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SITE-WORK DATE tDEtq COMMENTS
<br />\4yrM4Forms/Steel/Holdowns 4uhqT 22t
<br />Erection Pads t)v
<br />UFER Ground
<br />SLAB Floor
<br />Roof Sheathinq
<br />Shear Wall
<br />Framing Ut-"t/ts 1 iq*4.>r)
<br />lnsulation/Energy LI UL \.
<br />itt-.*tiDrywall4ltbL4 1,D)
<br />Ext./lnt. Lath tt UI
<br />Brown Coat
<br />tyItila so n
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif.
<br />l,tni t2tttFINAL{lxft-o ,t a-/
<br />Certificate of Occu nc
<br />Notes, Remarks, Etc
<br />x
<br />OIf, Nf,i BUILDEN DEITARATION
<br />I rs.l'y .rm undd Frly of Fr4 rhi I d ..drF toi rlE cdrdm lr.u .t
<br />a6i.< !d Profdioi (o&) Any cny or Cldt whth r.quc r Fni ro mdrud. .ha. hFove dt6lilh or et. ey
<br />rtMEG. Fd to it3 isue., &o Gtoi6 th. +pltot for su(h Fmn to fik ! 3in d nrtul lhd h. or tlE i li.oB d pEret
<br />ro rk FovnioN ot lh. Conr.crd't L-'enr.d lrw (Ctuprs 9, ('oMdin! wnh Sdrion 7000 of Division I of lh. Buind ed
<br />PNfsio.r Codc) or rhal h. or rhc i! .rmpr fid.ftom od rh. t rir for th. rlLg.d .r6prio. Any violdion of Sdbn 701 1 5 br &y
<br />rpplicml for a p.nnit iubj*lr th. +llicDl lo o cir il p.Elt, o f nol moE lh& fiv. hun&.d &tllei i1500).
<br />_1. a on6 oarh. F!pd!t. d s, alll,lotE $nn srg6 a rhor bk 6mFsdn. trill & llE *dt ad tL fid@ n n{
<br />idd'dol m oltdd am sL (SE 7ol.l, BciE Dd PiofsioN (ird. Th. Codrdd'r lilE Lr* d€ @r .Fplr ro n o$E ol
<br />rh. F{Ery * lh hiil& o. n'Im\6 rlE6c rn $b &6 $n $!lt hirell or lEslf or rimu8} hi! n hq osr csph}B
<br />Fovd.il lh, rucn iEF.rqcnr d d -rad oroEsld fr'r rt ll lD*t€. tlE tllUr'it .. lrq ffiil$ldsihi..c)-
<br />corpldbc rlE (\E B{ i,s $ill h6! tlE hrdor oIFo\Ts lht lE or !h. dn d hnld d lqror.lh. F!F!} to.0E tt lxEof
<br />asotrrcr ofrhcI'oIEly, mr.rrlu\tr.|y conradi'rg r hhr. \r{.onrktr th.pojd (Sa. ?Ou, l\^ins
<br />ind hndsirc.d.: Ihc(i'nnkl,n . Li.cnscLaq do6 tror y who hurl&or impovd lhddrn
<br />,trkl sho c.ntmds fin su(h flflNrs \ih r ( ()nra.nn1
<br />;l',/,,.-
<br />u,!!_!B\l!9.)
<br />I hd.ht.mrm und6 p.ialrr of pdlury otr oflhc
<br />I tue. ,rl will midrain . cd iacar. of coMl ro s.la lsur. ldr qort.B compdoinnr, s I'olid.d aor by s{ln,n !?ul o f thc
<br />tttbr Cod.. ror rhc Fr!lr@c. of rhc *.rl for ${ich rh. pdm i, (rucd
<br />-l h.v.rd sillftli rh wo*..' coDr<Bnbn iMmc. B r.qrsld by S..rbr 1700 nI rh. l,ttr Code for lh. p6f{ru. ot
<br />llE \ort fu q'hth thir Fnn ir irEI My *sta' omFuaio nw. ceE r{,mlky numbr..:
<br />Pdr(r Nunh(:-Errtr.s
<br />l.d1,li rhir 'nrh.pqnnn nr..l rhr\.r1fitr \h'.hrl,rsl{n, 's,ssu.i.l sl[lltrd urtnfr r tlE6oninnnt intro
<br />$ .s h h...m. subiRl lo thc n 0116' mmD.rs.lion la$ of (-.lilom lsr $ai 'r I slr,uld tid.m. 3dbjd ro rlE
<br />$!d6 cdr{mlion F.vn6Bof S.nhr 1?00ollh.IltEr
<br />WARNI|\C Flilr ro <ur solld NnFMhn .o\opt F ro qmind FrIi6 ..d
<br />Dr. d!os66F rLl l rlE.nil n.6 up r. o* huftlral rlhor.nd d.llE (ll
<br />s(rM :1076 olrh. htrr (,fr
<br />lo
<br />ll.l.ll"r&ul!]l
<br />I h6.t, 0lltrln und6 p.n.hy of prjury I hal I m I ( hll1d'r ((otr,'c .'n3 qirh Scdiofl 7000) rIl),!'sf n 1
<br />ol rhc lldins ed PmfertN cod., ad my lic@ t i. full (tr.. r'd .fist
<br />c0x,irallcllaNr[tDlxctctli(t
<br />I ho.ht nnirh und6 p€.olly orpcrju, r- rlur lhsc 6 a codlocrk'n loding rldcy for rh.lEnnnrn.. olthe *ork fir Nhich lhs lhnir i3
<br />issu.n (s( 10e7. civ c.)
<br />l,nid! Ad.td
<br />-
<br />AIILTCABLITSIIAI]O!
<br />I ha.tr .nm ur&r p6.hy of Fjury orc of $c lollo$iq d.cldllnBl
<br />D.moliron Pdnts-Ash6ros Nolilicition F.dcrll R.8uLlioN ( lnL 40. Pan6)
<br />-R.qun.n
<br />Ldt6 of Noaifr c.th.
<br />.d 'r\ rnd !h. tclrnl 'quhlrB rfrn.l ,. Bn ,rpli.6k ro rha F\'ld
<br />d'! rhd I ha\. dJ rhB '.aoldb. is ff61 I lsra rootrpv\nha[ cnt !i counq
<br />durhoriz. rcFsl,n6 {rr
<br />nhr. nnrnnen p(p.n) ntr
<br />\t,Dlirtrtrr o' .\prtrl Sistrxr',
<br />Bi;n t+
<br />::^:;&);r*
<br />t . BUILDING. INSPECTOR RECORD
<br />Set Backs
<br />SubfloorNenUl nsulation
<br />T1;J- a'e1g.A$,,n o$v(JI
<br />C-ir:-
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