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SITE-WORK DATE ID/SIG.COMMENTS OWNTR ATIILDI.:R I}[I,CARATX)N
<br />I rFEtiy ifarm und.r Fnlty of Frury { I u.rr9 nDn tlE (iddr6 li.r t , for r follovurS tran (Sd.7011.5
<br />Au*ircs !d Profcsiln C.d.) Any Ciry or Cedy *h.h Eqxn.r r F r. 6n{ML nk, itrp.oE d.frnkn or rFn oy
<br />sNruE-Frrro,r il.Jre,,ko Eqt6 E.pl,licri lu uh Frrnr to 6hr stEJ rn.ftnr rh!h.o.rLFLcn-d pusd
<br />ro r't rnvssB of rlE Co rrs,r lj..tr(d lrp tch.dq r), ConBrcin3 unh Sdirn ?lrr of Divisbn ] of rtE AuiEs dd
<br />Prn.nDtr! OiLrq 'h, ,E d rrr !.rr+ rh..!tuo.,n rlE br$ nr 'lt rlh.d.r,r{iEn ny rblxirn or sdbn 70r 1.5 by lny
<br />'p?If,, lnr r Fnr lubFr rlE ,flJlild 16 i civil p.mlry of Ba mr. rhrn fiv. hundrd dolhh (l5ur).
<br />_1, a orNr ol rh. !mp.dy, or 6y .r{by!6 *nh s.8s a ituk $h otrtEorni, wil 6 !h. srt rd .lE rdE a d
<br />hrarLd o! orf.ral f.. .k (S- 7U{4, ao.iEs ,nd Pmldih CriL TlE C{llddl Lm€ L* &6 ,Dr sly ro n ow or
<br />rlr pntFny wlb hJdr r itrFrE rtErE !d wto d.E ryt srt htlrlf ( lErlf q rlEurh hir 6lE oft cr4bre1
<br />F)riLd rh.r sh !4oEcm ft d ii..d.d (olIlrd Id !.1 ll.InrrE r triBtra Mi'rFmftfl bhld *ilrGor rtr
<br />ol(drplrra rOsEB{ i6 vill h.E tlE bun,. oIFovlE 0u h.cdE d! d bu!., itrpmv. tE FrDrdy tor lh. Fn!o..r
<br />-1.
<br />I owNr of rll Dopsiy. .m .r.luriwly onr.rin, *nh lieilal ddB1.6 !' onllM th. Ftrid (Sc. 7l)4a, Eurirs
<br />anl FoLrsin Cnd. TrE C. dq'r LE.n* b* dE d.grrly h x ovs ot I'rrEny *,lD boildr or hlpov.r 'h.m(.ri *ln mddi rq trh F)F(r w.t . C.dErdn li.!r.d F!1d 'o
<br />it Coddd r t.i:@ Lr*)
<br />I m.r.q{ urLr sd
<br />Eaaf,[f,5:(ortl;ltarlar
<br />DEg,n&llr!)l
<br />I h.ftFy rlltmund.r F ltv oI l\.rJun ort ol rh. n,lhrinS dr.llr$i,N
<br />-I
<br />hrv. rDi wrll Nnru r C.nra.{. of CoMnt ro s.r-tEuc iir ertm $nlrdD[ .r F.vilci lq t'y SdiI ]100 6l i!
<br />Lnq al&, rd rh. trror,[R or rll ,qi rd *nth 'lE FEn i is&d.
<br />_l h.E ul wru di.rtir w.t6' c.qrarir lN6az, it EltuiEJ hy larioi lr00 of rtE l,hor aod., nn rlE pdt(ffi. of
<br />rh. ud fd shth rhi, p.rnir ir iqal My srls. or{ENk'n NurG ffir rnt Frlry nurlE G
<br />Polic, Nufla.r_FiptEr
<br />-l
<br />anit rh! h 'lr F.for@ olrlE y.rk tor rhEh thn Frmir n !rE1l, I !hr! d c,{'by r.y Frsn in &, Mffi
<br />s abh..:ftuhilrrorlEs&. 'omllMrioi h*r orcrlif.nu, ' rlGrhiif,tt uld b...m ntrF rorh.
<br />uo.r.a @flFnetion pDvBDB ol Salion l?@ of tlr L,htr ODd.. Llull, fdh*ih .!trd, *nh tho* Fevi]iE.
<br />WAn]{IltG: F.ilurc io ru wd.6 onp.M., eEh8. 6 u.Lwtu! .,n !h.ll ebF r .lrploF ro sinid Fdi. ud
<br />.iv'l fir' up r. oE hrndtd rtburdn &lhE (tlo).UD),
<br />'n .dd.bn r. rh. .oi of .dqEMih. AN3.r a pmvdal for th.
<br />licrion t0?6 oa rtE tiq aod.. irdi In irr.ry r fd!
<br />{eDlonl:-
<br />LIIEE:@.SIMXTS8,IB
<br />DECIIAAIQtr
<br />I h.cby .mrE u,rd.. pcrly nf Fi.y lhd I m [ad.d uiih. Ftrvu.. ol Oupts I (ollrEin' wih S.dhi 7m) of Dlvtior I
<br />ol rh. AUiEB .tn Pbtrdr Cod., !n m, li.r i m tul ioc .rd ?il.d
<br />g}IGISIICU(A.LEDIIGIGEICI
<br />I lmhy dfm un&r F iyof Friuryrh{ rlEr it t @rdE lEdil{.!Ey tq ilE F rlEft of dE wI e. *ti:r! rhi' Fnf i
<br />nru.drsa 1r,97. Cir C).
<br />AISUSANIDISABIIIqtr
<br />I Hy lrfm un&r FMly of psjury o* of th. follo* hs d.<r.nr ionri
<br />D.hlirbn P.mik-A'b.nor Ndifidrion F.d.nl R.SuLrionr (-rirk 40, Pd6)
<br />-R.qurcJ
<br />tnG.of Ndl.dix
<br />_I !d
<br />'ry
<br />rhr rtE f.d?..1 ElrLrirN E3ddr3 r'lEror mtrvrl a Br {rl..bL tu rlir poFr
<br />_l ldiry thi I lr* rc-l rhis .p?lad ion .d dd. rhd rh. rb.v. olomuron 6 .!Bl I .38 ro mnply wirh lll Ci, Bl C@iiy
<br />onliiuEd r Sr.r. L*t ELrinSro ho,tlu3 cod rrbtr 'nl h.chyruh,e 6pr.dd,B otrh! Ciy.tn Cdn.yro ds urondr
<br />!h,v. tu.rrrdl pnrFny fd brpdDtr
<br />'l!.p*..
<br />rmh.ant.r .\!6r Silnntun- lrulr
<br />Set Backs ta llo',lt ,a t:
<br />^,Formsi Steel/Hold owns /777'"
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framino
<br />lnsulation/Enerqy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Ivlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Reporl
<br />Flood Zone Certif .
<br />FINAL Y/72-ZD /1 Cu 9/1J-2,//o3 -27
<br />Certif icate of Occupancy
<br />Notes, Remarks, Etc
<br />Rev. 08-0 /-2015
<br />BUILDING. INSPECTOR RECORD
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