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SITE.WORK DATE ID/SIG.COMMENTS owNDR B!u,DEn D1:t,(-ARn t',()N
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<br />) or Counry *trh r.q!n6 . Fnn tu codrud, ihd. rmtrov., &rnol6h or E En u!
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<br />'o th. ForBFE oa E ('onk*ro.3 Li.mr.d t!* t(-h!As'), comntrms sirn Sdion 7(xro ol rhishn I orrh. Irus'n.s and
<br />th,f*rnr (.od.).' rhlr lrn!h. B.ropr rhdcliom ud rt tEs6 tor rh< !ll.r.d.rorrFn Any![lnrhn.fsdh.,(r1l 5b!an!
<br />.$'licetiorip.nn[sobjcrsrh.appli..nrt.a.irilF.aht l nor m.r. rhtr fiv. hun&.{ dd]les (11(r(r)
<br />l. 6 0*6 otlh. FoFny. or ny opkr\c tr
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<br />ra{6 c lh.ir $k (.mFsn'on- \ildr rh. *ort nd rh indm 6 nr
<br />inrRlqi d oltd.d ny $k (se 7044. Durn6 Md thf*ioro cGL 'I ht ('ontidors Lkn$ Lj* do6 nor afiiy ro M otr nd or
<br />rh. Flpalv $h. hl'kk or dFovs tlEen. id *ho dE srh tro hrtr.lf or hs*ltor rhmuth hi! or h6 o*n 6plo).6,
<br />ro\ xLd rhrr ru.h u{m\!Enr dcd f,6i.d M.fi(61tu Et. lf. lFs6s. rtr hritllll o n{r.tnd is ild *ih'nom \@
<br />.l compkmn. rh. G n6 B{r[b $ rll ha\. rlE htrd6 of F.rns rhd h. d rh. did B! tuld or !mF.\r fi. FoFtv tor lh. Il4rE or
<br />l, 6 o\ k of rh. F)nqr), rn .lclEtr.lI codral 'n3
<br />u h hc4€d conradou nr co6Iru!1 rh. Fo.,.!1 tS< 7t{J. &8'n6r
<br />a.d FDErdin cod. lhcCo rlcrois Lic.nscLas Jo6.or.nFly'o rno*n6.rFropcny$ho build\ or trprcvalh.rd,tr.
<br />.ni! {h..onh.'riorl.hFtrj{trs*irhrcodrrcnr(s)l'coEdr,u(mrr.rh.(ont&1.isl-i.el.{)
<br />lim r\(tr,ln unds sc(non
<br />t.r. 0'16
<br />NORIiERS' ('dIIPtJI'ISAIIOi\
<br />D.U(]r$AIIOX
<br />I h(q\.mrn und6lhrhr ofFjuryon. ofrh. a.lhqi6s d(l dions
<br />Ihavcd!tr!llmlrnrtund(drlicdr.of(,rnsrhs.lalNur.f.r$orhdcomFnerFn,IFordAlfUbrS<1iorlrl[otrhr
<br />l.hr (-od.. turh.Ffoll11m.uf rh. *or( nr $hi.h rh. pdfrir s i$tr.J
<br />I h.\ c anj tr
<br />'ll m.inr.rn f,nrl6 comp.Barhn rGurrft.. a r.q!n.d h\ Sd Fn r 7O0 .a rh. I .hr ( od.- Iitr rhc F[i mBnc. or
<br />rh. \dk lor r h,ch rhlr poil B rilu.d My worl6 comlEoslron iN!ftnc. cad( rnd p{n,cy oum}Er r.:
<br />*.cdrfy rhd rrh.Faom.k..f rh. f,o.k for {h'.hrh'r Fmn is 6!udl.l rh.ll mr mtloy any lmn in rnt mmF
<br />ro tttorc suhjsl lo lhc *orl6s' c.,npc.gl nr hws of(.liroBi.. Md arre th6l ill should bcor.. $Ujd1l'r rh.
<br />rfrl6 (nnp-Lsrtr,n[l(l \ tnm of SFlrn 1700 o r rh. l ihtr ( .dc I ttrll. fod h\ d h con',n! \ihrh)aprnB('n\
<br />\t.lRlvlN(; lr hr. r! (uc (0116 cnmlEis 6 u.l,(ful. afti ih.ll 3!trd mnlo\6 !o mm'Ml rdnt6.Rl
<br />cnrl fin6 trn to on. hundr.d rhotrsnd dollG I iddnm k, rh. cor olconr.,srion.':W;*-'
<br />I hd.ta amrn und.r Fn,hr of n(Nn r Frtili ol(-i.t{dr) (omnkrnS $rh serhn 7(xx,) of l),risKn I
<br />.l rh.llusiiRsand l\otaions(id.. Md 'ny h..trsc
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<br />ltrlllnrc.: tl.ff\-r
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<br />""" Z/tz/tZ
<br />I lE.t! rrrn ueLr FMIrt ofFrur)
<br />'hd$u.d(S( 1097. Ctr ( ).
<br />rucirrn lotdir'8d) a.t rlEF()Irr@.of rh. (.d litr trhrhrh6 Fnrn u
<br />AfIIICA.NLDICIJ&IIIOT
<br />lh.rt, allm un&r porht ol FJuD on. oflfi. rolhqrn! ddhriti..i
<br />t).'nolilion llsmils-Ath6los Noriicdtu li.{dal R.rohlionr ( InE a1). I!an6)
<br />R.qu(n I dl6of lhftdbn
<br />I cElrl lnd rh. rdddr+uldn'N qredin8 $l!s(,r rd6 rl -. nor 4rpli.,hlc ro rhn rnidr
<br />a! {ar. rlh! rh..h\. rnao.na.on i3 mrly*nhall( )a.d(irrnr,
<br />( iry6d Co!n!, to 6r( otIn lhc
<br />//l-
<br />,k/r'FE J€
<br />z/y',2
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loorn /enUlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drylvall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Mason ty
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Qgplly F jnal Report
<br />E ineer Final Re ort
<br />Flood Zone Certif
<br />FINAL
<br />Certificate of Occu nc
<br />Notqs, Remarks, Etc.
<br />BUILDING- INSPECTOR RECORD
<br />>kbn^ 5)
<br />tu
<br />,..(-,,,,,., 2/r7?311ia2fuZF
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