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SITE.WORK DATE ID/SIG COMMENTS Ol'NfI BUILDER DETARA-TION
<br />I hddt lrm uftLr Frlty of Fjury thi I a .Gqi Eo6 rh. Co'ir-roE' l].* I.e f.r
<br />'h.
<br />followrl8 lgIn (56 7011.5
<br />Bsir6 .d Protsitn (-o&) Ary Cil, o. Coudt ehth r.qun6 . rEnr lo $'dru.|, 1116. hr.ov.. doellh or ftrin dy
<br />3tr.i@ Fs ro il! irlle. rh. r.qlc rh. +Oli.d for $.n p6tu 6 nL . risiod n.ffi
<br />'hd
<br />lE or rlE ir li.arcd pumar
<br />ro rh. Fo\ilioB orrE Conrtlg r l.icc.!d tlu ((tE9(a 9. Coffiis *nh s!.ri1n 70(x) of Dvtbn ! of lh. B6ind sd
<br />Pmadiod cod.)6r thn lE t rlt s .r6np t,E liom !d lh. b66 lor
<br />'!E.lh*.d
<br />.rarprbn Any vbliion of S6lbn ?01L5 lry tuy
<br />.ppltd for. FEi sqdr rlE @licd lo !.ilil F{hy olmi mr.rh.D fir. tudt d &'lla {1500)
<br />l. 6 osG of rlE p.oFnr, tr hy.npht6 snh *.!6 s llEr sL omp.tdbn- * d,llE*{rtajftfirrE; x
<br />i!rd'd.d or ofrs.d aor sl (S( 70,1.1, tt6iB dd Pmf6t'E Cod.: TIE Cod'rld r l.i..@ Lt* &€ ml 4?lr ro 6 orG of
<br />rlE FoFl} *lI t(ill.r ,!p.!r6 tlEotr .n *ho (h€ st sni* hirell or h.Bla o. rtNu3h hn or rs o*r 6phy<
<br />proriLi rhd !o.h ,rgsffi E mt doxldi d ofinrn if $L lt tsr(a. t tlitlrB or !tp.!t!ld ir sld s'irhir oE
<br />'rofo,plaiotr E()\{nd auilld *ill lEwrlEhd6of FornE rhd lEo..h. did n hliE or inF.w dE FoFy lor lh. Fi.pos. ol
<br />l. a otr nd of rhc lR'fdr, dn .[lri1 .ly .onrer U w h l(6.i co r&tuE b d'B'tud
<br />'lE Eo](r (s( 7Or4. Bsin6s
<br />-'d hoftsm (odc lh.(intmcln s l,ic.N.l-dwdo6 not applyro mown6ol pruDcny sl$ burldsor tnpro!6rhr@n,
<br />lnd rvho conrr&r3 fu ruch proj.cl! wirn s ConrE(o(s) lic€c.d pu6@t kr rhc ( (tlllruct,-s Li!.M l!s)
<br />I d cronpt und6 S(ron
<br />tlrr.: Oud:
<br />trcaliErs:grufl:r6af]aruicllr8allor
<br />I h6.1,' a,nrm !nd.r Fulr) orFJID orc oalh. folnruiry .L(lJarnrN
<br />Ih.r.tnuilldi .h. Cdfrlr. ofcoM ro S.l cefn*nt6 onpsErrr d F!\r,.d tor b) Sdrio.l7m ofrh.
<br />t t r Code fd dE Ffm of llr *ort 6r stth dr FDi it isrd
<br />I hrr..nd *ill di.r.i. $orkd' (onFEdirr i6ulEc s r.qu@d b Sd6n 17Ul olrt lrtw C.&. 16. rh. Faolllffi. oa
<br />ion il),llJe..mi., in Flk) .untE ..:
<br />b ?Q 3-r-tY
<br />I c.rlif, thll i.!h.pdf.rtu..olrh.*ol tu*hich$i!p.rn't is i!!u.d.I lhill .or mr6, d.y r,.Eon if,uymen6
<br />e 6lo bccom. subjdl !o lh. wo*61comFMion LMoacslifomi.. ed.*Erhd ill JFuld lE{om. lubjd lo lh.
<br />wortd' conp.Nlion provntunr of Snlion :1700 of lh. hbor Code I sn0ll. fon h"irh comtl, $,ilh ttFr povnios.
<br />WARNINC riiluc lo su. *r,rt6' comrdLralion .orsas. is unhwful. od lhdl subjrl d ddolq lo .riminal paElri,. ed
<br />c'vil fu6 up lo oru huntt.d thourod doll$ (ll00.O1x),. rn !dd{&n ro lhc c$r "t(omr'.Er'.n, &rus6 a! poliddl ao. th.
<br />sq1{n 1O7o I rh.l rhn ('urle urod Dd dn,ft}t 16 /l
<br />,,,,,*- 9,t-fa n**,, Vk*lLrcENsplqpNTRa('rpRDECirn^nol '
<br />I hqlby rnm u'rr6 Fult! or Fru r.-- rhd l 6 lE E d und6lDrlKn orcrul{d !l(umnEu* snh sdxn 7000) of Di\ ision !
<br />ot $. Alffi dj PmfsB (ixL. !n my lrc@ s m full lorc. -d.ltrr
<br />,.**r,^F
<br />n. *-3e. fi
<br />1oo44 *?
<br />I hd.by amrm ondd Fn0h, oa pdjory thd rh6c ie r sNtu(1ion
<br />isru.l(sd 10q7, (iv ( )
<br />.gdc, for !h. p6l..1ffir. of th.$o for*t'chlhisp6m'l6
<br />AfII,ICANLDTCIJ8^IIO!
<br />I hdtt ,rft undd parhy otFJury .rc ot $c followils &.krslFB:
<br />Dshllrion Pom'ry^3b6roi fJorifrdEr f.ddl R.suhlhB (Tnk 40. Pm6)
<br />Rqur.d tnld ot t*r'fribn
<br />6bd$ rdovrl s. d $r'lrcrbk ro rnu tior.d
<br />.thn rhcrtnc info@on * r(n.l I +rdr,.ontl) *ihillC'rt rndCou.(
<br />( &d hsn,rq tllh6e. r.Fsri:r6 ollhn (n, dd Codt ro 0{6 rqr. E
<br />ibor. nElFGj p.oFtr nn crEdrn
<br />Applic.nl or AB6rl shn.lurt
<br />ML,^)
<br />E 'to'it
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />Subf loor/VenUlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />ln s u lation/E nergy
<br />D rywall
<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 />FINAL
<br />Certificate of Occupancy
<br />Notes Remarks, Etc
<br />556
<br />BUILDING- INSPECTOR RECORD
<br />UFER Ground
<br />Flood Zone Certif.
<br />-. ^Eft
<br />/l rN'-/
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