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BUILDING. INSPECTOR BECOBD <br />SITE-WORK ID/SIG,COMMENTS <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />Subf loor/VenVlnsulation I <br />Rool Sheathing qJartTc Mfl.9 7 <br />I <br />Framinq <br />lnsulation/Eneroy <br />Drywall <br />Ext.i lnt. Lath <br />Brown Coat <br />lt/asonry <br />Pool Fence <br />T-Bar <br />Handicap Req <br />Deputy Final Report <br />Engineer Final Report <br />Flood Zone Certif . <br />I <br />I <br />Certiticate ot Occupancy <br />Notes, Remarks, Etc. <br />OWNFI BUTLDET DELCARAIION <br />I hcrcty llltm uftls pcnolry ol pcrjury rhd I d crch hom lh. conlalIon l.&nr L.* nt rh. ,{,udwn3 Ervrn (Se.?tul.t <br />Busn.s rdr Pror..ri Cdlc)r Ary C y or C,uily whrh Eqorcr . F.nn b u'Nruel, .ll.r, itr{'my.. &mnlth or FId uy <br />stuftR,Fxrons isB...l$ FluftsrL {tfl.dr fo. **h rrmt ln aLt. ISEJ rd.t.n rh.rlt rlE!lt.nrl llnd <br />ro rlE F)vg,nr of rh ct,nlIxru\ l.r.nh] Lq (Chrt{.r 9, C.hmftinr v'rh Serrh nID of Divli,n I dr llr Busrs .,rl <br />PtuLslonr Grlc) u rh.r lI or .hc r .rctrYn {s.Iruh nl i& br.6 nr Or .I.3al .r.mliDn. Any v[hii,n of Sern. 70-r I 5 r,y .r, <br />drpla.nr rr, r pcrmil iubj(ts lh€ &mlicul rorcivil!.nrlrrolnor mtr lhm fivc hund4ti dolki lt5m), <br />-L <br />r ow6 of rlE FoFny. c hy.nptrFs ,'rh r.s.r s Ur, !'L .utptMri,n, vdl.lo E *{t an dE rerh 6 or <br />d.nlAl o,L..J ror {L (Sa.r(44. BulIK:hl llr$lcltffi CrL: Tn Cotu&rd'r lI.N L.r dE! n l+llyt,uowrdt <br />rh. FIsy vt hoilh or E{'oB rh.Frn. trl wrr) Lk* h s)lt hmi.lf or h.rcl! r llNngh hn (, hd oM.t{k,r..3. <br />lrovdcd ih{ nBh mptuktrnlt u. nn intcd.lr uoncE{ for elc ll h)*ca. rtE t dtrB o qmrcB ire!* hinorc F{ <br />otco'i0bii4rtrO*ErB!fld*lhrEtlEhhLnolInvratlurll,{nEdidn,hi!ornr{nrhuEFutElyn,dEIrrID.ol <br />_L r\ owr of rh. pn)|Fny, in cr.lllEly conirer u,! w h l(.nsJ (nrrtm r, (nNru(l llr F'Fd (Sd 7t ,l.l. Ilurr$ <br />and thr(ur Cotlc: 'rh. Cin rlcnn s l-Nn{ l-t*J,r: fr .rfl, n, sn owncr or l'n)tlny wh() hurll\ or nr.r,vcx rhcr.on, <br />anJ wlx, onidcrr ntr \urh pnr.d r unh r Conrrr.l,,n s r licn$n lluNtrnr t, rlI C(,nts(tr's l-r.hs lru ). <br />_l m .r.nfl ud.r S&k <br />woRxrns' colltPI.NSATI(rN <br />DEctltallo! <br />I kr.by.ltun ufrk lculry or F|url or ol rtE iolk,!r! d.{l[.rinu <br />-l <br />hrv. d,rl *,ll nurra r C.n 'rirrc or Csn:.nr !, S.ll-lnsurc ntr k)*(i om[i n{non. a\ Int,v'JdturhyS.(rrrl70O Ith. <br />Lrhr Orlc.l,tr rh. !.rlornrnrc ofrh. wtrrk lar whf,h rhc trcrnir N,\rrJ. <br />_I hrw.d *il drlrh rorlm .oqEN.lir. NUr.Ec. a Elur.rl by S&ir{ ]nl) of lll L.hr Cq,.- ld rlr Ff{)fut ol <br />E q ror whrh ![ir Frnil ir isEI Mryql6 (Dnpolnr mrnt (ui, .ni IDII, nu't6.t E: <br />I] <br />-l <br />L.nr,, th.r in l,r JErlormB. or llE *.rk n{ *hrh rh'.Idrr ,i RiEd.I rh frn cdlPhy.ny Ftsn i. rny tuE <br />F sio hLoft $tFt n, rh. $ikcri (n{rnsariin hx of C.lifomr. rnd.sE !hr! if t $.ull] heom bFl hltE <br />$*dld'rIEnsrliDpn'visioBofSali,nl?U,oarlEtrtxxCui..Irn,lbdhvirncon{'ly*irhihkFrcvili,n! <br />WAnNNG FntuE k' s@ sxk.R d,r{Erdno $tasc is un,rqtuL .,n rr l runFl u si{,bF t, duld F d- ntl <br />(iv rik! !l' lo .E huniFi lh{gnl &UrE (lllll,uu, 'n .l nn ro rlE .o{ or mqENrn'n. dE8.r n Fovrldl ror tlr <br />selnn ]{116 .r rlE uhr cclc, hr.E{ .d rnotuy r tFr <br />D.k:_ Aepll r:-trc!$ElallB& a <br />DECII.IAIIA <br />I rEEh,.lfmu Lr Fuh, of Frnlt, rld I d la.nEl !rr.r FsBnn or Chds e (offiurs *'lh Sdln nfr)) 6t Dtsr, .l <br />of lh. Bulirc$ r,rl lt[fc$ions Cqlc. .,n Dy l..ns ! u tuU n,* !n .ffdl <br />qOIIIEI]IJIANITIDIIC.dGEBCT <br />I h.r.5y drm lrl.r FMlr, of F!r,rh, rlRa.! i iM lftlll8 .3.By nr r,E Fl(i1re. orrh. q t fit rtBhrhB Ftru ! <br />sMn (sr..!)e?.crv c r. <br />Afflll.lNfDMAS.IIl0! <br />I ,rnlry rfinm nE]c' Ftrrlrt ol Frpiy .n. of rhc ,'n hr t J.uldr.rDn\ <br />D. x,ln(,trl'crnxr!AitrnorNorrlurnnr l(lcril l{{nLr!,nsrT l(,1). I'd6) <br />R.quu.tl krr., o, Ntr 'rarr)n <br />Iurllyrharrhl..rrlR.Brltrhotr\R'SdnrFr\lrn!rr.lmvdlrr.r rml(fi|. nr rl,'\Iln)J.rr <br />-l <br />.Ellfy ltd I h.E Erl rt! rldr.rEn .d .r. rhrr t E .boE i.tomrr,. i, l1ft1. I rld ro .at{'|, w{h .n Cn, .,rr CMly <br />duELs .,n Srrr. L.e! Eldut ro b{illha .ordturrE lrl ltd)y rurhro EFr3fulffi of 6! Cil, .,rl CMry ro .txd rlhr tlE <br />relE lMrrirEl FotEly lq nrFlsn Fqn-t <br />Appli.s tor Ag.trl SiFnslu <br />ftmir(Emrprlnrrl <br />2r-4t <br />DATE <br />Shear Wall <br />FINAL