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SITE.WORK DATE ID/SIG.COMMENTS OWNTII EUII,Df,I DELCATATION
<br />I liEty .r!m un&i FExy ('l F JUry llBl I n cr.ry'r rmm rlE Cotuf,r{n l-arnc bw lor llr lollo}rg E on (s< n}l l t
<br />Bu\i6r .rd Prcfcshn Cirt) Any Ciry ot cr,udt rhEh EauiEs t tirtu !' flr{nEr. alt6. inll'tuw. (tmltt o, rFn dv
<br />sru1urc. ri, to ik t{sE!. .l$ Equn s rtE .rrltul fttr \*_h Frmi lo nt . nstud {d.m thd lE or {h. ii lien(n putotr
<br />io rh. Fr'vhio.r oflh. Conrctr\ Li..nsd Lrw ((lEFrn 9, Conncftin! wilh Sc.lioo 70(x) of [)ivhi,n I ofrh€ Busin.s,nd
<br />Pnllt$i,nr (odc) or rh.! ltorrrE r.rcnrr llErrro rnd rlt b&rar for lh. olk8.n.t oprion Any vioLl ion or serirn T0:l l 5 bvrnv
<br />!pl'li.. tu.D.trur$b..ktlr.rpltanrro..itilFmlry.lmtmrclh.nlit.hu*l..ndolltt(lslxD
<br />-1.
<br />.i oeF ol llE FoFrr. d ny ..q,bFr *nh *rsB .r rltt $k oqEnr1in will do dE *rt id ln {naie i. mr
<br />i.id.n noncrd f( qL (Sd.tl)r{. BDsiEsrd P,nacsE6co&r Tlr Gllrmror'r Lirns t P&E{ i+plviosoEEol
<br />rrE F16y *lb txiHs d inT.lB 0tua dn wb .t- qh ult nier or lErll or tlmulh hir d ,H own .rl]lov6.
<br />pn,viLd rhr seh rqDkmiB & r'a hkrd.d u ofi6l rq sL. ll rbws. rlr hlildlB r idt swmnl ir nu *khin om }t{
<br />or.un{,ldiE r Ouffi Bliklcr *ill h.E tlE hiftLn of F)ving lhn lE or JR dn ml boild o. in{mE dE F,lFly fot d. Ftlht o(
<br />-1..1owFof
<br />rlE InoFnr. rn.r.lusirclyco rsrhs *irh lt.6.d.onrslon t! rlttu ilr FiF-l ISs Tou ausl,6
<br />rn Msin C.d.: Tlr ConrEloa. l-k.n- h* d*r ml u'gly ro u o*m of ImFny wh. bnildr {t tmrms( rh.6n,
<br />rnd *lF $d.xrr ad *h FrFlr snh r Co'rErrnr, Ir..*i Po.<u.n b ilt Cotuda r Ltft litl
<br />/.<,aL
<br />llttlJLBdllu!
<br />I lErch' u0trunLr p.Eht of FYIrr
<br />I h.\c ol $illEinr.'n: (td'r..r. oICont t'si
<br />lih, (e.h. ftr llE Frfffi of rlr ro* ln f,hih rlE IsN i\ tsrkd
<br />I hr\. nrl * ill man lin * rld I (onlptnsll ion innnrRt. r\ rcqu,rcJ hy S.{r kr l7lr, .l rhc lrtxn (inlc tur thc Frfoirrnftc ol
<br />rhcsr'Il,nNhichrhi\l.ntri1\tr$'c']My$orkn\mtrrtrr\rfDirNurnNr.rni.Itr'xlBllty.unrl\rrc
<br />Icen',yrhrr thc fEif{n!ft. {,arh. *o* r(tr ehf,h rhNlt ir nr{kl.Irh,llrnuryhyrn)FI{rrinJ_'mnmr
<br />y) r\r)hc..om \uhF.'! n,lhc rllkcrl, .unrricnan bn h*\ol(rhk{fl.. rtrd 03r.. rhrrrl I dnukl hc.onr hjor n)rlr
<br />*oi(cr.otrlncnsari( m,$k,n\ ol S.yrion .]?(x) ul rlf, l trhr (iklc. l {lull. rrfi hs irh (onr y * ith rh,{ Pn'r,\i(rs
<br />IVARNIN(; Iirilurc t, {(u.. $ork.r{ ..n{xnr$ro\.rr!. i\ unlxrlul. rf,l \hrll\trhFcr a t lnot rr.ri'ni'rd F rlr*\ rtr(l
<br />.iril 6tr.\ un ro orc hundrcd rtr'usd dolles J(r.{rr)r. tr' rtlJii(nr n, rlr \o{ "l .unF ! tr$ ,lJ.t'!.\ J. 0Nd.d l!tr rh!
