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SITE.WORK DATE COMMENTS <br />Set Backs <br />Forms/Steel/Holdowns <br />Ereclion Pads <br />UFER Ground <br />SLAB Floor <br />Subf loor/VenVl nsulation <br />Roof Sheathinq <br />Shear Wall I <br />Framinq lo/r,,/dzrlo tkkr-ltA*r nl x- <br />lnsulation/E-neiqy a <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 />I <br />FINAL 7,ltsl ftl \ <br />Certilicate ol Occupancy <br />Notes, Remarks, Etc. <br />OWNI:R EUILDI:R D'I,CARATION <br />I lEr.by trf,lnnu c. IEnrlly,,f p.rlrry lhdr I o crcq'r lm'n rtr (.drL1(E'Lf,cnc ljB (tr lrr lollorm8 r.av,n (s.-7l,.tl t <br />Burim\r d ltorc*ion (lrtc) Any C y or counry whi.h r.\unci ! Irrmi r,' Nn(rucr. rhs. in{'r,v., {knr,lith .r FFr dy <br />{dcrE.. Firkr ir\ k1uR,d$ EAur.s th rmlri.t i(,r ru.h Fmrr k, filc r \isEd siir.mnr rh,r hor shc N lic.n€d puNrd <br />nr rh. Irfl'vti,trN of rh. (i'.kr.tr'\ l-i(n*d In* rchlllr.r 9. CommRin8 wnh S.clion 70(x) .l l)iriri'n I ol rtt aurft(i rnd <br />Pnrr.si'.\ C,xt ) or rhar lE or 5h. <br />^ crcnu rh.r.fmm lnd rh. hd\ir fd trf, {llc3cJ crs l r t,n Any vrl ion ofs(lion 7o3l I iyiny. <br />uppl,(! lnr !Frmir \uhF1{ rlE !t'rli..nr i{, r.irilp.Dlrtot Nr mftrhd ftc hudEn doll,rlsqx)r <br />_l.rso*xrolrlrFoFnt.inmv.'qrr,F{\f,rhr!8.\!rrrrtrr'tconlFNrirn.snld'llt[[t{ rltqulmrmr <br />'nr..dorofl.r.drdqk(Sr..7O{4.Bu{rcssmdft.fc!\i,,ns(ixlc'l'hc(innr,.ntrrl-i..tr€Lrwd.s.ur!fi,lvhano*mrorrh. F)irnv *h, llilli or 'trlxrs rll*h. irn rho tls uh *r,t h'mell or lf,r<lf'tr rhmu8h hr m h.r ovn.n{'hr6. <br />[orklcd rhar \urh irntroE Etrlr s rn inrqlci or oltrd kr eL ll h,wcw. rlr foiLlinA i inFoe.md i\ g,Li *irhin k Fs <br />ol (lqruir rli O$rr aliB.r $dl lEr !h. hr .n ol F*m8 rll! rr d dx drl rr hill q EIret! th. Fr?ciy n, th Nqrt or <br />L r\uwtr$ol rhc,'nJp. y. !rexclusilul,.otrtxcri'{ $nh li..n*dconk o^ n, on{rud rlE lti'Fr (Sd' 7(x.r, Bu\i,f,s <br />!d l\r6\sir(i'dc Th.(imt kn-\ Lrcn{ Ijr d,f,r n,,ml,ro.no}.er.lPnp.nyeho hu'ld\o.imlo\c\ rh.rcon. <br />und wli, .ontr r\for \u.hrmjNl\wilh0 (iurr&k)dn licn{d rur\unr r, rhc co.t{kr'r Lknt l,\', <br />I .rcmlrund..Scdrr)n <br />Itatrl;Bs:(auflNtaJtlJli <br />U}:CIASAIIIIN <br />t hc'.t't rrrnn!rndd Fnalr).fFrJurr" om "t rltr n'i['tr m! iNhrnr'on. <br />I hl\t dlrj * rll turnrfln r (tn ifK.r. ol (ih\cnr ro S.li ln\urc ntr Nrks! .o'nJEnr{ n,n. .t pn,vid.U lor $y Sc.rinr :l7m ul th. <br />lf,htr cd.. ror rh. txlfmEm. rf lhc *o lorqnth'lErrrn t i\ n.ucil <br />I hrlc !frI e r ll rurnlain uork.^ cor.rEn\lthn in\urrrc(. r\ ..rt rcJ b] s.tr xr 171rr ol rh. lr'o. (ii.. nn rlf Frformn c nr <br />Nl\4/42azzaef 44,zzn-@z7ijs.b/a <br />l!.rrn!rhl trirhrttr.l.'n n(.,nr[.$frklrn(l'rl'rh\lrnr'r tr t{r.(l l.rrllnor.t{!1,rr"vB'\nr,nrn] Brtr <br />s, a\ n, lxalr \ubFt ro rlr rr{rnr d,mtENt $n Lur ol ('rliloni!. lnd lad rh{! if I dsull h(,m <br />\ork.'\ .r,Nn\xr,tr' p',trAn)n\ ri Sf(ri( rrlx) oirh. Lrhr <br />r-rr n, !i,trnirl t.0rhr\ itr(l$,\Rlll\(; Irrlltrc r, sauc trlde'' .nnIin\ kr (( <br />.nil litr.\ trf r', on. hund,o,i rh.tr\itr,1 tlolIr\ r(1 drnE!.r .r F.vr,cd ntr rlE <br />I lf,rhv rrlnm trrlcr l{mlr\.1 Iirturr- rhxr I N I inE f, h Sd1r,n TUrr) of l)'\rir.l <br />nf rhc Atrnncsrn'l r(ft\irrn!(inlc. rfrl n,yli..trk n <br />'n <br />lulll,n( rl.lir.r <br />r '?7_ <br />I h.El'y afitD u'iltr lEuliy oa Frrr.t rhrr rtrr .. d,n lulint,scry tor rht F rl rh< *orl nnghf,hrhr Frn r <br />N\u.d ts( .1097. cir c r <br />AIELI$NLIJTSJSAITA! <br />I lsct^ Jlfr$ utrlcr ri..!lly oll)cl,ury om or ilf, (,ll{ rn8 delrrarr r( <br />I)c'*,l dn lc.n \ A\hr!1,^ Nolilicali,,n ltdcrulR.gulDrinr r'lirl..l0.l'xd6) <br />RrLttrtr.(l l-rrr.r "r N'iilnnii, <br />l..nilyrhrr rh. lu,l.rrl'.guhriotr\ rrgul, ! rnr{!\Nrdrlnr.i.'lplirhl i' rhtr |I,,.(r <br />l..n'r!rhrr I hrc rrxn rhrrt r)n hrurNr ldl.rlr r,) Nr{'lt trirh r <br />o i.!mr\r*t srarc lrw\ EElr8lo hui htrrc r.t,'c{rn r.\ ol rhis ( <br />'rynnll,t'$ trrnrioE(llrollny irr in <br />BUILDING- INSPECTOR RECORD <br />ID/SIG. <br />7--