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SITE-WORK DATE ID/SIG.COMMENTS OWNER BUILDCi DEI-CAf,ATION
<br />I h.rny ,lfid ur!& FEIy or Fjury rhr I @ q@F ton rlr Cotr-6- LirE r,w ror iE tollo*irs l@. (s< 701 I t
<br />Bsin* ,rd Prof$iod Cod.): Ary Cn, or CMry $,|lih r.quiB . Fhi lo o,(tu(r, .hd. !tp.otc. daelllll or d9., ey
<br />3rtu!1w. rior ro irs isluc .!o E+iE rfic +pltr for luch Frrur |o 61. a 3igi6d nnsE u b. or $. i lk6!.d F,$d
<br />ro $. provilioB oa UE Conffilolr l-E.ru.d t s (Chrptq 9. conndcin8 with sE on 7000 of DtisD. 3 of lhc Buiid ed
<br />Profaion! Codc) or thd h. or !h. ir.rmpt rhq.nom ud lh. b.!i! lor rlE rllc8.d q@F on. ry vioLtio. olkion 7011 I by y
<br />lrplicur fd ! pa8ir lubjrr! ri. lppli.st ro . cilil p.{lry of nor moc fiq 6r. hun&.d dolldr (l5OO).
<br />l, 6 .wE or ilE Fo!6ry. c 6), snFlo)6 *irh wlaB & rh.r sL .omp6iio.. rO tli ttE wirl rd dr rME ! Nl
<br />inqd.d d odd.d fo. $l (sc 70a,1. B6i6 nd PmfdbB Co& IE Co'frrd ! Li@ lrs dG d +ply to d off ol
<br />rhrF -r, wlb hilt d irnFq6 rhao rn *hc d6 rdr qnl h'Mlf o.,Erlror l,ru3lt to dhr om ar9k rle
<br />Fo\rLd rh! tKh !trFDrffi nm( -rsd.d troturd ftt * l[ lbE!. dE tu'ldrB d ini*-dEr ii $ld lihb w )r
<br />olcnpliiltt 0r o.G Buitlr wil] l[r dE h(t! ofF!$B U: lE n tE dn d hiE d i4.ort tlt F.Fiy tu llE Fipo* ot
<br />l, s o$nd oilhcpmp6ly. m.rclriv.lycont .tin8 with I'c€.!.d c!nr,6o^ lo coBtrud th. rrojd (Se. ?044. auind
<br />ard liDi!.ion Codc: Thc Coindrcf3 Lic.G. t,!w dG nor rpply t) & owr6 of prep.rly eho huild, or inp@vd lhoa'n,
<br />and who ..Mr for !!.h FrFr rtrh ! Cofa.ro(r) lt6a.d psBun ro rh. Cotuand t tt@ tr*).
<br />I D .rapr dd.r Se&n-, B & P C for dli3 len
<br />llaf,f,[ai(0MtllrAra!
<br />DICIAAAITT!
<br />I hdrbr.mm und6 FBlty ol p6ju.y.n ofrh. followin8 d.clddbN
<br />I h.v.Mdwill mi.tlin . ( 61ific.r. of ColMr ro S.lf-lN!rc lor uo 6 sip6B.rFn, a Fi'rid.d for by S.dioi 1700 ofrh.
<br />l rEir cale lor lh. pqfollie. o f
<br />'h.
<br />$srl for *tkh th. Fhn i su.d
<br />I h.!. .d *rll dil'd $da .!ir6ib6 i.sllts., D Gtu,ld bt Sdio.l70o ord* b!o! Co<h, lor lh. Ffffi. ol
<br />rh. *vi tm shah rhi! Fdir i3 erd My *ort6 @6oa!rbr iM ffid -d polay ndhd -:,., Sfuro Ftn0
<br />',."," ,, /97536b- za 11 /-z€ -zo
<br />I Rniry lhlr in llE Ffomatu. oarhc worl for whkh tnir Fii n nsc4 I !h!U.or @ploy uy Fsn ir my muE
<br />e s lo b..oft $b..1 lo lh. E.l6 onpaldion l:*. ofc.lif.mir !d ldr rhd it I rhould bc.or 3ut ..l lo lrt
<br />$od6 codFstion F.\t6c ofscrio. i?m of E r$o. Cod..l.ldl. fonh$nnonply vrnriotFovilio6
<br />$ARNING: l.ilu. lo re w 6' amgqErior sts.s. ! uL$tu|. ad rhd $bF:r E 6ploF b airErl FrlB rd
<br />cn nn6 up lo om huxtrd rhousd &iles (i100.000). in .ddnrn rc rlE .d of otrp.Mior drn46 a Fov'<H for llE
<br />Sdin 1076 ofrh. Lah{ Cod.. Dr(d dd drorrEyf
<br />La-n,,,-,
<br />DECTdIAIIO!
<br />I h@qL .llrm undd psulty of p6j!.y rhd I M lc.n .d und6 FDvnior ol Chafla I {co6lle'n8 wilh Sdlbn 7000) o I Divllio. l
<br />or rh. Aurd ed PofBroc ( odc. .rd mr lt.M t in tull fore !i.lT..l.
<br />/4 6/z-, 1"(
<br />coxiltrllcu(aJ.lllllg [NCr
<br />I hq$y dmm undd Fnalry of palury lhd lhd. t . coNrtudion kndirs d3acy aor lh. lqlbmft. of lh. qdl br wfii.h rhit ,qhil i!
<br />ls.d (56 1097.Civ. C ).
<br />Ldrld'r Nm.
<br />knLr ! Adi6
<br />-
<br />AETIICA.UI.DECIASAIIO!
<br />I hddr ,f'm undd Ful'y or p6lury oa ol rh. folhvin! i(Lr.' Fn!:
<br />t).mol nrn Imir!-Ash6to! Norifi cliiotr F.ddal R.suldi.n! {Til.,l0, Prn6)
<br />Rcqrir.d t.lr6 of Nolificalion
<br />I rdit rhi rh. a.d6.l rc8r,IbN Esdi.s ch.n6 @rrl G iot nglt.bL ro rh! mjd.
<br />I srr&rhr IEv.6dth!g9lf,nrnidd.r.lhrdr.t E ofoidbn i! cnal l.srlo@npl, win dl Crr.dC.ud,
<br />Gdrffig ind sr.r( tis ch,r lo b,ldns.orE rdr !n lEr.b) dlFrqa rqEau'€ of th! ( ny od courty lo alq uFn 0E
<br />rbo\. mri.n d FlFty for !spc!-"p",stc// ./
<br />App,,c.n,orAid,s,ar,!E-E-/2 U*z- ^,,/Z-A'/Q
<br />".nkar..ona,tZd"uWlL
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loorA/enUlnsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq l'fA" 2,n0 t tu 1/ad4..
<br />lnsulation/Enerqy I
<br />Drywall qflrpr,t.h-llilA
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif
<br />tl I ,7'4r6FINALf l/t//o )I '\12il0)
<br />Certificate of Occupancy
<br />t{otes, Remarks, Etg.I a)
<br />/'9-*'
<br />BUILDING. INSPECTOR RECORD
<br />d#--
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