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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 />Subf loor/VenUl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<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 />Flood Zone Certif
<br />FINAL ,f-7+r .Z lrs ,-/e--rt*-ZV
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />OWNEf, IUILDER DEIIAR TION
<br />F!!y of Fjlry lh, I h ampt tum th. Codr..lo6 Licoe L.w tor lh. tollowiry l8n (S€.?oll.J
<br />Co&): Ary Cn, or Coudy whi.h rcquu6 ! pamir io @istucl. !nr. nFor!, daEllh or rlt tr ay
<br />il] suecq ito rcquiE rhc lppli.dr for s.h Fnn b 6k ! ti8,rcd r'dsEn rhr ll or tE i lt€E d F,l!rof E Conrdor's tk.G.d L.* (allplq 9. Collllltrirg wnh S<rion 7m0 ol Div!i,. , of lll BaiIB od
<br />) or lhd lE r nE a d.npl fiddom ud llE hGi! tor rh..lLs.d qoFion Any vioLlio! ofsalbn 7031.J byMy
<br />ir !ubr61! llE rpglkd ro i civil pqdr y ol tur @r rh!, n1 . iudr.n doll8 (1100)
<br />h. proFly, or my cmployE uirh w!S6 a
<br />'hcir
<br />$L comFM rcn, "ill 6 tlE mit ,rl tlE slrdw ! ml
<br />for s.lc (so.7044. BBin6 od ftot*ioB Co&: Tr!. Codrrl ! Li.e t w do6 nor +ply 16 a o*c of
<br />tldrl or tr'q!6 tlEaq !'d $b dc atdr $ hiNlf or hc*lt or lhrcurh hi3 or hs own aryloyc.
<br />imFovordr ft mr htdi.d d oftadl ft, sL ll lb*M, tE hil,i.s or nnFlvad n b! *nlin on. )@O*E ttllldd wiX n e. rh. hrda olFoMnS rh!1 h. or !h. did Dr hnld or inlhw rhc FFry lf tt Fllra of
<br />h. Fopolr. e u.l6iv.ly co, r*liry wnh licda.d conrrElo6 lo codru.1 lh. pro)El (S{. 7044. 06md
<br />Tt.Conlrtoir Lrc.nr.liw do6 nor.pplrto s.*ns oaprcFny who burl& or ihproE lhamn.
<br />for su.hln,)(c$ ha ( \,ntnclorl, h.frr.] I,u6u,ur 6rhrCofltdor'r t.f,an l:r)
<br />0nLr Sdion ,B &PC forrhL ra$.
<br />\oaf,f$:coutEdsarq!!.liclJlAlla!
<br />undd paally ofpsjury on oilh. folloqht d(laltoN
<br />I dinrd. . Cdifr.'. of CoMr to S.lr.lBr. ftf, st 16 onFEchn. 6 F!!i{,ql aor by Sa-lion l?OO of lh.
<br />rh. Ffolrj4. . f ilE sod( fo. rtich rhc Fsn i! isu.d
<br />ill noint!6 wortd conp€N.rion r6!mc., 6 Elut.d by Sd i,. I7m oath. L.bor Cod., for tE Flolllle. ol
<br />,\l! (nrld1 !,,mr(dFn
<br />lnsut-at^cC Lo.
<br />cffi rn rEli, numhc r.q YY e 5 5
<br />PR wc L1 .1 q o ,.,L- btttiltt ,- ,
<br />in tlE pqfoffic of lh.qorl lor shich ihis parn ir ierucd. I rh.ll nor @phy &y Fson in.ny nsnq
<br />$brcl ro lh. wolt6' .omFantun h$ otcilifon'r. &d agE rhr ia l JDdd b<oG eticr ro llE
<br />r. prcfi.ioB oas.nio. I700 ofrlE lrbor Co{c. I CEll th.s FDvitir6
<br />aploF lo simitul FEIir ed
<br />ion, d!us6 a provid.d for thc
<br />FDlur. ro s@ wrt6' c.mFsi,n 0\6+. ir
<br />lo oE huftt.d rhougd doll,B liloij.Oool. m addil
<br />o
<br />DEC|jSAIIq!
<br />undd Darlry of pdjury rhd I 6 lis!.d udd FDvi!6o of Cluprd 9 (c.@i.e *nh S<rir 7000) oa Dn irion I
<br />sd Pmf6io6 Co&, an my kN ir h full for a4kfiEl
<br />b,ca
<br />t,,
<br />t C2o qs 0n
<br />QIL"L* lac.
<br />cox au(1a!lrrDl!(i-Ac!;!cr
<br />undd Fd'l o i pnjury ihd Od. s i ollnru.li.n lirkt,'g ,!dcy ior rh. pdfo,M.. of th. mrl for which rhii Fnir i
<br />AfU.IIANLDICI.AIAIIO!
<br />!.do Fuhy of pdjury otu of rh. nnbsins d<lsdrioB
<br />PmnlAlbdor Norincd iod Fdrdi R.ruhro.s (Iirl. 40, Pd6)
<br />! 0d $. i.dsal ,.suhtioN Esadrtrs sbdtos rmvsl ec nor .pplaablc lo rhi! poJ<r
<br />rhd I h.!. r6d rh6 !ppl'.roo. e nd. rh,r v. i.aotu.n B .ffi. I .!c ro comply *nh r[ Cny &d Coury
<br />6rbrn r.F.dd 6 ofIhn Ciry&d (oury ro rs lpontlE
<br />J ".," o:loyfzl
<br />BUILDING- INSPECTOR RECORD
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