|
BUILDING. INSPECTOR RECOHD
<br />SITE-WORK DATE
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framins 8a+>Vt"4E 'l'll-17 VYht)
<br />lnsulation/Enerqy alJ
<br />D rywall
<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 />Flood Zone Certif .
<br />FINAL b-7f,1
<br />Certiticate ot Occu pancy
<br />Notes, Remarks, Etc.
<br />OWNER AUIDts-R DEI,('ARATION
<br />I trFtry .r"m u .r Ful! or Frrury rhd I m.r.hpr froi 'lE
<br />co r-kn lta€ L.v tur lh. foltr*in! u6. iS.{ 70115
<br />Burtrs .nl PmrB\!. Cdl.): An, Cny o. cou , *h.h r.{uftr . Frs, b u'n{tu1 n6, ,i{r.(, d.mnrh or EFr xy
<br />{odm, rrr (, r n .h., is. EquiEs rlr rprlr. nn su.h Fmir tu tiL. n8n J {.'.m.' th.l lr or dE ! l,c.nErl Puru.r
<br />6 rlE lh,vlur of rlt Cimu.*tr'r l-Nnql Lw rCrEI{d 9. (rImBu! ,irh S.{r-n 7cltr of D'vrib. I ol rlE BunE( .rn
<br />Pnrr.rlx,N CdL) d ihl h. r llr r clctrt r rtEe6o6 .tn rlE h.rn nn rlr .!k!.d .r.n{r.n. any !.htr'. ol Sdl rr ?01 | I ty .ny
<br />aptltr.nr lu r 0.mir shjc.h rhc lpplicanr ro , civrl Fn.hy of ior mr. rhln rrv. htr"tlEd d.lhB ($500)
<br />_1, .. ow ol rtE FrFny. d m, .rtlhF.r vilh r.t6 .! llr! gll !$rFMan. * l rlo lrr utt r, rlE rBrc n r
<br />htc .n oroltir.d for !k(5(.704,1, BurE!. lrl PNt rbn\ Grr.: Ttr c(dtuloir l-E.nBL*&Erd, rpPly ro r. o*ffi or
<br />ItF rh'rEdy vb hoi[r d. !t|n6 rhclq !s] wlo Lrr! run s,t hm.ll or h..rlr or rl@ulh h! u lEr on.n9l'y..s.
<br />pn,vrlal rh.r akh ligxw s c mr d.dal qoff(cl ftr ql lt hoq€. tl* t!$!B ', liFNmd ! s! r.hu c Fs
<br />or rwplxrh, rh. Ohr Blrll.r xdl htE rlr hrl.n ol FDvnA lha lr o. & dn m' tlo'! r lrtFt dE FDFry fd rlt Flrpdt or
<br />-
<br />l. .\ o*ftr nf rtr F rxdy. r .rrturiEly codr*i n3 *th ltr.n<l cdrrrts h $nrdr rll lnrj.{ (Sn. 7orr4, Butfts
<br />anl t\ .{sB Orjc: Th. Conrknn r l-i(.nr. k* JF! nor +ttly ro..o*ncr ornhJEny whr 6url!! ot mpruy.s lhfen.
<br />and who edarlk,!!.hpn* r* h. aontrr'l..is) lrcncd,'urMr n' . Ci'nkttx't l-a.rk tru)
<br />I rm.(mB untlcr S(rtr'
<br />!!AE|Ef,5:TAUEI;dIAIIO!llElilll&lrlgl
<br />I hcnh! rlltrn, trnJ.r p.nrlry of p.rttrry rR !n rh. n,lL'*u,r 'l&hfurr'n\l
<br />I h:E .,n *rI mhr.m . Ccn'l r!r. or Conrd t! S.lrlnrtrc n, *\,rls' .of,{rndDn. .t Jn,vdcl ror |ty Sdriln r7m I
<br />'h.ljhtr C(ld., I,tr rh. pcrfi'mncc ol rh. mrt |,tr snich lhc n rm s nrucJ
<br />_l hr\:Jrr *rll mid$ *o*.n' ..tr{Etrqrhn ntuiE...r rgld hySalDr lT(rorrlx litrtr GrL, re rlr F.lolrrler ol
<br />rh. kr* rd *hrhrhtramn rr nibl. Mvkrt6 (,ml!rdx,n {rk.(.trr rnl lfulr't nuntrr f.
<br />FXdF,r4,(<
<br />l ..nrfy rh.r h rlE lrrlomBr .f rlE *Dd nr rh rnn I'crnt :r EruJ. I ihrll ftn .ryt,y rry F.s)n o.n, 'fuE$ rrbtf,u'B ruhjdr k, th. ux*6 dryEnr.l6n hwrofcrl(,mr. rrrl l3G rhrr I rrEuli lE{m st'Fr ttrh.
<br />work. o rlih\Ini F,vison( ot Sclri,q l7I[) ol r hc l,ilrr (ixlc \tu|l l()nh*ih.oh0lyw h(h)rnn)vrn)n!
<br />$AR\l\(; I-nllrc r, !aur. $nrk.r\ !n\u wfll .rn !h.ll ruhxat u cn{lt'rr b lml tIsl.r .rn
<br />t) oe hrdr.n rh,u\Jn<l nr rlE mr .f .trlll.nr.rlE dn8.r I Flvd.d fitr rh.
<br />[\
<br />I lEFhy.lttn !r{.r JEMIyolF iur} $r I6lsnrn u l.I L\u ol Ch.Fd 9 r oltmEhs *lh Sdiu 7ft )orDrvM,n l
<br />ol rh. BurR!\ lnd Pn,l..efi Cqtc, &n mv l.cnr n o full n
<br />qq
<br />I h.^'hy al rmr undc. FBlr, or p.,Jury I !i . ...{Mri,n l.Jin8 .8.Ny for rh. Fd(fu. ot rr. srk ior uhah tni. Fnr n
<br />nuJ(se. Ir9?,crv. c )
<br />APPI I(]ANT DFCI-II'IATIOiI
<br />t hddry ltIm udLr Fn.l y ot Frlrt, om ot tlx follow'n8 deLnh'..:
<br />D.mndDn P.m,re^rh.(or Ni,rllE.rEr rB!.,r1Rq LrEn\ (Trl.{o, Pd6)
<br />R(quft! LlrcrolNr i.'n.
<br />_l c.n'ryrhi rh. Ldchlrc8u15()n\hI islr{o\rcfr)vrl I rmtf,rhhn, rhrfn)F_l
<br />I .!re lo .onv,l, *!h .I C, y rnl Counry
<br />h.rdly rlrhru. rcFccnrr rB i)l ltn C", r,rl coutr'y |o .nl6 UFD llE
<br />.t (rr(r1
<br />4
<br />I
<br />ID'lurr
<br />ID/SIG.COMMENTS
<br />tnkr ! A.lt ri
<br />[ -----T------
<br />I
<br />I
|