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DATE ID/SIG.COMMENTS OWNI.:X IIIILDEI DET-('ANAION
<br />I rkrcb, ,firn rnld lrml!, rlr Frlry lh.l I 6 .r.,r+ rmn E Codr&1im Lic.E l:w fin'rh. toll,si.t r.r$. (s-70:r, 5
<br />Busim$ !'n Pr.Lsshn An.) Atry Cily or Counry *nth requi,ct ! ttr rir ro sn{trr. rlrd. iqrnv.. rlcmnnh u EFn .ny
<br />\rNclurc- pritrx, il! issuatuc, rhu rcqliEs rhc lpplicnnr 4,, such rf,mir k, fi|. r qlned {ot.nEnl lhal tEor in n lncn{d purulnl
<br />ro rtE pmvtn,ni of rtr Conrftr.rs Lic.nei lj* (( h{'tc, 9. Comtu(in8 rirh sftri.n 7{xxl uf Dilishn I or rhc Burin.s tnd
<br />fttrf.sinr ( ad.) ot rhlr h.rnr ia cr.,pr rh.rdrom d ih. tEdr r(, rh. trL8.n.r.r{rii. nyriohri.n.rSdi,n7o:ll5r,yrnt
<br />.0pli.r.r rd rFmir subFk rh. rptlK.f,r ro..irilFMhyofmi mncrh nlc nu'dEn doll,i (35(nr
<br />-,.
<br />$ .sr. .r rhc pmFnr. ,, my.mpbF3 *ith riSc\ !r ihcir q,h 6n{tniar ii6. wrll ' rlE$(ik!d rlt {u1; A n,
<br />inrcnlcd or oficrcd lbr slc (Sd 7(X4. Burin.$ r.d Pn,fc<i,,nlCd. ltE Cr'nrrr.is Ltc"{. I rr docs nor ,pnly io rn osm. of
<br />rh.I,oFny slx) hikh or iryxtr( rh.'6n. s,rl rlr' JN\ rrh *o hih$llorh.r{lforrhnruthhirorh.rosncnDl.y.cr-
<br />pmvidd rh.r $ch nrgrnEmnt e mr inr.nd.J ,tr ofl6l fm el. lf, lIlr.u. ilr l.iUihE,{ rtnnrm nq'!*ihmoEFe
<br />of..rnhlrn rh. ()f,mr aurttr sill bE tlr tiod.n ot JnrrS rtd h or sh( drl r, hiB or i,rlhF tlt FoFny fi, rlr llqre or
<br />_1.ar.*m..lrhcFot'cnt.!,.r.|!\ir.ly..nt&itr,!rirhliccnsd.ont! rihcotr(rud rtr Ir'F-r (S.c 7(!.r, Bu\ms
<br />MdPnissrr(icThr('.nr&rr'rLicc.rcl-Jrdn.\nurpflyrou.orncrofpoll.rly*lx,hrildsorimP()!c\lhcr..tr.
<br />rnd wh! ( lmcrsntr \uchIn*.k *irh ! On,hcn'n \ r li.cnrd pu^umr k, rh. CbntRntr i Li(.ne l,w)
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<br />ucr.nrpr un&r Sdrhn
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<br />I hrro[!,Liltrn,trxl$|t ]ry'ntutrir,tr'.olrhrr,'l!$tr'r,1.!L'rritns
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<br />h.r in *ilt mi.hin r Cdif(i. or Co.rnr k, S.lf lniurc for uort6 fl'rqEndiln, B I'.vlLi for by Sart,n 17(I) ol rhc
<br />L.trr Cn<k- nn r& Ff{nrltN orilE rdi rd $hah rh. Fmir 6 $Ed
<br />6r*k r l *,lt m'nram worl.^' (un{{nqrnn
<br />'n$nEc. .. EquiEd I'y S<ii,n l7m or trE lrh.r Cd.. for rl! FtfolrlraE ol
<br />th. srt ir shichrhBFrmi n ir.En Myworkd! n,mp.nsrion inrurs. cdi.i trd Fn.y nu qE:
<br />ldiry rhsr in rrr FrrormN rf rrE work ror *h.h rh8 Fmrr n tr\sd. I rhall mr rn'Pk'y rny Fr$n i. !., ronmr
<br />s !s ln tEsnE uhjar lo rhc *nksq sq.idnn hk or Csliromir. .nt! i8r
<br />'hd
<br />il I sl$uLl lEom s!hr{ n, rh.
