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SITE-WORK OATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subfloor/VenVlnsul
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />ln s u lation/E nergy
<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 />,
<br />FINAL a/6j1rc aFru 3h,</4[,
<br />Certificate of Occupancy V"LJ,"(
<br />Notes, Remarks, Etc
<br />()r6.8{ild6 D..Lr.tit.
<br />I rEr.l' rmrm undd p.Et, ot p.r[ry rrrr I rm .r.hfl torn rh. Col ffror LEiE lrr lor th. lolLwhs r-F. lE 7o1 l 5 BaiBr
<br />Dd Prot6ii.,n Corl.) Any Cny or ( .,!'ny whxh tquir6 r Fnn 'o(Bhrl..h6. inrro*, d.frn nh or r.p.tr uy .tN.'u., Fhr ro i't
<br />Rluft.. ! bo Equts rhc lpplic.nt for luch rErmir to fiI. r rirn.d lrtt.trnt rh,r h. or rh. ir li..d.d pmod to th. pmvirioB of lh.
<br />Conb.dor ! L'eB.d lrw ( Cllprd 9, Conn.tu'ns w h Sd.i rom ol D'vB6i I of rhc Bu,n6. .id Prcf6r6a C6d.) or tll|t lE or
<br />rh. i! .rdpt th.r.ioo rd rlE b.tir lor lh. .lle.d .r.mFion Any tioLr.. of S.dhn ?01 My .trt .r9!ir.r f6. . Fmn iubid! tlE
<br />+plicrd ro..nilll.rhy ord turc ihn nv. hu.d(d dolB (5500)
<br />l. a o*F of lfi. ,mpcny. or oy .mploys * itt u.8.r .r lhct rol. comp.B.l hn. w ill do lt wod Dd lh. rrrudu. it nol iit.nd.d
<br />or ofld.d aor rl. I S< 7o.l,l, Bur6r ..d P.of6.6nr Cod. Th. Codrdn r Lr.e lr* d6 mr .pply ro .. o*M of rh. Fop.ny
<br />*ho hoilrh or imp.orq ilEron. .txl sho &6 rrh wort hinrlf or hs*lfd rlrorJn hit or h.r @n mphy6. Foril.d ihtt Ich
<br />improv.n.n[ r. hl i .nd.d or olTald aor oL lf. how.\ 6, llE t{ildins or ihproEft..r ir e! unhin oR }.u of conpldhr. thc
<br />Ow.n- Buildo *ill h.v. rh. bord.n ofpblinj rhlr h. orrh. mt build or improlr for rh. purr.rorub).
<br />l. ! 0*6 or rh. p.oFnr, .6 .r.lciv.ly conr..ri4 $ h ltcE d.onrmo6 ro.odrrud rn FoJ.n( S< ?0,1t. Builld.!d
<br />PDfBion Cod. Tn Co'irdoar l,Ene t w d6 mr tprl, !o .^ orG of p,oF y who burl& o, 6p.ov6 rhd6n , .nd rho
<br />contrrck aor toch troJeB *dh . Co.hdo(, I'..nr.d Du(uit rorh.Connrdor'! l-'c.n..L* )
<br />I m cr.npr unda Sdion
<br />IABIi};ASIA}TII:IIAIIALSESAf,^IIII!
<br />I h.r?b\ rllirn und6 p.Mh!- of Frury o* olrlr {dhtr 'nr d<LErnB
<br />I h.!. rnd w l m.inrlin t Cd ific.lc ol ( o6.nt ro S.rf-ln$r.lor m.k.B' comp.nn! 6n, .! p.o!'d.d lor by ser'on r70o ofrh.
<br />Llbor(hdc. forlh.!.rao.dnc.of rhcqorr tu*hichlh.r.rmh n nru.n
<br />I hv.rd *,ll mnt
<br />'n
<br />*0116 @m0.BrEn rBurne. ! r.qur.d by Sdb. r?moarh.l.bor Cod..lor
<br />'h. Fformnc. of lL
<br />*ort fo, *hrch thB p.rnn B sru.d M, *ortdt' emp.n.r6n rn mc. c!Ei6 od p.li.' numb6 r.:
<br />Policy Nurnb.r l'\ptr6
<br />( nrN sarkn, n.cd nor h. compl.t.d 'arh. p.nn,r N aor on. hlnd,cd dolliri lll00l or l.$)
<br />_ ! .drf, lh.r in rh. p.rfot m. oath. *orl lor *hth rhi Foh ir isu.d, I $rll d .rploy.ny r.M. ir m, mmd $ ( ro
<br />b*.m rubrd ro rh. ErL6 o.{Eer.n LB oa C.ilornr. ..d .aE rhl lf I rh.uld beom rubrd ro rh. hrl6
<br />il-'-"*""*"*^T-ll'fX'ffiS&b<
<br />WARNING t 'lur.lo Gcr.*dk6 @mp.urFn cor(.i. rturLqfll,Dd rh.ll rubr< .n .nploy.r ro tuinrl p.dhi6 .rd c'ril
<br />fin6 u! to on. hundr.d lhou. do llB ( I100.000).in ddilion to th. c l of comFnul ion, dr r.rBprovid.dforlh.Sdion1076of
<br />rh. trbo, Cod.. ' sar rnd rdrn.y t a6
<br />L&E!!ED-CAEI3AqAS!.0!C|4aAIIa!
<br />I neby .flim undd Fulry oa p.rJury rhrr I D lim.d und6 p,.rnio. of Chlr'n I (oMCi(inB wnh S<rbn 7000) ol Dirlion 1 ot
<br />fi. aNiEs.nd ProfdlioB Codc, r,!d my li..cc i! in tull forc. rnd .,16r
<br />'it"U-l.-1 lenlturrg
<br />(atslaLr(llorl.ElDnc_alirN(}
<br />I h.r.hy tfliirn und.r Fn,lly or p.aury lnlt ln.r. n ! coGlrucrrcn l.ndrns u.my f.r rh. p.rfonunc. ofrnc sorl fu shich
<br />'h6
<br />pfl.ir i3
<br />irsu.dls.c i097.( i\ (')
<br />ATEIJSAITI.IICIdEAUAN
<br />D.mlihn P.milg Atb.rlB NorifErli,n F.n al ll3ullbE ( TaL a0. P.n 6)
<br />Rcqlir.d r!16of Ndifidhn
<br />I .cnirr rh.r rlE &...1 cBuLrir r.sodint sbBror r.mvd e tur .ppli..bl. ro rhir p.oj<l
<br />I ..niry lhr I hlv. €d thi. .@ltdbtr &d ndc $.r rh. .bort irforur b. b Nrr.<r I.8Gr.@rply rirt.ll Cir.,xl Coo,r,
<br />ordrnrm.! ttrd Std. lrss r.l.!in8 ro buildin8 .ocrdd ion, .nd .urhorn.r.Dr6.n'.riv6olrhnCir'.nd('ounryro.trrdoD.nrh.
<br />.boE r.nr6ftd 0rop.ny ior in$<rn,n
<br />(
<br />BUILDING. INSPECTOR RECORD
<br />ms\Bul0n9'l^sp.clon Rsco.d doi 03 31 06
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