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SITE.WORK DATE ID/SIG.COMMENTS OWNEi ATJILDEN DELC R TION
<br />I hq.by ,,Im udd p6.Xy of pdrury lhr I h ddfl 606 rh. (.,iEdm' l-ic.M tt* tor fi. lollosiq ran (S( 7011 5
<br />BBi!B rin Prof*ioi co&): Any cty or co! y shah r.q!i6 . Fmi to codru.t, !16. inFov.. ddelith nr EF! ay
<br />nrud@ ri, to irs i!!lrm. .lo cqi6 th. +?lkot ao. ixh Fnit lo 6L. lisn d nioE lhi lr o, ia i! lkq!.d FNd
<br />to 0r Forilios of E Co.!&ld , ti..nr.d t w (('tuF6 9, (\min* wth Sdion 7000 ol DivEbn I 6f rrE Bdim rd
<br />Pmfdio6 Co&) or lh.r lE d sll. ir acfipr thd!.ron d rlE tsi! for rl! .lh.d ddFion Ary violdion olsdnn 7Ol I J t'y ey
<br />.pplicu lor. Fri eti.tls rlr qplic&r ro . ciril p.olrl of mr mc llE 6i. hurdrcd &,U,rs (1500).
<br />-l,
<br />s osd otrh. FDFty. d my 6phy6 $nh s.86. fi.! $k omFE FEnill& tlE qqt tn rE tdR i mr
<br />ilnod.d m orq6l fd rL (5{.7041. BuiB ed PrDadn6 ( o& IlE ( Mhdo.'t Li.@ r^ {h6 d {'gly lo e o*E of
<br />llE FoF! qrb hiLl n insors tlEq rn "b dc.dr \$t niretr or h6sll or &ousrt hi. d lE o$n .iph,6.
<br />FnriLd rhi scn idFoci.dr e @l incd.d d.lfqld if, xL l[ rsq6u. tlE hlildi'B r ilserasr i' sld wilin d yd
<br />ofort)kia tlE Om Buil& *ill hlE lrr hn d, .fFrrrB lk lE 6 rlt di, Dl hdd c i,p.ot! dE p.DFIy tot tlt FsF* of
<br />-1.
<br />Bo$E of thc pinpsry. M crcbncD codB-lins *nh lic.ed <ddo,! !o.odoci th. Piojc(1 (SG '70{.1. 8r@6
<br />,,{ Aoasion Cod., Th. Conlflclo. ! Lic.# L.v rtj6 mr +rl, ro 6 own( oaprcp.ny *ho buildr or imProvd lhaon,
<br />lnd *to odBcls lor suchFoJ.n3 wnh ! Co,n6d.(r ltsal r,IRd ro rh. Co.nrclor'r Lk@ L!s)
<br />-l
<br />d.&mo und6 Scrion-, B &Pc lorrhtrGon
<br />D.t.: 0r!6:
<br />lla&i!&u(l)u[I!lA!!B
<br />D}:CI.A&ula:J
<br />I hs.h) amrm und- p.Elll. of FJUry onc of rhc fdkrqmS dalr tr' r
<br />I h!v. ,rl sill milllnr . Csriff,sl. of CoMr ro S.l! lNu,. for *r,tdr onrFulion, a Fo\ilcd for br S.dion lT(x,orrh!
<br />tlb Codc f rlEFfolrle.of th.lort fd utth lh. n6ni! L i$.d
<br />_, hrr. .nd \ rll m.i.r.i. wo,*dr conFsri)n iBrnft., s rcqlE.J br S.clhn 1700 otllt tlbor Co&. lor rlE Fl(xll1m. of
<br />rlE $.rl fd *hih tht Fmn i! isrd M, *qio mmFsion iMm. crF d polay n@bd r.
<br />-l
<br />cqtit thd i, fi. Ddf.llrre of rlE worl frf, whah thlt Fhil it isu.( I 3l!ll mr nnptoy et Fsn i. ey ImF
<br />s B h tr!@ rut*rr lo rh. *!d6 onFlr.n Ls! ol(.,ifd@ od t8re rhr if! Jrull t6om sttd lo E
<br />srtd' omr@rioo !rDr!io6 ols6!b. 1700 of rhc Ltn ( o&, I rldl. fonhsnh odply wnh llos protsF6
<br />\taRNlNC: l'.iluE to sm wrtd' ompsudhI cotglsc n uLqtul. !d dldl rubid e dpbtc to cimi.l rElhi! ed
<br />.ivil linB up ro oE hur(H thoMd &,114 (1100.000). in 6ddn6. ro rh. cor of.ompds.rior dm!s6 B Fovil.d for lhc
<br />S.dion 3076 ofthc L.!or Code i.to.., &d.nonEy . lc
<br />Appllorl:_
<br />tll:llslDroNrtatlllBllgJaarlQli
<br />I fiGby.mmundE Fraly o I Fjury lhtl l o licas6l u.ds rovbion.fchtlla 9 commacins siln S.cliotr 701X0 ofDiv$n,n ll
<br />of rh. BNin* md PrcldioB Cod., lid my ltru s in tull n(r d! crTd
<br />co!$alrclrc!.lrBDllc-acElcr
<br />I ha.!t dfm @!b p@rly ol Fjory itr thq! ir . @ddi'i Enig rs*y for tlt Ff6rn&& olrlE mrt 6r {nid lhir Fha i
<br />is.d (Sc. 1097. Ci!. C.)
<br />allllcaxr.!!{JAaAlr9x
<br />I hEdt !fth und6 palhy .a pdjurt on. of th. f.ll.sin! {t{ldd ions
<br />l).frniion Pmils'Asb6los Nolificalion [rddal Rcsulll'oB ( I nb 40. Pd6)
<br />-Rcqut.d
<br />L.u6 of Norificllion
<br />I cdilyrhd rh. a.ddali+rlalioB rc*&dnrs NtEsros ,6no\ 0l trrc not smli.abl€lo rha p6rc11
<br />l.a1i! rld I ha\. rod rhis applic.tion nnl. rh.l th. iltrv. i.tormd ntr B cotud I .src ro conply *ilh .ll Cny lnd ('ounl,
<br />or'jin!nc6dd s'ar. tiws El,liru to
<br />dlr,r. nmrhndl piop.nt lor
<br />\pplicrtrr or \s.!( SiBnrlurc
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<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 //'2o-79 Kc,??/iA Ary /
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc.
<br />BUILDING- INSPECTOR RECORD
<br />l)ifu:
<br />oz *,. 12/t7//{loTZ-Z--
<br />I
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