<br />Srrri 1016 oflh. Lrhn Oxi., iin.r.{ md.tr
<br />I h.rhy ltt-rfln trndcr p.ntrlryof FrDry lhol I an lien{rli ir.',)i(n rr.rtr! trnh skrktri
<br />fl rhe ln,s c$ rnJ I'lna$(ns (i'(lc. lrrl my li..n{ N r lulltur!. rl(llir
<br />I f,.n\. (',t,,$
<br />l.ialsrB!1:UllN.LENDllt;lt{illl}
<br />isu.d (ss .]09?. ci! c )Irnhli N.m
<br />-
<br />Lanls t A'ltlrcs
<br />a.tllr(AlfDEcrdxarllrli
<br />I tnllry lllm unJcr p.nahy ol ttrjury olE.trhc n,ll'*trrS dcrhturitrF
<br />I).rnIi(!rl'cirnil\Arhc{orNori,l.!rr)nrtdcralRcIultitrtr'\('Iirl.4).I'ina)
<br />Rquir.d ldrq of tllrifKdr)n
<br />rh r.n r.l rcrlLridnr Ead'n8 Gh.noi rcfrn d,. n amla.hl h
<br />'hn
<br />l,sj.l1
<br />t!I l!v. Eld rht {pli.rion .d {rrc thd rh. .lrN hroturn F .(nNr I lsre ro 6rr{iy rirh .ll Chv .d Counr,
<br />Sfut L tr\ drrnlr r,' hu' nrt n. ml h.rchy rh,,r rqr.crrarira ot rht ciry.ftl Coury ro .nro uFtr rh
<br />tr-?--/ y
<br />7/ez tl A/ar€e4t
<br />Set Backs /-n\
<br />Forms/Sleel/Holdowns rf t'(v /,t)
<br />Erection Pads \ -iv
<br />UFER Ground IaN'
<br />SLAB Floor
<br />Rool Sheathinq \'&2)
<br />Shear Wall {(/ \)E\
<br />Framinq a llu lP7\lf,rrer @2
<br />lnsulation/Energy I lW r)7 ;\J*4,().ar)
<br />Drywall rl dlt'I 1 .()\,<)
<br />Ext./lnt. Lath I r,r\erz'ry-
<br />Brown Coat I 6 irxuJJ /vl )
<br />Masonry I ol
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Report
<br />zzp'k)^, lN6*-.X\*<*h 2)
<br />U
<br />FINAL irlr i,ra<$^t 4 i?9)r)fCertiticate ol Occupancy
<br />Notes, Remarks, Etc
<br />BUILDING- INSPECTOR RECORD
<br />,11
<br />Subf loorivenVl nsulation R.
<br />n 1
<br />Flood Zone Certif.
<br />l. n r rannt undd Shrkrr;. r'*-/ f
<br />l.ruE ftr s\rtdr' din{xndb.. .s F!*j.d lor hy Sdbt l ltD of rlr
<br />Pr)lry NumL.-
<br />tr-? -/ ?'
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