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SITE.WORK ID/SIG COMMENTS OWN}:R BtIIt,I'ER DTI,CARATIoN
<br />I hci.tty lfnrfl u .r If,Elry in F |Il4 ltEr I an c(ryr fnrn rhc (iDtlrth' t.icn{ Iiw ftr rh. f.,llntr C rclvn, lscc 70.11 t
<br />auiin.sr nnd Pmlir.nh Od.l Ant(iryor C.unry whrh rcquh\ n Fflni ro conirru.r. ahs. iarpr,lc, d-ft,16h or EFtr lnt
<br />{d.rtrr., llMro ir( irsuM*. rho rcqunc h. inflronr f,n \uch Fmnt t' fito iiSmtl {!r.,Enr rhrrh.ot rh. ir lrc.{d ,llrunl
<br />t, rh. pmlxtnr ol $c C.nt*nrt l.it.<t ll{ (Crsfl.r e. (ir'lme1.t }[h Sccrhn 1(lr) of l)ivibn :l ol rtf, Bu(ims rtul
<br />Pnrf.snn\C,xj.lorrh,r h.rrh. ir.r.n{'r rtE.lmn rnl rh. ho(n for rh.ollcs .r.nq,lha Ant lii,lari,r ofsd1 nl0.ll5h}iny
<br />.ml,.rd nraFrmir suhF.rltrr onnlicrtrlloa(ivil|'ttr0lryorn.rm,.rhrnrir.htndr.ddnllui(!1(x,
<br />_l- .r o*E otrrE rrnrEny. d my..r9hys uirh *+.r I rrE, $lc $qnqrbn. will(h rlE srrt.d rL (dm h ml
<br />i qi^l .rof.rcn lor {lc (Ss 7(!a. BusiE( Md Pr.r.donr Codc llEO,nrdor'sl-t.nsll*&E.frnlt'rlyn,Mo*ffioa
<br />ih. InlEny wlp triBr or itrIrcR rh.iEtr lrt f,lh d6 uh k l hio{|, o. h.elr o.llmuSn hir or lEr o}n ci{,loF-.
<br />Fmvd.d th.r .Eh iirmffir & d lr.rtrl ff d'dd for !L lf. hrr\s. rlE lxihiry or iryreEmnl i. *'B wnhin !ft )d
<br />ol orvlri^ rhc Opmr Build.. sill tuw llE txnln of tmvin! rhd lE or ih. il nn horld or intmE Or InFn, for rlE I"FE ol
<br />Lrsoqmr.lrlrln,l{dt.0.r(lunv.lt.onrDcrn8wirhli.cn{d.onrNn n, .on(d.r rlE Inldr (s( 7lr{r. BunEs
<br />s'i lhlixtnnCodc: fn.(i'nrr,.tr'r l.rcn\c 1.,* n,Es fr, np?lyro,norn.r offn{r } *h. hrildl or lfrpnnc! rh.rd,n
<br />ind *hl ddtu1sn* iuh F)F1( r{h i codfrri n liin{r! nurrunr r. rhe (i)DrrNcrois I iinr Lwl
<br />IUTAIiEEStlr)ufElllI-ll9I
<br />t}}:(LA8/Iuot
<br />I h.r.hv rllnnr of,l$ r.Mlrv.f|trluryotrc ofrhr n,lk,s$! d.clirittr)n\
<br />Ih!\.ml{'llnu'nrrr!(.dni.of(,rnrirr'S.ll lNorclDrk'*6r.oDIitrq[i,rn.r\ pn,vi(lcdi{trhyS..rhn:17(rrolrhr
<br />I f,lrtr C,rl.. ,(tr rtr p.rlnnun( o l rhc uorl( ntr rhirh rh ntrn xtr{rd
<br />-lhd.,nd
<br />lillroi.tr$ *.rlc^ cotrrlEn\{i in\ur!N.. trs rdlui'd hrSc.ri(r l'7(IIofrh.Ii&n (i c. ntr rh. FrlonNm. oi
<br />rhc *orl lin *hi.hlhN nernir i\ i\\ucd Myworkr^ conlncmrrtm 'nntraNcur md Fllil nun$.r d.
<br />-l
<br />ccnile rhd inrh. p.rlortumrnfrhc rork f(tr !hi.h rn'\ p(nni! n 6rutd.l rh!||ft, chPhyany Frsn 'ntnrtunmr1 dr ro lEa'm ruhFt k' rlE *dl6 drFp.nrrrion k* t .f ( .liirnb. ..d .!r rhd if I slnuu lrtom tubFr h trE
<br />rn*({ onrmeri'n l,Dvkbns of Sdrion tTtx,ol rlt lrtr, Orlc.lrtull. fonhrnh urrfly rilh ltx,c nmvition!
<br />WARNING F,ilorc k' su. R.rk.r slnpcnqri,n uuKn8c is unlos,ul. !.d {n!rl r 'F1 d!*rFr b dmiml FMIB anl
<br />flr'l lin.r ut b om huBld rhouqrxi dotldi (3lm.filr. i. aldnim n' rlr c.( ofc.qEngrion. dam8.s t. F vikn tu rhc
<br />se-1irn:1076 0f rh. Ll$ cdl.. mrd{.fic dkrEv'\ lft(
<br />grllirauqll}irEdllac.Acllljl
<br />I h.Eby lrh und.i Felry ul n rjxry th,r rh.r. ir r $n{ru.r i,n lcndinS 6!cNy nn lhc ps{ormB! o( rrt nrk r }hich'hn Fhn i.
<br />nsucd lscc .1O.r?. Civ C L
<br />Afrllcaur.IlEcLAlalra!
<br />I tB{, itron undcqEnr lr! ol ll.rrn,, otr ofrh. folh*rnE d.tlxriti(fi
<br />t).n$liri'n Pcrmih ArtE\ros Nolilic.rion lrcdcrcl R.culolinN l'Int r'0, Pd6)
<br />-Rquncd
<br />lrtr.r of Miiri.lir
<br />thd rh. {.d.hl E8uLri).r Etdnline astr{lr rcmrnl c dn rp,rliihL b rin I'ortr
<br />dnet I l8re ro (nDly $nh,ll ciraftl Q)unN
<br />.s arns of rtir Ciry dd cl{nry rr ..rG uFrn 'rr
<br />Dnt ,,,s f zf ,6
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framinq
<br />lnsu lation/E n erq y
<br />D rywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />FINAL E.I.E^R n--c-'z',
<br />Certif icate ol Occupancy
<br />Notes, Remarks, Etc.
<br />BUILDING. INSPECTOR RECORD
<br />DATE
<br />lr (\.f't,unl.r \(\rhn ll \l'( rirl'.'.r,ri
<br />lrHrr
<br />Irrr.: Ap?llont:
<br />r rcrr*ln rrrtrrrt rrti
<br />DEI;IdAAJIqN
<br />I h.r.hy.mrmundc.o.irltyol pcrttry rhd I nliuqlunkrForni,noICi'pnrqr.omnsrintuirhScdbnl(ttrrofDiftirI
<br />.f 'h.lrunFr.dl Pn c.ri'r(in . r .ry li..c n in rull tnrN {rl.lr'('
<br />Flood Zone Certif .
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