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SITE.WORK DATE ID/SIG.COMMENTS OWNEI IUILDNT DELCARATION
<br />I h.rchy .rrm undd lEmlly {r lcqury rhrt I .m .xchl'l rn'n rh. Cin r{ctK Li.cn* Lrw ntr rh. tdlorin8 E.s,n (S( tu.ll.t
<br />Ausinc$ .d Prcta$i,n CoLlr Any Ciry ot Couni, *hi.h rcquiB a Frtur (r omrruc!, rlrd. rmtn'!.. &B)lah.r EFr ry
<br />Ncru., For to ns tsrrc, .I$ rcqun s lh. +d(d ntr ruh Fmir h rft . rl8rJ rr.r.ftnr rh.r lt.r rlx i! lartr{d t'{$mi
<br />to lhc pn,visFns ol tiE Conlr(l{ri Lacrsd Ll* (ChN,{cr 9, Confttu'ns *irh Ssxon ?Oul of Divrn'n I or rh. Busmr. ..d
<br />PNtssnns GrtG)or rhll lE {r slE i .r.hDl l,EElmn Url ltt hrrtr ntr rh. rlkS.rl.r.n $n. Any vi,Llnr of Selion ,01I 5 hy.ny
<br />.l'plk.nl ror r F.mll subr.is lh. .mlMnl ro I .,vrl Fn.lly or nd mrc rh.n n!. h(rlcJ &'Usr llrfir).
<br />_I..s olft. orrh. pnFny, o, my.mplt F! w h*.8d8rh.r$kdmFB.tDn.wil6rlE*dt.trlllln lGi!ml
<br />d.naloroff.rcdfdeL(Sa.70.4.BlrIBssdPr\n.s$BC-ulcfh.C-onrr&tr'rlIcElr*.hE,+d,k'uowBof
<br />rh. ImFny wl- hitt o. !qn,E dE$G.d,b r t sd him(lt or ts*lf t, rtriulh h! n lE d*n.rFbyer.
<br />Fovrldl rh.r such ,n{m@.c e n{ inlaral oronccr n" {l Il l$xE. rE tu intlr olterin B r w.ho (* Fd
<br />drrr!)lniJll. 0! O*Er Bu Lr * ] hM r,x haLbn oarnlyo8 LIE! ,r d rlE dd n{ r.lll d !r!h)E tlr FIEry i,llE FrFE of
<br />-1.
<br />s owr of rlE FotEny, M cr.tunrcly corrslDr s'rh lEtreJ onrr-r6 to oBtui rlE FnFl (Sr 7lxa, B6m(
<br />.rn h,tsi6 CqL: TIE Conrr&roir Li..nr br rkr$t .prl, b u o,Er ot FDFa t *hr tu'lll or npn,E. rh.r$tr
<br />rnt wh) odfut rs srh FoFt wlh r CoffionO hsGl Fru! rorlECdrratx.! LatN L.y).
<br />I rn.r.mpr uElcr Sdnn ,a &fC l,trrhtrrc.sr
<br />rrcaf,E8s:cqurEliAlq!PICIJIAIIA!
<br />I lE .by .ff h uRLr Frdty of F,ury oE ol rlE folhvn3 d.LL,.lFnt:
<br />I h.E.d will Dhrs. C.nifr.r. of Co.sr ro S.ll-lmF lq *rtm !,niEExrD. .r Fohlal td, ry Sarbn rru of E
<br />L.hr Ccb rq lE ,sl(mN of ln. wl ftx *nrh rlE tE nl t lnbl
<br />_l h.rc nd w l nrnr.u k' c!r' .onFcircn r.tuhn.. :r qlrtJ t'y Strlh l]ui ol rh. Iil}, C(ir.. fd rlE Frtrllr^t of
<br />rlx hrl n{ $,ih tlE Fdn B !.rn My vdr6 Nq$di,n o,u,m. (dE !n tnEy nu.rlE d.
<br />I adily lh.t r rlE lErfor's! of lh. qrt fd shrh rhs Frd B Bru.J. I !n [ rul fl{rt,y.n, F",i u ottuiB
<br />gr r t. troE !!hFr ro tlE 6 6 orqEainn l,*. o,Crlrf'fu- lri {N rhd 'f I rlbutlt.$oft suhFd lo rtE
<br />srtdc dr{ENrio. F)ytrB ofseirn l,7()oot rlE lrhf,Gi.,I nrll n hr h! nr'l, *iin lh'r F,VIIN
<br />WARNTNG: Fxturc r, sE srlc6' oEFnsrrn . vor. it unLvnrl rnl rlull lohFr u 6nhF h (:1,rEl FllE [l
<br />.Ml nNs up ro om hualrd rh.ued &nh's lllqr,{)@), r .x'r$n h r,r .r,c or $'{trgrtrrh. Jtm8.r I F*rLd ror rh.
<br />Serbn 1016 ol t E L,hr Cak. inr.rt ul nnftr'r lFr
<br />UCENSE.CqNIBAqqB
<br />DACIdE IIoU
<br />I lEFb, rlIrm ,oj.r Fr.lry ol Fjur, rl,r I ro liqsl unr.r ln,v6bn or ChrFd 9 ((iImkr3 wrlh S*rrr 1)(l)1 or DtEm l
<br />ot rh. BnliE$ rd P,nfcssrn Cdl.. lrl my,f,cnc K u tu nB. dn cllel.
<br />coNsrBl]cuaNrENlll!{i-al;liNlf,
<br />I hhFhydtltrntrtulcr I{mlty ol lEqury rh.i rlEc Br. Nru(lrr klxlint!3cky 1,tr rh. If, lorroN. ol rhc qo n{rh(hrhtrFrm[\
<br />isskd(Sr-. .1097. C,v C I
<br />AIIIISANI.IIEIJ.AAAIII,I!
<br />I lENhy aflim uBlcr n nalty ol p.rjury orc of lh. t)llosh3 J( l{r0r tr,n
<br />D.m,lIon PcinnsAsh.ros No!tuari, Fcdu!l RcBulrrD.r lTnlc.(r, lldnb)
<br />Rcqun,.l I.llcr or MiriurDn
<br />l.enifyrhlr rhc lidcr.l rqu[rit)ns rc8e'irry r\hcno\ rcn,vrl rR rtn lmlrthk t, rh,i tln'rar
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Sublloor/VenVlnsulation
<br />Roof Sheathing
<br />Framinq zl1l?r Dtr&
<br />lnsulation/Eneroy
<br />Dtywall
<br />Qxflnt. Lath zlTlz-t Dtl+8,
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />II I
<br />FINAL Zlctlvt Drrv.n57
<br />Certilicate ot Occupancy rt
<br />Notes, Remarks, Etc
<br />BUILDING. INSPECTOR RECORD
<br />Shear Wall
<br />Irrr. _ cDnrark, _
<br />L.nJd < N.mc.
<br />kndci\ AJdEs' _
<br />IenrlytturIh.vcrca{rhnrmli.arionun{r.rcrhirrhclh,kinr,'mrtr,h!on&rI136t)com,yeh.ucnt. lci)unr}
<br />ordDr*.s anl Strrc tjws Ehrirr io ttrildin8 $nnNdnrc,n h.Ehy.uihrrr. qftsnr.nr! oarnn Crry &.! Cirnrytu..16 u!)n rtr
<br />ftovc mn'omd pNlEny ror i,rF.tNn puq!,cs
<br />,{Ell.mr.r Aenisi,EluE D.l.
<br />P.rDItc Emlpri ,:
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