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SITE.WORK DATE ID/SIG.. COMMENTS OWNER BUII.DER DEt'AN TION
<br />I h6.B .lfm uixt6 Frly olFiury lh. I e aalpl tm dt Cod,.d6 Lro. l,w for th. follo*iE '!en lS* 70ll J
<br />Bu!n63 dtd Prof*ion Cod.) An, Cny or Cou,rry *hich r.qun6 ! pqnil lo ointud. stc, inphve dsmlbh m lq.{ 6y I
<br />ntu r@ Finrd ar. dl4q.lo r.$i6 rlEeli(Tr ftlr trh Fnn lo fk. rie,ld .iEr lhr lEor tlEil ltd.d Fl,ld
<br />lo tnc Fnvliod olrlE Conrra.loit l,ic.n*d hw (Clufls L Comdcins wilh Salion ?Oo0 of Divtion ! ofrh. Bi!'nd dd Ih.f*i,c Cod.) d rhd lE d rlE i! q.qr rhclim sn rlE tGir ror lh. .lEs.d donFio. AnyviohionolsdlnnT0ll t, b' D,
<br />$pli.6r for r FDit rubjarr rh. lrplnror to r .ivil p.Blry or ml mr. fio fiv. hutdftd dou$ (ttl)O)
<br />L s .$c.f th. FDFry. o, my.q)lo)B with *.*6 s rhcn sL snpasliol! will d,ll8 s.t rd tlE rffr@ is a
<br />id6i.d dr6lta.d for $l lsa.7o44, AGiE $d Pmt*ioE Cod.. nE co.r.dd't r.i.e t *&6norslylodo$cof
<br />rhc FoFry wh hil& o ii{rcrq 1h.sr al *ho &6 sn eil hiNlf or h*lf or llNush ht or hd oM dPlor!6.
<br />provirqi rhlr tu.h inp.oldiEfu e d no'd.d o o,Is.d tu eL. lL lD*@, rL b'ldins or iqrh€ld i! sld wrti! nE yr
<br />of.oErpLrbtr 0r O${s Builda sil h!r. ttE hrdo of Foviry dn tE or slt djd dn hdd or inFoE rh. FoF, fr llE F,poE of
<br />-1.
<br />BoqG of rh. FoFry, d.r.16r.l, codrding {nh lkdE d co.lra16lo.odru.t rrE Fjd (!iE ,()4.1. tl6iB
<br />.rn hDftsbn (it : Tt. conrrr.roi. l,icce l,v do6 ml 4rly rc e o*.a o aptupriy *ho buil& or iDprovd rhdon.
<br />&d ufio onr(l3 tor.u.h poF! *irh . (.oido(o lided rEE@ b rhc codr.df '3 Lk.e L$l
<br />_l d .rmp! udd sdi)
<br />^,2:617
<br />I hd.nt .mm !nd6 pcnal!, oi Fjuy
<br />D!:rll!&r.ua
<br />I h.vc rn will n.int.b r C6rificir. of CoB6r ro S.lal6uc for wk6r o.rp6rrion, 6 Foriddi lor by 56160 l7o0 of rlE
<br />rtbor cclq ad rlE Ffolm of rh. srl fd \ni.ll lh. Fnn i i!u.d
<br />-l
<br />h!r..!d witl Mir lin wortdt .6mFE{io. in'ry., s rcqui.d b! Salion l70O of llt Lrbo. ( ode fot th. Ff(tu. of
<br />rhc worl tor vnth $B p6nn i! sr.d My workd mmpadion 'Burffi. @iq ,{ Flty nlobcr e
<br />Pol(r NubG
<br />-
<br />-!
<br />cdifyrh,r in rh. rdfol1M.. of rn. wort for whkfi rhh r'<Fil ri aiu.{ t !h.tl not @plo, e, pc$n i. ey n1i!F
<br />$ s ro b.sE $bjar ro rh. \!n6' o,iD.i..rsn r.N of c.lifomd .d .sr lhd if I JDurC hdoc sbit' to tlE
<br />q'olt6'comF!.riorFovnioBofs..rion.tTooofrh.trtorC.d.,,sh.ll.l(mh*'nhcodply*ihilb-Forth6
<br />wAR INC: r.il!rc lo m *mI6 oDFBnion srdt*. a shtrtuL .d Jdl tubFl s dphys ro dimi.d FEIiit.!d
<br />cilil nn6 up h on. hu*jEil lhous.nd
<br />sarirn 10?60frlE lrtrY coda nrd
<br />l{x).ux))- m lddinn h rhc cod of comlrol
<br />I ffiy lrm uid6 parXy of pdjury rhi I m li.fl.d u.d.r Flvtion or ChlFa I (offi6g *irh sdli'n 7O(x)) ot DNtioo l
<br />oa rtE lldiE ed Pref6io6 Cod.. .d Ey kae n i tu[ InN !i .lr<l
<br />LicmcNuntF
<br />co.Ul:IalJcllllli.l.EduacrrcEAll
<br />I tE.tD irm rn<Lr Frn) of Frury th. tlE t.odrudi'n lodns r{ft} lot ih. FfolM. of rh. ultl 6r r hj<h rhir pnmit b
<br />i$u.d (Ss 3097.Civ C )
<br />L.ndd', Nm
<br />-
<br />AEIICANLDIS.ASAIIII!
<br />I h.rt, .trm un.ld pd!I) of Fjury orc of tlE folh* in8 &chroi i6d
<br />O.oohnri PnniE-Arbdor Noti6c.lion Folall Reulilionr (titlc,l0. Pd6)
<br />Rat!&d Int6ofNdr6cdbn
<br />-
<br />I .dif, rhar $. t nall ntrl,rioN Etsnin8 Btstu. im.v6l rc nor oppltlbL b rhi! ptuFd
<br />'.aton atut srd. rhd ih. ali\. rli'nn.rin rs.otrd Ia3.e
<br />,,(/Z
<br />rocomrly * hillC yanLl(ounry
<br />lrhlrciryi.d (r'unlt ro ors uFrn tlE
<br />, ,. 2 -c':/?
<br />Set Backs
<br />Forms/Steel/Holdowns ).o\r4 -..-#)
<br />Erection Pads /G i\^ - [!a w{/
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathing l*4ln 1 V,,/t*r?a kb) Zz//UrJ/?/Z/
<br />Shear Wall /P,ilr\ut flt-fr^,)L *n-ffi'
<br />Framing I t u \_,v
<br />lns u lation/Energ y QL,-1r.,Wba
<br />Drywall j -?-{ -re
<br />Ext./lnt. Lath
<br />Brown Coat urtttrat.2
<br />lvlasonry ul
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />*&t<ut f^rz Q.a-<-ra 12^ Q lo:
<br />FINAL l-?r-17 wtrS la
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />BUILDING- INSPECTOR RECORD
<br />tdn/n 1 r'7,)
<br />7
<br />Ladd'r Ad&6
<br />-
<br />I
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