()wNER 8Utt,r}]R Dltt,(-ALA1 l{)N
<br />I h.r.h, rm,n u*rd p.nrhy rl Ftiuty rhd I m.r.'npr fnm rh. CDnr'.loF l-ic.ne litr i', rh. f(rlkr*in8 rcuon (S'r l)rl.'
<br />Buw. lnl Pn,f6si,n tixid Any Cry r (i{ y *hih kqu&. r Fri t, ilnrrud. arr. imnmlt. d.mlli\h or r.rEr dt
<br />{frlu.. Fnrn,.r n11e.. rle Gpn.\ rlt rptll-Mr f!, uiFrdh liL. !3Gd <d.r rhib \h. n ltdtJ F'rsd
<br />xi ri. m)e^sB nt tlr (n rdor'r L-.trd l:s lClEBa 9, (,Immtu'i3 *ih Sdnn 7rrn,{ Divirirn:t ntr,r BuliD'( rnl
<br />Pn'Lsl,n\ C.(1., d rlsr lt r \h. t.kIrIi th-.fiom irtl rhc h.nl nr rh. rlkt.d.r.nrirn Anv vtr,bi,noIS.drln,orl5nvinv
<br />sp0lt' n,rFrfrnuhr.krkrpplnanrt'n(rvilO.nrhy.lnrmtr.rtu'ifiv.hnnnr.ddrlli^(lsrx))
<br />Lr\ Nmrollh roFn y. r ny.nrr,!?.r eifi r'is.\ r\ rlrr !)h omFnq Dn. *rll ) rrdt 'nrltrdE i i
<br />i .nLd i ' rrY.r.d ftr !k r Sd 7(lrJ. Bu{r\ .nd PrrL*Drt ( (rk Trr (i!drd,, \ I.ftn€ I rr trE\ i+plvnr!ioqk,or
<br />rh. |,r'Fnv *lI' tuirl\ or rqt*t! rlEBr. xn rh, (kE uh Bnd hi6.lr or lr.rlfor rh,, Shhr (' rri orr .mpt,t..r.
<br />pNviddl rh.t ttrch itr{troF'Edi sc mt rkrkil fi,ftftlfttr ak ll lr,*.8, rlr h{itlrry.r n\nrv.m n( rrhhokF!
<br />;f comnLrhn, rlr Ovmr ltuith *ill hah rtE turJ.. of pNvinl rhd h. or \h. drl n r hu,Il or inirn,v. rh. FnFn v fo' rh. ftrq$e 'f
<br />l. 'r.*F o( rh. Irl{ia y. im .rctulEh ..dBi.3 }rh l...rd onri,^ n! d,.r&r tll nnlr( I S( 7l!r'r. B!ri6
<br />.(l h*iq'n(-flt Th. (i,ntdoi r l.E.it Ltu d(E. fr .PPly fu u o*mr .l,nlFny *h' h.'ld\ o, rrnrv. lsoi
<br />ind *h) r$dB( ftn !!.h tn'Eds *ith ! (i'ddro( o lf,.n.d nu^ud () It! Cn rdor'iIr.n€tjr,
<br />Itn urkr FEIY of F |llry rhd I
<br />ll)llra.l]groM.tlullcllil3l}lr..n.con{kllnk lin3ia.Etn,rlrFn,'']st.lilrNur(nrnthrhilFId n
<br />e7/
<br />o-ta ,rrr5&7
<br />I kEhy rrftmund.r p.n yofFjoryok nfuh. fi,llo*in! J(!nri.nr:
<br />-l
<br />h.E rn rill mi o . Cdiftr. of (tndr io S.lf li{.. nt Hrtd' .rnnF.dnn. r( FtrviLd ft, hv Sdion l7m "
<br />rlI
<br />L.e, C'd.. ,!r itr Ffirrrt ,,f (lt *tl ir *ni.idr Fnt it r{.d
<br />-l hlE .nd r ill minuii ro.t.r' cnmFnerr{ ii!u6m.. rt EquiEd hy S(riJn :l? } of rt! I il'n C'd. tn rll Fftrillfr? I
<br />rh. yorl n, rhicfi rhk f..mir k irsed Mysurt.n d'nIEnrdir i.<urec. cnkr.nd II lty nomh.r m
<br />finir Numh.r
<br />-ard.'
