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<br />ID(IABAIIIIN
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<br />APPLrcANT DECL f,ATION
<br />I Hly utrrr unJ.. Fnrkr ol n .jrry oB oa rh. rorllwr8 &drnrron\l
<br />D.nllir
<br />'on
<br />P.mirsAsb.nos Ndii.lrioi F.d.r., R.8xhiirtu (T 1..10. P!n6)
<br />_R.quircJ t rld or Ndifr'{tih
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<br />,n,\r tnitrtrRl0k,BIy 1.tr [If,.ii],,
<br />.lmlnrd or,\t(nr Sif nnlrn,-2J=z?-
<br />Set Backs 1
<br />Forms/Steel/Holdowns '? ltla\t t \5thn^"r il81 0l'1fi Atv(Z
<br />Erection Pads I 1\ -
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Boo{ Sheathinq
<br />Shear Wall
<br />Framinq
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />l,4asonry I
<br />Pool Fence Klz /Xn rD vl4l,t.l t
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Beporl
<br />Engineer Final Reporl
<br />Flood Zone Certif .
<br />I
<br />FINAL /il",/d.1 |1.,, )
<br />Certilicate of Occupancy /' '
<br />Notes, Remarks, Etc.
<br />BUILDING. INSPECTOR RECORD
<br />I
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<br />-* /:-2 s12^-
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