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SITE.WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUlnsulation I
<br />Roof Sheathing lah{nl -Z I ln
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<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 Certif
<br />./:zFINAL10h4/ltr n
<br />Certificate of Occupancy \/
<br />Notes, Remarks, Etc.
<br />(,WNER'UILDER DELCARATION
<br />I ho.b, .ttm udo parny ol pctury rhd I m q@F nom dE Co.r,.cr6 Lic.ne Llw tor rlr folk ei.g lqjn (sd 701 I I
<br />Bsins ad Profdion Cod.): Any Cily or Cou
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<br />trhth r.qut6 . Fru ro @inru.t. .td. in4Dlr. d,mlirh or lP.n uy
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<br />ro rlE FvirbB of rh. Contdq , Lrc.i!.d L.* (Cn 6 9, Cotudins *ith Sdbn 7000 of Diraio..t of rlE BailB -d
<br />Prcfsiod Cod.) d fir lE or rlE i s6"F rhq.fion !'d rlE b6a fd rtr .llg.d q@Iio. A.y vi rbn ofs.rlion 701 LJ by uy
<br />qplicbr tor . FEn rubj6r! rlE .prli(rr ro . dv il F ty of mt mc 6a liE h!d!d rhlLB I$m)
<br />-1.
<br />s o*E oatlE F!F!t. d m, .{plotB *nh $+6 B rlE $k onFsbr *iI & tlE \ql tn d. itur@ ir d
<br />inod.d or oEscd fft ilc tsa.?o4.i. t\Eind ed Prot6n6 Co<k Th. cdr.cld s Lt.@ t^ dr6 d Tplr lo d o*E o,
<br />rlE p.sFry who briLl6 itrqlrE llEs .d *L dE sfi *.d hi@lror L-lror tI'DUgh hB d ha orn mdo6.
<br />prorida, rhd such imFo\tiEa E mr -rdrjdi d orsql fs it. l[ lstrw. llE hlildi'B or insDrEcn b $ll wrhin (E \a
<br />ofo6pLrir!. tlE O*rE &d(b *dl lEt. 0E hrda ofF.\aB $d lE c dE dil d hild or i,F.tr\r th. FoFq tor lrE Frro* ol
<br />_1, I dsnF o I rh. tropdry, Mr .rclu.i\ clt .ont&r '.s snh lic.n d cod.&lo^ ro .oNdd rh. Fojd (S( ?01,1, Il6Dd
<br />fin Pbftsion Cod.: Ifi. Conlrrclo. r Licd. l,rs d<)6 nor rpplr lo e own6 o f pmp.n y uho ltoildr or im ovdrhd6..
<br />an,j uho codrrcrsfor 3uch lrojd! w(h ! (liar6do( s) l,cm.d puR6r ro rh.Contndois l-icN ljN)
<br />.s.0ali}:&u-rllu8tas4rr!,)!Dl(]rl&[IQ!
<br />I na.b, .lfm und6 FElry of F)urr o.. of rh. nnb$ 4 d..lddioB:
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<br />hr\. !n $ll mintin r Cdiff,.r. of ( ollst tu S.lf.lM. lor ruk6r comp.n&ton. s Fo\H for b) S.(lir 1700 oa rlk
<br />llbd Cqr., lq rhc Ff(]llre. of rh. $r*t lor *hkh rh. Fmi ii is.rl.
<br />I hl\..td sill Eint.in wrdr conFE Ian 'NnE.. 6 Equndl b s<rio.l7m otth. lirr cod.. for tlE Ff(fu. of
<br />llE uvk for trhth rhi' Fnn ir is,.d My sdta' con'FEiion ilqlr4c 6i, id poli, mrba rc
<br />Polir N6bd: Erpi6:
<br />_l.driryOar 'r rh. Fforl@( of th. s.rr frr *h(h rhir Fmn i5 ir{.d, I rh.ll ml6doy uy,E$n ri my oe6
<br />$ arobdom bintotlE". 6'omFqion Lst orc.liaomi( !d .srllld
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<br />I ltDuld h6oclubFr t lh.
<br />worl6.onpaerionFovtioEoas..riontT(xJoflh.l,hrrCodel$.ll,fonh*nhondyvilhrlbrI'nlilhB
<br />* RNING: Failu. ro suc Nrk6 @mF!an'n ov6.rrc n onb*tu1. ed shdl slbj6l u 6ploF lo oinind pdrni. Md
<br />civrl nnd up r. on. hudro.l rhosd dollm (tlo0,o(x)l rn raairmn ro r*rtlsr ot cor"p(enoll' dlrrs6 ! povid..j for rtE
<br />.ry/-;--sdrion:1076 ofrh.L.bor(od., inl66r md.trornr- r ld
<br />otr' /O'77 "zctN {rrclN@rrotl
<br />D}IUJIAIIII!
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<br />t.G Li m tull nna an.,Id
<br />I h6.by .l'rm ond6 p.nrhy o f Frury lhd I dn
<br />of $. B6iK Md Pma*ioN (-od.. nn ny I
<br />D.n /y' Zz' zat&
<br />I fidrby .IIm u& FrIy ot Fiury ftr lhat a . odr*rbi Edirg e6t aor dE FfM of llt rdt 6t r'ltth lh! Fhi i
<br />is.d (Sd 1097. Civ C)
<br />AIzuIANLDECI,AXAITOB
<br />I holt'y aliim und6 pc.llty of D.riury on. ot rh. tollo*ins d(l&!i n ni:
<br />o.nohion P@n!&b616 No'ifi.riion r.d6.l R.guhtuN( litl.40, Pe16)
<br />R.qun n ktdoaNorifi(dion
<br />-lcdirylhal
<br />ihc Ld6al rquhlrcN r.8rd'if,
<br />I cdiry rhd I h,r. r.rt rhi! .ppli..rbn En $r. rh,infoirdE! i corcl I .s,6 ro ompf enh .I ('n, &l (irunty
<br />orliled.nd sbr. tlr E6li,{
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<br />hlildin,r lsor_ dhE. (Fsrrir6 o f rni! ( ir! .nd Couly lo o16 uF,n lL
<br />rtn\. nEliorcd ,rDFny for uBr..rFi p{rFc (
<br />,\ppllcrnlor Asfll SlsrluE X
<br />.EJE,
<br />BUILDING. INSPECTOR RECORD
<br />l-. { ! Ad&s:
<br />Erection Pads
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