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SITE-WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subfloor/VenVl nsulalion
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsu latio n/E ne rgy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />FINAL h/tdJ-ot o -7tr/
<br />Certificate of Occupancy / /
<br />Notgs, Remarks, Etc
<br />ol 0u/
<br />J
<br />OIINER BUILDER DTI,CARAIION
<br />I h(.t' .i! m uido panlt! ol p6ju.y lhal t d *.hpl lrcn lh. Cdorrt lou Lrm. Ldw for lhc follo* in8 ..&n (Str 70l l 5
<br />Ilnin6s d lrufsio. Cqk) Any Cny or Counly shich rcqutB t Fi,il to codrucl. alt6, inph!., &nolilh n EPdr tuy
<br />srruduq For h irr N@... di. r.qun6 tllc rpt ltd for 3uch pcmnl !o fiL a srsn d ral.t6r rhn lE ar sh. b li(.eJ FNU|
<br />h rlr |xolt{B of rlE Co' trrois Lrcnsd lrs {Chlpro 9. conn*i.g sitt S6hn ?0{0 of Diririo. I oflh. BB'B md
<br />PmfNors (tdc) or $at l! or shc s.r@pr th<6o,n od rhc bs6 fo. lhc alks.d .rdDtion. ny viohrtun of S..lion 701I 5 by y
<br />ipfl'ca ror.p.mirsubj(crh.olpli.anrro!.ivilp.naltyolnorror.rhanfir.huidr.ddolid!(itoo,
<br />L s ow.6 of th. FoFl!. or my mplo)6 wth war6 d lh.t qie conrdeirn, $ill do lhc sorl Ed lh. enxtw it hl
<br />inrod.d o, oils.!, for eL (sc 701.1. Bsi.6 skl PmfdDN Cod. Ttc CodBlol3 l,icw b$ &6 .ot +,,1t b d otffi ol
<br />nr lr.Fry * ho hotl& tr nl4ns6 rlEor nd sh. d(E trh k * h'relro. hdrlaor lhDoBh his d hn otrT mphyc-
<br />thli(h rhd su(h mpmldFlr.i e d irtatnl r orlgsl for sL ll ll'**a. rh. t(lktlB or inForad 6 sld within .ft \@
<br />ofcompliio[ rh. Ovn6 BuiHd willh.!. rn budn ofEoviry thd h. o. sh. dd Nl b{ild or inprov. t. pR]psry for llE pt[rFol
<br />l.6o{trolrlEFDpsry.dn.rclusr.ly.od,..thasilfili.dsd.odnd.ct.ord d ilE ri..llss. 70J.r. BGrB
<br />.'xl Eofsnn Cod.: Ih. Contsroar L'.@ L!$ dB mt .pDly lo d 0$'.6 orFordly Nho 6uild. or impor6 lhsor
<br />.nd *ho .odBds for su.h FoFls $'irh ! Co.rri.1o(r) liderl tlRud ro lh. (bnraror's Lad. ljsl
<br />,,,,i,,b/rw"
<br />I h.r.b, ainrm unds Fnahyol lErlrlv
<br />I halr Md sill nwniain ! Ccnificlr. of CotMr ro Scll-lBu,. for {ork6' .onpc.ldtun, s providcd ln by Sdlion l?00 of th.
<br />llh{ Codc forrlE Fr(ru. orrh. sdt lor sti.t rh. Fttril ir isu.i.
<br />I hi\ c ind \ nl .rarnrain \ d,I.rs (orpe6arn)n
<br />'Nnancc, d r.rtttr.{ by s(..n r 7ol, of rhc I jll, { od.. tu rh. Fadnnr.. df
<br />rltr $ork i$+hichths pmil is rs.j Mr *nrL6 .orp.dkrion nsirdl.c.3Fra E FnEI nudh( d.
<br />I cdifyrhdr,nrh.tcfoirn.n(r.lrhcwort for trhichthG F 'nrl
<br />is issu.rl,l shill.or dtloyrnrtdson in anymmns
<br />$Btob.com.shrdrolfic\orldaonrpoerionli\$orcalin,nria,MdisEthdilIshouldbcco.subjd1.,lh.
<br />s0116 ranrrEqrn. !.or isn,N o, sR.-! n I700 of lhc Iit r (i{c, I rldl. lonhNith .oarrlv silh lh.c pNr isFB
<br />$ARNING hilur. lo suc $dks'
<br />cNrl nn6 up ro or hundcrt rlhlsd
<br />Sdion 3076.f$. L,htr cod. rl(d
<br />ll suhj.Tr d dplot6 ro cimi..l Fuhi6 dd
<br />of coir.Mrion, d,mr6 6 pro!'d.n for th.
<br />,/r-,/ ts7 7-/r)l!ltlt\rr')\
<br />I hcEby aflirm ud6 lor.lry of pou!-' lha I &n
<br />of rn. BGrffi Md ProtsioB ( od., dd ny I
<br />undo Fo!6Nn ot (-h.Oq e lconmoc!,is \ at S.d irn 7000) oa Divitbn l
<br />callilxli(1laxl,lllllNlilclilc.I
<br />I hscbvrllim u 6 Fnalry ot rojuD- rhrr rhlr. n 6 coretudion ld'Jiu srmcy for lh. lg olr@c. ol rh. s orl for \rhi(n l[is tbnir is
<br />issuLrtrsd.109?,( i\ C )
<br />I odo'\ Naft
<br />AIILICANIDIOJBAIIO!
<br />I hdrl,y arm u.da Fnally or pqir) onc oa rh. folh$ inE dc.l&.raons
<br />ln olirion PmiB.&b6td Norilicrion F.daal R.lllarions (1ir1.40. Idr6)
<br />R.qutr.d l.al6 olNoinc.rion
<br />I .diry in! rh. acdel r.suhlioB r.sadiry 6lEros r.m\ al d. nd 4Pncabk u rhis pNj.{l
<br />c rnn!$ ion nc.rdl l asrrro.onFlrsirhall(-'ryrnil(-,,dnt,
<br />hs.b! aurho.ze.€tr.$ddrssof lh's ('(yi dCountrrocnr.r uJ[nrlE
<br />/2 /,,
<br />BUILDING. INSPECTOR RECORD
<br />Flood Zone Certif.
<br />"'/("_
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