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SITE.WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steeli Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq
<br />lnsulation/Enerqy
<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 />Enqineer Final Report
<br />Flood Zone Certif .
<br />5c1/P- fir*Lt+.lk 1i'i lte ht
<br />FINAL 'l lzt lt I
<br />Certilicate of Occupancy
<br />Notes, Remarks, Etc
<br />O\}NER AUIDET I}I'I,CARATION
<br />I h(chy rnrn !nd.. FExy or Firy rb, I m .xcq, Imn rlE Cod6.lon li.tr* L,* tu, llE folhrlu Ersn ( S$ 70l l 5
<br />Buimr\ {d Prolcllbn Co&) Any Cil, or C.o y *hah r.qliB r lEDi k, 6^nM. d6, ltr?rcE- &mlih ot EFn &y
<br />nrudu4 Fiir k' iri LsulN, rls,rquiEr rlE .rpl.rnt fitr such Fmn ro filc r ritEd d.r.mfl rhd lE or slE b liMrn Pt!$d
<br />ro rhc loltions of rlE Conr.elf r Lt.nst tiw (Ch4!.r 9. CommrcinS wirh Sdion ?000 of Divirion :] 6r ttE BrsiE s Md
<br />AbLsions (b<rc) M rhd lE or slE n .r.mpr rlmlron drn rl. bcsn i'or ih. rllcg.d .r.mdion. Any vhhlion ol S€tion ,01 I 5 by an,
<br />qrlt.nr tor e pcnni! sobFtr rlr rpplr.nr 16 r .ival Fohy of m! mE tlEn fivc tudEd dollr! tt5@)
<br />-1,
<br />$ oemr oa r,r rop.ny. or n, cnphy.cr wnh uB4 ( rlEir $L cotr{Enslkrn, *iI do tlE *.rt dn ll* in\rm n bl
<br />i.r.d.d or ofr.Erl lor sL ( Sd '7044, Buimrr &d PDr.sios Cod. TtG C.nE&ror. Lienr ljr do.. mr +rly to u ow*r of
<br />rlr Fq6y llb hiur d iqnE rEs& sd who dE qd hrt ni'Mr or h.m,I ot rlmuth hn d ha os crphy.d.
<br />FoviLd rh.l *h lrFoEE,Ir G not irdd.d dofidrd rr el. r. h.tr dr hildirts n littit6rn i! nld *rbid F,of6rtl.r6( x o*ffi Auildd wiu h.B dE hr&n of Fovint 0ld lE d slE dA mr !.ild or nrtmE ,E [rcF , rd dE FrF. of
<br />-1.
<br />drowEof rt ForEly, ucr.tusiEly.ontrtlitrs *rt lirnerl d,drbro o.!lM rrE FUF (Sa 1),r4, BBls
<br />ajd FDr*inCod.: Th. C6.rdoas Lk.n.. t *dc mr +plyb moqFolFoFnysho hoiuroriqroEr tno@tr
<br />alld *ho o Bls ror such Fntcds wnh ! Controcrorlo li.rn$d pu^Mr ro lhc Conr&ror'r Lk.nc r,s).
<br />_l rd.rmpr u r.r Sari,n
<br />Err8tr!8c'!0MrlNsAIIItN
<br />IIECIISASAN
<br />I h.rchy llllrm un&r Fnily of Frury om ol rb. folb$uB deLhr.nr
<br />-l
<br />havc .!n *ill !ri.!dn ! Ccnia.aE of Cotrcfl
<br />'o
<br />sclr-lnsurc ror wort.6 .onvEnst iotr, !r ralidcd for by
<br />tiu. 9,1c. lq lhc FnblrrEft. of lhc vork fnr ehid llr I
<br />,-rl* "* *u, *.t. *",acB' mqEnd.n hs,mc. B R{urr(i t'} ssrEn l7m orrlE !,h.r cod., lor
<br />IIE Krr lm rhruthE Frdr E B$.d. My worr6' onllEn$li,n itrrdrm dtril {'d tEl.} numb.r c
<br />,*., - 9.ta-at (,- | Z*t -q ^ .. -
<br />-,t*yx.,,u, z Ll\ ?[yl '"-^> rrprr J1'14
<br />-l
<br />ccnilyrhar inrlE p.tformrcc ot rl* *o.l ,n slth rhis lErnir ir kr$d.I \hrlr n .nfhy .ny FMn in 3n, mnmt
<br />$ B ro b.str obFr b rlE wd6'or{En a'.lrwr of C.lifomir .d rrN lhc if I slDuld ti.o6 sbFrr ro ll!
<br />*0*6 6nixr r,npEvni,N of sdaon l?mof rlE tlt r Cod.. I {dl. fonhr'ft @trpI, *irh lt . pmvniB
<br />WARNING: Flihr. ro G@ mrt6 6ntE6rion o8f,8. i< unL*tuL .rd rhlll rut{.i 6 .oplojq lo 6inin l Fuli6 !d
<br />civil fin.s up ro om hundEd rhousud d.UrR (SI00.c()0), in rddibo ro rh€ co{ of.6n!rn{rion. detu8.. .t rrcvncd for rlE
<br />n*,-7 wjrzPprl@ll
<br />,--.---L i
<br />LT(]JIIILCAM&IIAtru[gJ.&Il&l
<br />I Hry rllm un&r p.MIy of Fr,lry rlEl I m lirr!.d un&r.FDvnEn of CtEpld I rollmN'n8 vrh Sd.. ,(Urr or Ditilb. l
<br />o, rlE aurm$ !n Preisbnr Cod., rd mylff F r tull for!n.fidl
<br />& / c-r|/oo7g <lrrnc Ctr-:-1'7/ /*t
<br />grNErSlIJxxiJeDnEJiEdcl
<br />I h.Elry Jrm odrh, Fuly or F1try tlu rlE n. otrrnErir Hin8 r8!Ey for tlE Ffm of th. xrt tor |llih lnt Fnt i
<br />hsu.d (s6. 3097,civ. c.).
<br />AIILII]AdI.EEIIABA.IION
<br />I ffiy ltrm ud.r p.rly of ,.riry 6r oa rlr tolb*iff &rbdbnr
<br />D.ml rn Pddnl Asb.sros tlorfk bn trktul Rc8rhrhnr (Titk .(l. Pd6)
<br />-RcquiEn
<br />kllcr ol NoliaErlhn
<br />::l cdtiry rhoi rlr Ldcrrl Esuldi,E E rdin8 8b.rk[ rmrd e s, .pplarbl xr $n FoFl
<br />f .cnify fi{ I }uw rcod rhi! lpplic.lion lrn dsr. $!r rlE.h.E iaformnio-n i. ctur l.gE ro com/y sirh nl cnyand Cou.ly
<br />onlim rr lnd Si.rc liws rcl ir8 tn buildin8 hcrchy rkxrc rrIlrcrtrrxrircin rh^Ciry d(r)!trryh.nrcr uF)nttr
<br />rtx{c nrnri(ndl pn)r---nyn 'nj{rr
<br />\pt,ltr. rr,\!rnt \,!tr ruru z/tl-t
<br />BUILDING- INSPECTOB BECOBD
<br />I
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