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SITE-WORK DATE ID/SIG.COMMENTS OWNER BI'II,DER DELCARAIION
<br />I lEr.hy lrtrm undrr Ftulry (,f Frlry rh{ I .n .r.npi ln,m rh. Codfu.t,6 l-icnk tjr lor rh. fdk,ring Er{n ( Sc 7{) l l t
<br />B!tin.( !d Prof.(,o cdlc): An, Ciry or (irdy whkh r.q!,cr r Fn, h mn<ur. .hs. itrFot. &mlnh or Errt ry
<br />{fl.rm. Fin n, ik nrurc. lko Equn r rh. trppliur ftr turh lxrmir t' lik . riEed {d.ftnr rhd lE or rh. n li.enrd Jtun{onr
<br />t' rlt pn'risioN of llr Cont-toil Lian€d tr* ((lrprs q, Co'lmnr.s rnh S6ti,n 7fiIr of l)irhi.n .l ot rlt EunR( Ll
<br />Pma.sn,nr Cod.) or rtut lr o, rhc n.rcmfl rhcEl'rom md rh. t'u\is tr rhc ! llcs.d .r.n9r ion Any vn,k hn .f seri'n 70.1I I by.ny
<br />rmlk.nr fttr r Fmi sbj.rt rlh rmlirmr to . .iril I'crlr, or mr fr)m rh:n nrc tuntEd doll.r l!5{x)r
<br />-1.
<br />,! o*E of rh.IrF.ly. q my cq ,F.3 w h *tS.s.r rlEn a,b on{Enqii.n. *illdo rh. n* !n rh. {tuim n , L
<br />inr.lrldl ,r ofi.md td {h ( sd.7lx.l, Busimss i.d Profc*bhr cod. Th G,tuodois Lir.s lrw drE! mr lldy b 'n oN mr ol
<br />rh. FIdy uk, hiltr r nqhB rh.fr4 dn rlF dE! ah urt hilffilf or h.Rti or thmuSh hir .r lEr o* n mq,L'rc...
<br />rovilci rh,l tk',r ir{rnwnrs e rx il,d'ded orolYcid ,or ek la tnM, rlr hiiuin8 M aryrffid k rrlil wnhir oft ,r
<br />of mnphlio( rh. Osrr Buitlcr will Mw rlE t nbn of lft)vin8 rhd tE or clt drl mt ho,U or irym* ltE psFd, fo rlt prrFE.l
<br />_1, al owEr.f rlE lroFny. m crctusiEly mdi.nin3 wnh lren<n conrBlor x, oo{tu1 rL Fn dr (S( 70,1.1. Bulir$
<br />,n, PDftsion cod.: 1'h. Conh.rr's Li..ns. t,w ddr no! rfrly r, in.wncr ofl,oFny wh, nuildr or inrpn,vcr !icr.on.
<br />.n! *,F o Glr ror ruch rord! *irh r C.nrid,f,(o lacncd Furud r,, rlr (i'd.err t LirM krr
<br />r,rtr'hi{,
<br />I trr.hy arfi,m unds Fmhy ol Frury nr .f llE ltlhs rr &<l,rdihi
<br />-l
<br />h.vc iln *ill roinrrh u CcrtifErrc of Concnr to Sclr' ln{r. fm *orksa or{xrsri'n. !! I'.riLd for lry secrhn .l7lx) or
<br />'rEtitrr Gx,.. ld rlE F f{l'll!r. ol rlE *ut fG *nah 'lr Fnn 6 irN.n
<br />I h:R nd * ill Einrln *nrl.rr' .or{xnsriirn 'nsurrEc. rt r.quircd h) S(r i,n .17{lr of rtr l2tltr ( odc. fttr th. Frfomm. I
<br />rhc work f'r*hrhrhk p.rnir is isrkJ My*orkcF .r,nlPcn\dii,n inruhtu.orkr ml Frli.ynumbc.e
<br />-l
<br />dify rhd '. rtE rErfo.mre of rh uo* n, vh-h rht rErmil r ir{xrr.I rh.ll r cr{,b, r., Fsn inrny mnnt
<br />$ o\
<br />'o
<br />hccom rubFr ro rh. wo s onFn{rnrn hwr .r Ctlin ni!. .nd i8E. rhll f I rhould tE .m sul'jd lo rlr
<br />*o.tdr mqEn{li,n novtiom of S.d iin l](x) of rh. t h{ Gdc. I rlEll. nnh*irh on{'ly * ilh rl,i pmfiioN
<br />WARNINC rriturc nr surc *ort.6' oqEnqriotr {recn8. i! onkeful. 6d \h,ll tlbjryr .nrhFr io dimiMl ,E h* lnd
<br />.'r,l finr\ u, ti o( htrtut ,l rhotr\r,xl lollr\ rll(xr.rrx)r. i"nunn. Jrm8c\ .\ Pn,vrl.J fnr rlE
<br />sdhn 1076 orrlr hhn (in . inr.rc( ond l omr's fes
<br />C-tt-!o eppu-/t
<br />I h(rcb, il6rm unl.r Fnlh, of Fr)ury rhsr I d l'!rn*rlnndcr pfl,rn(inof( h{tr 9lonrmk g*nhS6.-t,n
<br />f rh. tlu\im( xftl |,r,tu\r 'ns
<br />( (i1.. rnl i,,y lr. \'^
<br />'n
<br />lulli,trrc i,rl.lJ..r
<br />I trr.$yrrirnr cr t*Hl
<br />1\trLd r5( lrr. ctr (' I
<br />tr]ltrBrgll]rl,Lllrll!-icttl.r
<br />rv,'llrl't'trvrh rtutrar.otrnni.rk'btr(|tr'gildkr_knrtuturo'trrrn!r,,r!lk\,!kk{trlr'.hrl'r!tr"ra
<br />appt r( aNf nECr
<br />^trarro, h6!by lfrm udd F..hy ol FrFry oE .r llE tollopin8 &.b.Ihnt
<br />D.mhhn P.rmnr Arh.sos Norili.rion F.d.rilR.Sulnrhnt (TirL40, Pd6)
<br />R.rluir.n Idr.r oI tidifrdiF
<br />-l.di,yll
<br />rlE f.rlcEl qrLrpd3 Ealdin3 lirEr|or ffi'trl tE r rllFIic'bL to rhir tttuj.$
<br />-l
<br />d,l, rh.r I lrE E d rhir.|Illtrhn!n r.rh.I rlE.lI,E infoldi'n n (rr..i I.!rEroo.l?l,wnh.llCat,nCou.ry
<br />ordn nccl tul Srdc tI*rrl'(nI ro htrrldirt trrhoir,.rcF.s. !livc(ollhisCiiland(i'uniyt'circ' trF,nrh.
<br />u" (-lt'zt>
<br />rtri. nrtrrkif,rltx)Fn\ rd hti{r
<br />Appliounl or As.trt Siiulurc
<br />t'rmrlle mnE rprinr): i2c,Go=, 1l.A (. L\ZtO C)
<br />Forms/Steel/Holdowns
<br />Erectron Pads
<br />UFER Ground
<br />SLAB Floor
<br />Sublloor/VenVl nsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coal
<br />lvla sonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif .
<br />FINAL 6Zy'.Zd /1C*,rv6tO3-i17
<br />Certificate of Occupancy
<br />Notes , Remarks, Etc.
<br />BUILDING. INSPECTOR RECOBD
<br />Set Backs
<br />-l
<br />m.r.mfl ud.r Sdi('n-
<br />ur.6-(t - Z<> o*.+
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