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SITE-WORK DATE ID/SIG.COMMENTS OWNER EUILDER DEI-CARATION
<br />I h.Eh, .fitn unLr FmNy ,)l Fr,!r, rhd I n .k,!rr rnrn rlE O,nrr-bn' l-un€ liw r rrE fi'll'wu! Eu,n lsa 7o!l 3
<br />Bu$n.\\ r,rl Pnr.s{on c'iL): Any C y or Counry whah rcquucr . Frh ro c.nsrB(l. alrd, .npft,vc, rrcfrntl or dplu d,
<br />nNdur, F, ro r lluer. rls 4!6 rh. {phsr lor .kh Fmr b rrk. qFJ n.kmn' lh.r ,r or aE 3 I'sql Fr'l.rr
<br />ro rhr Frvf-nr ot rlr Conr.cntr r t...n!.it lrs {Crrfld 9, Co,jmtm! e h Ssri'n 7(m of Drvrrin I of lrt Bo}En ril
<br />Pnn.(krns C,t.) or lh.l tr or tl* B.r.mfl th.Errom.tll trE I'anr l.r rh. dkSal .r.q{!'n Ary v bri,n of Ser$n ?0-r I J 6vinv
<br />.rpltr. ntrrrEmltruhFrrtrE.t!lr.dt,r.rvrlFMlryol turc'h, rrrt huBjr..l &llhtr\ (s5m).
<br />L rt owE of rlE tn,rEtiy, or ny .mobyc.i Pnh *.3.r $ rh.! bt .l,rqtt{rDn, w l d' rrE ult ul rlr qBiE tr r
<br />licrrcj ir oll.El (* rr. (S-.70&, Butmr. u.l Pn,l6q'N (ir.l: TIE G)dtant r LEn< ti* drt n'l q'd, i' u o*rr oa
<br />rh. pn,Fny wh) hr .lr { EF B rtEBn 8l *l$ d(r tuh sr* hhr.ll or h.r(lt or thmuSh hn .r lEr o*h .mpktyccr'
<br />,rcvrLJ ih.r lsh mlnrt/t]idt e.i ,!l.dn! oroliir.rl ,tr rk ll. hruE, rh. h{ 1[3 ot lrprDtrd n sE urhr oE rs
<br />o,co.ptln( rlE Ortur Bullhr * l h.E rh. hlrk ot F)tuE Itq tI s rlr Jrl tr{ ttrll ( lqEx 0r Fqdy ftxrll FqBt oi
<br />-1.
<br />r. orN, ol rh. |h{En y, .m .!rlu! N lt $drlrm! wnh lk.nsd .odtsr,F nr drnrdrr rll F'Fl ( ss 7(}{ Itu\m*
<br />,Bl thtsq,n (d.: 'l'h. Contdcroir l-r.nr.l.rw 'lNi frn rlply (, :n owi.! .1 ln}I'cdy *hr 6u'U\ or rhlovct rh.ton
<br />.nd uhl r..lr.ir ld su.h F,Ak w h . (i,n!tur)n n hcn{d nnFurnr b I h. c(,.tr&ttr'r Lrc.{ Lw)
<br />I mcr.nFl und.r Scrrion
<br />Itll8f,EEg"SqUrEUSAnA!
<br />IIECIISAIIAN
<br />I h.r.ny.ltun uD].. FMlly ol |triu.y or ofIh. tult,*o3 &rlmrjN
<br />I luv. rd *rll Ntnru . (tdf..t. f con(nt !' S.lllNurc t, eotk.^' Lor{'(nsatnr. !t [r[t rd tur hv S.ur int ]7(l) ol rh.
<br />l:h* CdL. fd rh. Falillrre! of lh. $rt f(t !i.h rh. Fm B nsxJ
<br />I hru rnJ *ill md In eorkcri ()nrll.nrrrr)n rn\ur!R.. 3\ n qutrcLl hy S..rinr .r7(xr ol rhc ljt,t C(xlc. ld rlI l^.-rlrmk. I
<br />. *hrh rlrtr lxd ( Lr$.rj. My krtqi oqxnd
<br />x"",
<br />Ko,^,
<br />Co ,,.h le+tr,r'{-7ht lt1OLD
<br />*:| )al..n'lyrh:r n'tr Frl.]mr.or rlE *olr ri{ whrhrhF Fm r rn ..{)hy.n! |ER,n 'nrny.MEra, b tE uE s hF.r b rh. ur.*di cohpcnqrkr h*r ot Crl'lom,a, .nl a8r r hd rl I sli'trlt h.(om suhi..t lo rtr
<br />k,rt(i d'mFnerin Fw'rirn( of h{lhn.lTixrorrh.l2ti Gxk, I rhrrl. fonhwirh.ohlly *ih lh'B Pn'vni'B
<br />WAiNING rlturc r' suc mrr.n' omfEn{r.n . !rE!. n unl,*lul. 'il rlull sthFl - 6tlloy.r b (rrllwl FEIB:rl
<br />rivrl linc\ W t' otu hundrcJ rh'r\atul tlou.F (iloo.lxxrr. h nlfnn r! rh. ((
<br />Cu].. dcr.{ ehl .trorr! i
<br />X
<br />, h.nhy!flmrund.rn(nalryoln ridryrhrr Ia undcr F'vr3ion ol Cnapro 9 (.omnE h3* h S.d $. 7UX)) ol t)tvtrnn .l
<br />ol rh( BuqmsrnJ Pnn.1$,niCrxk. {rl n,y h.n{ n
<br />'n
<br />lull l,rrc lrlrtl
<br />D<^."*.,..
<br />r'*
<br />I h.^hy tflnm undcr Fndryot t tjury rh, rh.r. s..r,.(ruerb. LndtS r8.ncy Lr rh.IEdoIlIEc---'. of ilE wtrk lir, *hih rh6IEmn (
<br />srkJ (Sd- !lrr'7. crv c ).
<br />tJnLr'i dOt$:
<br />-
<br />AESUSANI.DECI.ASAIIq!
<br />I h.r.t', .nim unLr Fnrlt y ol Frjurt "m ol rlE r,nb* u! &rli,!rrns:
<br />nn I'.,!c'xlR.!ul. nii\ { Idl..l(,.l'.tr 'r
<br />r at.rl'n! rhcitr ltfi)vi e dn rl'r'lrrllk ro rhr !$Fr
<br />K,n.ri {rtc rh.r rlE rh,vc rn,mrx,n ir oRrl. I .rE lo o'rlr)ly *nh rll Cirr.nd Cooiry
<br />6n{M.[ rn h.rch].urhtruc .crt.l's ol ihtr C.y .!t Cody l. cnkr uII,n rlr
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Roof Sheathino
<br />Shear Wall
<br />Framinq
<br />lnsulation/Enerqy
<br />Drywall
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enoineer Final Report
<br />Flood Zone Certil
<br />FINAL l2-'Yl1 -BrE/d,
<br />Certiticate ol Occupancy
<br />Notes, Remarks, Etc
<br />.-.:-\
<br />Eltllqt q.{,-
<br />^^r L^,
<br />BUILDING. INSPECTOR RECORD
<br />3
<br />ih,v. n{trrkn('l pn)Fny l!tr
<br />[eu-"r*t-r
<br />edilemh.
<br />tfzz/rc
<br />Sublloor/VenVlnsulation
<br />Ext./lnt. Lath
<br />Brown Coat
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