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SITE.WORK DATE ID/SIG.COMMENTS ()w6,8!'ldd tkhnlio.
<br />I nd.by tmrm ud6 r.Mx, of FJUry rh.r I rm.x.Ept form rlk ( o.r.cto5' Lrc.N t w lor rh.lollowris ro.on (t( ?0rl5 Buln.rr
<br />rnd Pror6lion Codc) Any Cnt or Cou y f,hi.h rqun6 ! Fnt ro oBrrucl, d6, anprolr- dcmlalh o. (p.n uy nMm. Fior ro n,i(u(., rLo rquid rlE 4?hclnl fo.3kh Fn lo 6rc. nJi.d 'l.tdEd th.t lr or!h. it lic.6.d DoBu.lr lo rhc pr.rBio6 orrlE(o.mdofr LreN.i tlr{Ch.prd9. Comn.EhS* hSdbn7000olDreBo.Iofrh.Du'n6!tndFrofdnoNCod.)orrtErh.or
<br />!h? k .r.6pr rh6.li.o rnd rh. t.sn for rlr .ll.s.d .r.npr6n A.y iol.lion of S.(nn 701 Lt b, xy .rplic.d aor . p.mn rubjBu 6.
<br />.pplnlnl lo.cnilFEnyof d mc rh.r lie. hudr.d dolLB {15(l)).
<br />l. a 6sE of rl! prep.ny. or ny mpk'rc r irh Mg6 ri th.i, &h cotrrp.ulFn. s ill do llE s orl .rd rh. nrudu. ir frr ,m.nd.d
<br />or otlir.d for sl. I Sd ?o44, 6un.6r md Prol6ronr Cod. Th. Co.rr.croi! L(..r. L.* doB mr .pply ro .n o*nd or ih. prcp.ny
<br />*h. hril.h or 'nproy6 ilErFn. !d *.h. do6 r*h $ort hi6*lfor h.rxlfor rlrouah hit o. h.r orn.nptry6. pro\iil.d ih.t N.h
<br />impror.MB e ml inr.nd.d or olIa.d fo, sb I t hov.r(. th. buildins or ihpro!.m.nr ir $ld * d hrn oc ).!r of complaion. rh.
<br />()wnn-Burld6 a iU h.v. lh. buda or pmvinr
<br />'h.r
<br />h. or rh. mr h,ld oi inpror. ror llc purroE oa rL)
<br />I. a o*noofli. prcp.n)..m Gr.luriv.ly cont(inr *nn licced conirrdon to sNrrucr rh. Fojd ( S( 7Ol4. Aui.6r rrd
<br />Pbadb. Co& lrr Co.t.do, i L..M rr* d6 d .pplv ro.n ow of proFy *ho h{'ld! o, 'Bpror6 llEron , .flt *ho
<br />.oattclr for ruch po|.crt ullll r conr.cro(, lrc4.d pur.u.nr ro rh. conr'clor'r l-'c.nt.l,* I
<br />I m.rm urd6 srrhn
<br />\aal$as_(autE-tsallotlDtslxarar
<br />I h(ch! r ltirn und6 p.ulrroip(rjury on olrh.rollo\insd..lrr,rnrns
<br />I h.\ c &d *ill tuidti, . C.nilic.t. of CoE.r ro s.lr.l6u'. ror Erldr comp.Br on, s provd.i aor by S*r
<br />'on
<br />I700 ol I h.
<br />Lhor Cod.. for lhc p.rforrunc. ofrh. eorl tur *tuch ln. p.rmn B n$.d
<br />,(",. -o *,, -.,". *-,.-'
<br />::,:*w;;a
<br />r@u .d by S*r
<br />Mt *ork6- comp.netEn ,&uB. c.rE 'on
<br />1700 ofth.uborCod., for rh. psforrunc.of itF
<br />Co..Zutre\-wLsSnZ)3 oo)ttgra ' /.)
<br />( Trtn ...1 nn td el b. .onpkrcrl if rlE FrDn i. ror orE hundr.d &,116 It I O0 | or Ls )
<br />I c.nifr_ rhr! r rlE Fd.mft. otrh. *o forrhthrhn Fs[ 6 s!.d.1rhrll mr
<br />It .ft.uhj.d
<br />'o
<br />rh. m*.8 @mFnstpn L$of (.lrfo,nn-md.$e
<br />conp.Nt0n prcrlnN ^rs.rrcn r70t)
<br />'::^^ !l::/.:",,:
<br />ffrft l ilrtr (.Jc lnrll
<br />Anfrran X:_
<br />conrp.urDn.ovdrs.6unl.*ful..nd.htllsuhr6r!n lo\c' ro c'mtu'lp.mh(! aftl cr n
<br />lio6 up ro o* nu.d..d rh.u{id dolh6 I ll00,0@},ir ddnirn ro UE 6! or omp.ulb.. d.mr6 s pmri.n aor tlr SdiE !076 of
<br />iE t hd Cod., 'drd.nd.nd*y t fs
<br />UCE!$DCqNBACIABS.OE(:IA8AIIO!
<br />I hd.Ly .llm urdr p.ol, of pdjury rh.l I D li..uqt udn p6vsio. ol Ctu$6 9 (conm.n.ins snn S<lioi ?000) ot lriri.io. I or
<br />lhc BBin.B.tn Prca6rr6 ('od...nd my ltce i! in tuU ft)(..n.fr6t
<br />:;:7,€7a L
<br />I I's.ty.rm udd p.uhy otFiEy tlur rlE i. . .oiriu.rb. ladirs .s.Ey 6. tt Frtotrls.oltlEso lor ehicn tn! pdait ii
<br />iBo.d (S€. 1097. Civ. C.).
<br />AIILICANI.I.DECLAAAIIAtr
<br />Dctuhion PGTilt.A!b.!lor Norili.Ib. F.rLnl Reullioro {Tik,l0. Psl 6)
<br />R.quiEd hls of Nolifiqli.n
<br />/..#,rlE f.da.l c*ulllaN r.arding Bb.rkE i.mr.ls. nor rpOlic.blc ro Ihis proter
<br />.inaolm'bni!cotrd l.a@rocomplyrirh.llCnyr.dCo@ry
<br />.nd hE.byauthorn. r.pr.s€nratncs ofrhi! (-ny lnd ( ounrt lo fltd up.nth..b\. n.nrion d p.op.n! for
<br />nor,"*, *.r-, r,, ' d
<br />P.mi e Mm (Dri ) tF
<br />*,. lr/D)) y-
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />SubfloorA,/enVlnsul
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coal
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />FINAL atltul t{-.N l?m/0t)
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />n
<br />M \WP51\P6mil'lnsp.ction Foms\Burlding'lnspoclio. Rscord doc
<br />BUILDING- INSPECTOR RECORD
<br />Flood Zone Certif .
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