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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 --.,,i:Subfloor/VenVlnsulation ,.-to 14
<br />Roof Sheathinq
<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 />Enqineer Final Report
<br />Flood Zone Certif
<br />-lr - - rl.)
<br />FINAL q\L1 l.t Irllw1
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc.
<br />--+
<br />r.(
<br />I
<br />fis
<br />I
<br />OwNF-t BUILDET Df, ITCARATION
<br />.lIm u.da Frhy of Fjury rhr I m dd$ frod 0E Con -16 Lt.* l4 lor tlr foUow[3 ren (Sc 7011,
<br />!n ProfB.n Co&, Any Cn, or Coud! snah r.qur6 . Fni ro oldur, itd,
<br />'6p.ovc,
<br />(laelirl or r.F &y
<br />FDrro itr isus.. lbo EgrE rt {plic! for N.h Ftur ro frk. riSi.d nco@t rhn ,E or iE i li.ss.d Frud
<br />oa th. Confuu r Lic.Ncd Llw (Ch.pls g. Comndcrtrs wilh Sdi6n 7000 ol oieitioa I oalh. BuiEs ed
<br />Cod.) or rhar lE or sh. n .r.mpr rh@arcm md rh. baln for lh. .llcs.d .xmpl ion. Any tiollrion olsalioo 70.1 I 5 by ey
<br />aor . pdnit subjdls th. appli.ml to r civil p.mhy o t nol 'mrc lh& fivc nundrc{ doll&! (St00).
<br />o*E of tlE FoFl,. or iy ophy6 wnh $ ry6 6 th., $L ompqBdFr *ill &' tlE Nrt lxi llt Erlal@ u dn
<br />or ofis.d ld sl€ (Sd ?ol,l, t GiB ud liofdioB Cod.: Tt Corn dor3 tiaE le &€ lbl +pl, 'o
<br />6 oeG oI
<br />s lb bJ.k or inprbtq rtE6tr in e h. dc Ln wt hiMlf or ha*lf or llmurh i! q lE o*t dploy€.
<br />rh{ uh imFD\@r. s. d lrqd.d dor6ld n rL ll }brss, rtrhJdlB m lsoEla i sldvina(E )*
<br />$. (xM AuiEs *ill h.E rlE h,rlar olFoli,S fi. lE or ltE dd ml hdd r trqftG lrE FoFy ft. dE F,F * ol
<br />oithc pmpsry. un .rcluiiv.ly co.nr..lins Birh lEqB.d tunt.lcroG ro .odtu.r rh. Irojd (se 7044, B6ind
<br />Cod.: Thc Co.trrro.r l.icdr. Lrv do6 nor tprlyro e o*n6 ofprop.ny vho build! or ihprold rhqarn.
<br />.onlds for srh p.ojdr wirh r ConldonJ) lkaqd rruRuln ro $c Conrri.tof 3 t-ic@ rrq)
<br />.B &lC r.r$E'Nn
<br />(}i!6
<br />!a&iE8tt-gl!u!!s ra!
<br />DE(JJAAIA!
<br />.,lim unda po6xy of pdlury oG o I rh. aollo*ins d.{lr6NB
<br />ed sillminrai. r Ccn',icarc ofconsr to scll-l ur. for $$rt6 omDdion. u pmvid.d for by Selnrn 1700 of lhc
<br />fo. llE psfol]u.c nf rhc tr orl tor e'h(h rh. lmi ai Bru.,l
<br />. l vrll minllin vort6 conp.sdiotr ilsllrlE., a Gtun.d 6y Sdon l?m oarlE |lbor co&. fo. llE Ff(!!M. of
<br />aor $ htt rhis Fnn ir isFl Mr *ort6 @drdirn @m. (eiq !d tblk, f,umbq ftlr jr-Rr< €.^r''A -
<br />** - 121,3t1b;t/o,b,,,2
<br />ifyrhsr in rh. pqloruncc ol rhc wolt for which thir p6nn ir ir.usl.l shau nol alllloydnyF3on in anymeocr
<br />suhjdi ro th. mi(6 .ompc.ldion bB of ( rliIohi4 d sgrlh.l il| dbuld
<br />..nrnMio. prD\iri.a ol salion I70o of rh. L.t r CGle I CEll. fon
<br />drploF ro cirel FEls QlC Fnlw to suc rsl6 ompqBdion o!6.s. n uhwflL
<br />up ro oE hu.rlrd rbusd &11,6 (1100,000), r r!n.. b
<br />Cqtc ntcrcr rn rnonr--'$.-s
<br />D[CtdaAIlAN
<br />rrtrm und6 p€lally ol tdJury thrt I @ lraB d uidd F.vi!tun ofch.fld 9 (commo.ing f, hS€lion7000)olDivis'onl
<br />Brin6 ed PofNioB ( o&. Md
<br />'ny
<br />licN is itr fuU rorc. ed.ttccl
<br />ch-. - c31 , E d
<br />ltz\.oo,ooo.)4
<br />!l]j !n unds p.nalr, o I p.rjury rhar thEc i! a codtudon loding 6Bdcy aor lh. pclonBc. of lh. work tu *hicn ths pdnn s
<br />ll097, aiv C.).
<br />AEUTATLD}:OJAAIIOI
<br />undd Fuhy or Fjury oc ot rhc aoll,* ins .t rlId i..t
<br />PmiB-Asb6r.! Noriiciibn lj.d6al R.Buldions i lnk 40. l'an6)
<br />edtrbL ro Lh! FoF
<br />bn i c6r( I qr6 lo @nqly rith rI Ciy .d Coory
<br />..F6drriv6 oa rha Cny rd Coudy ro aid '4o. tlE
<br />iay rhd llE fcd6d rqubl oG r.tadin3 6bdos r@o\ rl s. fr,|
<br />n,, t 6A/t'
<br />BUILDING. INSPECTOR ECORD
<br />It rhd I hn. rad lti! .lplkdioo rn
<br />>.nJ Sr.r. k*: EUr,u !o ruBft
<br />nxon d FoFiy ad Npdlri
<br />,r or
<br />^Eo'l
<br />sisniruft. )<
<br />.*."rp.i,,rr,X lA 14 nt ilrtlV ^-)
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