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SITE-WORK DATE ID/SIG.COMMENTS owNtr alul,En Dl:lrt llTtoN
<br />I tft't .rm un Lr D.Dly o, Frry 6I I n .r.n+ fbm rll Cotu6 liw l, ld tlE tollowlU Een (Sd.70ll.5
<br />B(ift*r ..d Pr.LENn Cn&): 4., Cir, or C.r y *hth ,.quiEs . Ff,t r. o.nM. rlt6, ripmw, &mlnh or Ep.r sy
<br />ifl. , llritr ro irs uturtua &) EqliE. th. rt}plj.$r for o.h Fmi h ,iL r n3E! ,rrr.lMr rhd IE or dE ! l,Ftr*l puord
<br />ro trE lhvi'h .r r C.nhrtri li.En lr* (ClIrF< 9. Colrerin! wih S4rbn ?GJ or l)iviri.rn I of rL B6iB r{
<br />Pbf.lird Cul.) n thi lt d {E a.kr+ ilE.lron rd il! t3x fd rlr rlk!.d.rtrIid Ai, hLii{6rsdi- 70ll.l b, ry
<br />rppliclnr fo. r p.m rubFb tlE .pflErnr ro ! ovil !.Mtt of mr mft rhan liv. hu.drd iloll.u 1l$0).
<br />lz"_:I a orw nlrlE tmFny. n my.nphlr.r yih rra.r D rh.n sL mqEdhi, *ii do rrE wrt rn E rMc i m
<br />,r.dal tr or.Ed rr d. (Sc ?o,L, BnriBr .al PIiE rih Cqr.. TIE Cddd! lrqt L, da d Sly t. u ow or
<br />rlE proFn, *ln hun d rpr.B rtE a.rn *t[ dc rrt Et hilulln lE rlror rlyDu3h hn d lEr.h.rpLrrE!
<br />Folid.d rh.Buch rFnEc .Grlir!.tx,.n.,o,r.crlIq.]. Ill L*r6, rtE hrlllA i.id!.sccd ir$ld *irhi..ft Jrr
<br />orconpbrhr tlEo*ErBuiud *ill h.E tlE hnlnofFDv,E rhr lE caE diJ x b{iu ir irFE [. FFl] aDr rlI ttrF*or
<br />-1.
<br />!! o*Er orilE F)n n y. M .rclo$Ely cod.&163 lnh li(.trel .oduron to (r{rud llr Fl..1 156. 76rl, B!1iE(
<br />nd PlolisiihCod. Th. Ctntxttr ! t-ic.n( Lr! d.f,! (n !!'ply ro rn owEr ol prol'<ny wh. huildr or iry,rc\rr rhdatr
<br />Md *h, co tur tu s(hptr'r..h win r Cndrrdfo l-.hrd lonld k, rh.C. i(o* tjc.M br)
<br />DECTISAIIO!
<br />I lErby .lltm und.r Futy of IE lfy oE of rlE rolh*ing .k LdsN:
<br />-l
<br />b* rd,,ll tuinrlin r C.n,frrt.of CoM k,S.l ruE tr *116'd,trp.Mi,r. x FrviJ.d tor bySrli,n l7m orrtt
<br />IllH Crd.. Id rlE tEnr'le. of rh. rut rd *hrh rll Fftir . isEd
<br />_lhav.rtrJw'llnu,nrltr'sorku.onlp.nsdktr'trtrtrmnr..r\Equ'rtdhys..nonl7morrh.t-'h.rtixl.,fo,rh.FrlumuN.orrrr *.r[ l!tr vhi.hrhtr Frm ilsrd Mytrorr.^ c.qi.trlrr i ltrlu' d. .f '., 4l lr)l'.y numh.r r.
<br />Polry Nrm|r:-f rprEr
<br />-l
<br />d'1, ihr in tt. Fnol@ ot r w,.t lir vhih rh! Fdr i! !r&n. I lhll dt .rpb, &y pqe! i! e, 'lWo a io lrdd 3ubj.{r io rlE wld otr+.rrbn h*! 6l C.firomu. r,rl {d rhd if I rt uldt antr sbJ.d r. rlE
<br />wodicro' unrEn\rdon r vnioNo,SR io.1700 of'h. Libor co.k, !{ull, tonh*ih Nn'ply pilh rlE pDvnioo,
<br />WARNINC PriluE h .@ *orr.E onp.6r$. oEo3. a u.Lvrul. nxl ,hrl rubrd u .nroloFr to amnd FEI-..rxlcrn nB' op to oE h{idrcd rt-ed .tolh6 (tlu,,uxlr, m.ddr of .oqtMri64 d.Nt.. o F.vd.d ror rh.
<br />Sdrp. 10?6 orih. brrr CdL, dd .!n dur.y r rG
<br />n",",k1D12D
<br />Llllf]lt:l-1\l-t_!l_I!1al]r!L!8-!ll!\
<br />I h.Eby rrnrm u,!kr Frlry of Fiiur_v rhd I rd lirtu d unAn Ftrvti.i dl clqra 9 (..6ftrii, ynh Sdi'. 7{I)0) or Divirbr 1
<br />ol rhc Bu$m$ .nd Pmlc$ioa Cod., ,rl my h.ne a n tull lo@ &l .ft.d
<br />c0!$Iar1clrc!,EDtuclcDrct
<br />I h.Ehy rrrrh u!d.r FDlry of n rjury rh, lh6. a r edMli,n lndry rt.Ey for rh. Frlot]r1B. of rlt *qt 6r *l hth! Fmn ir
<br />ir$.d(Sr. ll(r7,Ci! C.)
<br />ATILICANLDECI4MIIAN
<br />I Hy dfm ud.. Fory or p.rjury m of rtu folbrinr ddlsrir:
<br />D.mlirion tomir$A.h.(or Nolific.lion F.d.nl R{uLrionr CTnk a0, Prn6)
<br />-{aNirsl
<br />llrd ol t{din br
<br />-lLd'brhd
<br />rlr LJ.olFsuhrn E8.r!rn3 DtxrorEDhl.ra{ +r,[.blbrhF prcFr
<br />fairr rru I u* *-l rhlr.ppltrri'n rJ,r. d E .[ov. 'nrDtub. h !*1 I ltG ro 6npl, *rh.ll cly.rl cs ,.d lftt y.utuE EFEdrrB of ttir C., .d Cd yrodalFnili
<br />Set Backs
<br />Forms/Steeli Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Sublloorivent/lnsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq
<br />lnsulation/Enerqy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coal
<br />lr,4 ason ry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Reporl
<br />Flood Zone Cerlif .
<br />//1
<br />FINAL (c,'24"fu hl,tLyt
<br />Certilicate ot Occupancy
<br />Notes, Remarks, Etc.
<br />Rev. 08-07-2015
<br />BUILDING. INSPECTOR RECORD
<br />(rilllad rnl Srd. ti*! Eldi.ts ro
<br />Itrtrr R.nrk'R{ PrurL ynn
<br />^ h/s/eo
<br />tt
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