<br />-
<br />t c.nilyrh:r inrh. Il.r I'rm,m. of rh. sr* nr rhichrhii Frmir i\ nu. . l \h!ll noi .f,lttv anv n rsi ii BnYm{nn.r
<br />$ a.r, tro'E $hj.Tr xr rlr q{t€iomFndin h$r or( rlnrn'!. mJ !!E |td ifl rh'ul lEr,ft ruhFl t'rh.
<br />$*dr drirnetNn ni,vnDni of Sdt'. :r7(lr f tll Lh, ( d.. I \h.ll ft{hraiorri'lv r,h rnrc no\nx'.!
<br />WARNINC FiluF to rcuE rgL6' 1i qrtrsln or.nt. n lnbshrl nl rh l {hrd M .itrhF nr dimid Fmri5 'lrlciiit I'm\ !n h orc holr.d rh{qnd d lla itllx,.(xr)). in ntir t' rt .or .l.nnYtidn'r. dms.\ r nftrdal rr rlr
<br />\(rxin \i176 I'lt tih, (irl..
<br />'nr.Eq mlr!,my s f..\
<br />,.", -s,//,/tq,,*,t*,, Y\7Vd//42r,-cT
<br />I rc]t{srri (lltrh f,^L'rur
<br />IlllllAEAIlq!
<br />I lrEhy.rlirm unld p.r'ht oI rr!r, rhd I o lEn!.rl undd lt vi(hn.f(.r$Fd e((\)mmNi3 *[hs'di'' 7lxx)) ol Dnn'i r
<br />of rh. llu\iRs and Pun (-ni Cod., dl my li(.trE i{ in tull n)n. md .fLcr
<br />lltLlllxl.ulllAlauQ!
<br />I halrly dfrmunJd l!.n!lit ol lE.iir.,- om olrlr n,lkrurni J.clrrrk'nsl
<br />tk )lirbn t! nirlAl[{o\ Ndificak'n li.d.r!lR.cul k,ir( lirl.4r), Pn6)
<br />_R.{umd Ir s of Mitf.dilr
<br />I (dfy rhd trr. adknl rallb.r Etrha r{E(olrmril rE t* rl't ul* h rhtr lhrFi
<br />I.diiyrhd I rriv. r.'d rhn rmk.ri'tr di {trr. rhd rlr ihIY. hli,rdrnn r.orkr' I!!.6 b.ort'ly sirh illCrv rBl Cd v
<br />.rdinsm.r;idSrsr.kurELliiSrotoildii8.on{oclrot.! l lEEhy aurbnr. Erencrnll of rhir Ci v rnd Cl{.rv h .itd uFrn rlr
<br />Applkrn! or Ardl SisEt,R
<br />ID/SIG.SITE.WORK DATE
<br />Forms/Steel/Holdowns t /,t /,.fu -/o"
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />SubllooriVent/l nsulation
<br />Roof Sheathinq b/c)1,o rYltl /o)
<br />Shear Wall
<br />Framinq 0/a,t lql D&tr r^2
<br />lnsulation/Energy
<br />Drywall
<br />Brown Coat
<br />Masonry
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enoineer Final Repo(
<br />Flood Zone Certif
<br />FINAL zltc/t q ttd r.'l
<br />Certilacate ot Occupancy
<br />Notes, Remarks, Elc
<br />o',) Ok ot t'D
<br />T;i €5d re)
<br />7
<br />BUILDING. INSPECTOR RECOBD
<br />COMMENTS
<br />Set Backs
<br />Ext./lnt. Lath
<br />Pool Fence
<br />,-.,
<br />-l
<br />im.\.'npr uft]s sdi,n
<br />*,. 5,/il2 lr .( l'( hr rhtr kilri
|