<br />*odcr LomDcnqtiotr rmvi\ion\ orSc.lion 17lx)orrlE ljhr Cdl..lrhlll. rifihsilh comPly wirhrlht ln,vhn,rs
<br />WARNINC rdhE b suB eorlcr drnrJtcns.lon (or.s8c is unla*tu|. otrd shatl ruhF.r !n mPlo)er ro lritninil lErolris lod
<br />.*'l finc\ ut t' oe hun (d rh'u{nd d.ll6 rtl').(rrD. in arinion r, rh. con of.o'i{En$ri.n. d.msB.. F vid.d toi rh(
<br />Sftrh. ro?6ol rh. trb.. GrL. d.rc{!i.rttn .t-r ls
<br />Jt /goru ,oo*-,, f{,'f< +S;l
<br />i I u l Nsrp coN I |.r( lol{
<br />![gdf,trua!
<br />I hrrcby lllirfi undcr I'.uhtnftdrury rhtrr I.m litnrd undcr Fivhion ol( h.pr6 9 (cumrhfr irr8 *nh sNlbn ?(xrrlofl)Nirbn.r
<br />of rhc Bu\nrq 5nd Prer.r\k,niCdL. rn my lkcn* t m tull for( id cllel
<br />-Lrcn{Numh.r
<br />(Bvu 6 }--Di {UqtL tLlr,l &i/i'sn-D ffYd\6Y\\
<br />'g}!$au .rNLEuu!&rirdq
<br />I lEby rLun un&r FExy nr F,rry rhd rlEr ir r 6n<Min HinS rs.Ny aor r,r F,f{,furt or rlE *'dr ror rli.t lni{ Fnt is
<br />irsEd lsd .Il9r. Civ. C.).
<br />t.ctrJ.i\ /\rl(tr.\\
<br />ATTLICANLDESJAA.III]!
<br />I hdd'y drhr !.d.r ,En.lry ol tEriry or of ll. foll,*in! .krhfrrhnr
<br />D.mlni,n Plrmir\ ArEno. N.rrt!'bn ftncrrl R.luld b.l (Tnt .&)- P.n6r
<br />_Rcqui6d l. crof Norifi.!!6n
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<br />c.nify rnd 0E acd.rl ElllLrioir E8ddi.r .{E{.r ,tmrl e fl{ lrdi.rtl ro rhn prcFr
<br />-Et/.ar,l rtuV{ t"* oa rhn +r r.!rr.d n.h rhd rh..tnE info.r ion ir istd l .gt ro mitly sin .I Carr.id Coonry
<br />oidiut$ rod^rrrc Lr*. El !! ro l[,ldr3 mntuhr .,i lmby rurbri& 6F..furiB .f lhir Cty.d Co! yrodtduFnrtE
<br />nh^c trtrnrtrrt(l tn,t.dt liir i,
<br /> ppli($l or Arc SiatuluE
<br />n *r-;*rn.,,, Bl
<br />LJ..+J**
<br />Set Backs
<br />FormsiSteeli Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framinq
<br />ln su lation/E nerqy
<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 Certil
<br />=)FINAL 7//trlto s jr
<br />Certilicate ot Occu n
<br />Notes, Remarks, Etc
<br />BUILDING. INSPECTOR RECORD
<br />SITE-WORK
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