rlE !,'ll*,r3 J.(l rrrt:
<br />ftmni.n Pflfr!l^\tEcos N{'f{rrn. F.d.rrlRctuLk'.rII k {r. Pd6,
<br />Rrt',r,(l l.rt
<br />'
<br />or N.i'ltrrri,,
<br />l (.'rrrh.( rl'( lnhrnli.ptrl,rr'r\ kIr,itr'! r\lx\r\ r( i^xlrr nor rmlkrhl. r, rhA lrl]l(r
<br />nhr. nr Nx(l pr't ny lnr n\F*M Pur
<br />,tDDlnxnr or ls+nr (ii {ruft
<br />Sel Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />It/ason ry
<br />Pool Fence
<br />Handicap Req
<br />Deputy Final Report
<br />Enoineer Final Report
<br />Flood Zone Certil
<br />FINAL Y \?,$\\1 b qQ6.
<br />\Certilicate of Occupancy
<br />Notes, Remarks, Etc
<br />BUILDING. INSPECTOR RECORD
<br />ID/SIG.
<br />L.ntr'r A,i.&.s:
<br />,,.'"6/try2fl
<br />Subf loor/Vent/lnsulation
<br />T-Bar
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