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SITE.WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />UFER Ground
<br />SLAB Floor
<br />Subf loorfu enUlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing l-A-+t x"\L.r!l)
<br />ln s ulation/E nerg y
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />ta
<br />FINAL 2-z/ -fl KJ.,l1(,
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />BUILDING. INSPECTOR RECORD
<br />OWNER'UII,DER DEI,CARATION
<br />I hacl,y lIrm u.da Fdry of prjlr, rhd I @ .i.nlpr fho $. Codr.dor' t,icdr bw for rh. 6llo*h8 r@n (Se 7031 5
<br />t sind d Profahn C.d.I 4,, Cny or Cod, shi.h r.qui6 . Fni to codrxl. rtq. in'Fov.. dsrclih oi EFn e,
<br />rrruclue Fulo n! is.e.ho Equi6 rlr +plt.nl tor rkt Ftu ro frk ! rBi.d niffir $ilEo!tE!lkau.d ptlld
<br />b rh. pr.rbioB offi. Contr*roa! Lic.ned t,w (ClEfld c, Comm.inB wnh S6rio. 7000 ot Divkion I ofrh. Buind ed
<br />l\.f*ioN Co&) or thrl lE or thc it qonpl fis.noE lrd lh. b.rk tor th. dksd qdFbo Any viohlio.olsdion 70ll I t bre,
<br />.ppli.d for . Fnn iubrdr Ln +pli.or ro. orilFElit of &t eE fia 6\. hlndrd.k!,lj! (tJm)
<br />-1.
<br />a omd otrhc proFny, or ny Gmploys wirh pas6 B rh.ir $lc codFBa'on, trnl do tlr korl !d th. 3lrudrc ir n
<br />inrd'dat o, orE d fn slc (Sc 70{4. BBn!< od Prof*io6 Cod. llE Conlnclor'r Lb.M uq.106 nd.pplylo DolG ol
<br />llE EoFly $'ho hil& or itrsoE tlEq !d wh. dE sn wlt tiello. I'G-lf or tlFush hi! d lE os, nnpl6y6.
<br />Fnri:tal 'h, s(h inFDrEldl e Nr indi.d dona.d *f, sl. I( rbEs. tIE tlildlB d itrsottra i -ld *iin c Fr
<br />ol@mpldi4 {E ol,na tiitb sdlhlE dE hdid! olFovus rll, h. d !r dd d hill] or inF.E th. FF] for E F,FE of
<br />_1. a o$G of thc F.F): d d.tuir.ly.o.ndiis "nh laqEal ..ddm
<br />'o
<br />.!dM
<br />'lE F.j.< (S€ 7(x,1. &sB
<br />drd Pro6.m Cod. rh. ( ontrdor'r l,ice l,w do6 mi !!ely ro & o*'!s oaFordry $ho burldi o. impm6 lhq6n,
<br />.i.l *ho $6t .1! lor such projd! wnh ! Ointdo(O licas.d puR@l to rhc Conlr.cld t l,icdc L*).
<br />_I m .lmfl u,& Sd
<br />lla$!8li-c9llflSrllro!Dlicla8Allo!
<br />I hd*r{ rfiim un& pdulrt ot Fjoq oEol'lr rolbsiry dclj,rhB:
<br />I h*. srl $ill Mim.in d C.rlilrcll. olConsl lo S.lf- lBor. for workFt qr.D..srbn, a ,.ovidqi for b, s<rbn 1700 ofrh.
<br />l.bor C.d., ls rh. Ffoll1e. o f rh. {ort for rti.h ih. p6nir ii is.rj
<br />I ha\. lnd $ ill dsinr.h *!*da conp.lsdnr iNroc., s r.qun.d hy S.dion :r 700 of lh. I !h.r (ndc. aor th. pqfo,l^_.-^c of
<br />rh. work nn which fii! pmil is islual M, wortdr' .onrENrion iBurdcc cuna ed Fili., numb.r e.
<br />Ijrl,tr6i_
<br />_l cs!,ry lh.r
<br />'n
<br />rh. rErol]rr,e of rh. *ort lor *hih rhii Fnn 6 i$.n. l ih.ll mt mph) u, Fer rn dr tl,IE
<br />$ 6ro b.{a lbixt h tlE solt6 odFsion lrB or Cdilomi 6d {rllli,rI snou8 tEom $bjd
<br />'o
<br />llE
<br />*ortd' compdion pmritioE of S€dion l?00 olllE lit{r Cod.. I JEll fonh*ilh Nmpl, sirh rhoe FovilioB.
<br />WARNINC Felur. ro kd. worl6' compas.rio. ovoa*. ir @hwa!1. ed sh.ll lubjd e mplorq lo ain ntl Frhi- md
<br />( l fin6 up ro oE huod'<l lh.ue.d ddlLn (ll .in ddirhn r. rh. or of onFrrioG d!.rs6 a p.o\it d lor rlE
<br />sdion:1076 oarh.lihrr Cod.. |lnsi3 rd.nuE!'l
<br />llL-t$r:Dl.talBArroatll:(I.l&ula.!
<br />I hsrb, afinm unds ralhy of Frury rhri I m ufltr rhriioo of (lEprd 9 (rmffiin8 $ h Sdl,n 7000) of Dr 6i.n .t
<br />oi ilr lr6in6 ed I'Nl*ions ('od.. Md lny li(o$ is in luu torc. sd cfl(l
<br />Z4/27/t u ,
<br />(lrllraxcrQNrEturl1i.A(illrl
<br />Ihcrehy0lft ud{ pcnllryoIFJry rhar thd. h a conrrru.rtr,n lddii$ irdkt ntr rh. Fdlomm( ollhe sorl li{ $hrh rhrs F6f,[ (
<br />'snr.i (s( r()97. ( i\ c )
<br />ATfUCAXLDILIJIAIIO!
<br />I halq .trm u.d.r Fnilty of Fj!ry orc of llE followin3 d,El[rlioN
<br />Dnolhio. P@iE Arbdos Noti6..rio. Fcddrl R.gul,t ioro (Thl. ,10. ld6l
<br />R.quncd krrd of Nd,6.iin
<br />-l
<br />c6rrfyrh.t rhc fcJ6d rc8uhrn'ro r4udrtr8 Bbcstos ronov.l ar€ nor.r'plicabl( k' rhs pqer
<br />-l
<br />cdi6 rhd I lur. rad lha {oli.r6n !d rd. thd rlE !tor. intorndNn n or..r I ec t. @mtl, { nh .[ (-nt 8rd ('ounlt
<br />or,jmam6 lrl sr.r. l,$r Eldiu lo ,rl h(Gb adtnrE. '.Fend '\
<br />6 ofrbr Ciry dd Counr, ro 616 upo. ih.
<br />ob!. n6r i(!n.J propdy lnr i
<br />\Dpli..ni ur,\pdl Sit.r(
<br />T ?<Y /Uzz/zt
<br />Erection Pads
<br />)
<br />Pool Fence
<br />Flood Zone Certif.
<br />PolicyNunbd:--
<br />,",'., n//z//e
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