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SITE-WORK DATE ID/SIG.COMMENTS OWNDT BUII-I'ER DILCAIIAT('N
<br />I ho.hv rrtum rNlcr [1nrlry (, JErrury rlur I rh cr.mpr lionr rhc (tnh('s l-!.Lr. liu ,'r rh. lall.uurt rc.s,itr (se 7tr:ll.t
<br />ll,wrcs [l h{csrDn (iilc) Anr Ci) or (irnrr *hf,h rqu 6 r Fmu b utrsrn(r. .lrs. rrlltnrlc. &nrl'sh o. ri.! my
<br />rrn(trtrc. prstr r| (\ rl{hrr_c. iln' rcq[rc\ rtu trno](r tur\urhFm !) lilca n!trcJ s cmtrr lh.l l*or rh. s lE.r€n p!^d,nr
<br />r, rh. pfl!v.s!,n\ ol rlr (irkrrti'\ l-f,cnq, lju {Clu|llcr'), ConxNrrn8 wirh SE.-rru ?m0 d Drv,lon I dt$c l}r!r11.nJ
<br />Pr.r.$rr\ (id.)or thill{ or \h. $crrnlJ't rh.rctromdnJ rhc hJss ntrrh. rlkscJ.kmfli('h Anrvxthx.no,SR.-tnn7}1l5hyaly
<br />.rulrinrntrdIrrnrsxhBr\ih.trfflklhrl,'ddrrlnn.lr!Imrn!ftrh,rvchurir.dd.lld<(15fii).
<br />L rs owkr or lhc FroFny. or my cm,,loycer wilh ulcs a\ rhcr $k rohnctrr Dtr. rdl d. lh. w(trk lrl lh. srulurc tr nn
<br />nldrldl nr dfi.to'd ntr sk I 5&.1144. Itortr\r m.l tt('rc\qnF (',i.: th. (i'nL*kt'. tr.nt f,w &Es 'rn .I'flt t' 6 o,mr ol
<br />rhc FD.ny *h, hnlJs or rqn)vcx rh.h,n. rrl *h, J6 sr.h *d hrmicllor hcrcll dr rtu.ulh tr { lEr ownchlloy.cq
<br />t.qicd rhrr u.h mtnrE Bnlr e nn nbDLrl q oarqld lil, qh ll.,r'*.kt- tlr MtrUd3 or urthEmnr is r r sih'n.k yu
<br />ol .onpLri , rhc ()**r In k w!t! hr( rlr titrtlcn ol tBrvs8 lld h. or {E Jr! ft, rul] i, mFov. rlF FlEry ktr lt* tEqr* ol
<br />r, as o*kr ol rrk Fn'Friy, dm.rllu$vcly e nkrcrinS *nh h(.n\cn ro rn(,'n n' $Ndd rh. Irorcr ( Ss-' 7tH{, ausNs
<br />r lhri\sr C(rlc: Ihc (otrtr!(r,tr \ l.(rnsc lJ*.hr\ nor rtlly t' Mown.r offlon dy wlxr btrrlds.. xnnhv.r rh.r.str.
<br />a"J who .onurr li* ru.h F'tlrk w hr(ir rkrrinlr.n\.{ Jlu^unr!,ln G,nrBrois Lrcn* b*r
<br />_l m.\chfl xnJcr S&!nn__. A. & P.C. I'n rh6 rca$,n
<br />llaaf,[as.!:auraiiiArla!
<br />DECI.AEAIIAN
<br />I hcrchy rl I tr r unirr rEulr v ol lrcrjury oN o, rhc llrllowtr! J(.'lnrarrD\
<br />-lh,v.lnlwrllmi
<br />rn'rCcn ic6lL o,Cotr{ nrSrMn\ur.nlrk crr loBrn\atron, s l'nrvxlc.l i,tr by Sc(ron .l?0o ol rlr
<br />trlltr Grk, li, llr Fd.rnumc o! rhc wod ntr *t{n 'lr Fm E r\o.J
<br />lhr\cr d snl nrmrJn' w.rl.rf ..,nncn\rrknlnn
<br />rlr r' l i trhtrh rh\ n{n ,\ tr{,i ll! $url.,i r
<br />,.",., . slele F6rn J
<br />(rEc. ,\ r.nu(Gl h, Srti.n 1700 ol lh. L.h, clrlc. tur rh. ,rrtomLT .l
<br />r'hpcneik,' inruratu. (atrf,r un FnrrnumtErsc:
<br />,l
<br />,.,,".. C/zsf2ozt,,,r''r n,.rr.r,t I/OI5O5
<br />-/Ll(.nrryrh. rl[I.rr,{n.n.i,l'rhc}nrl 1,tr,htrhrhnll.rmirtrtr(ucd.I(h(ll.!{cnrtl"ydtry!.BonrnsnyrrnNr
<br />'-, ..r' hr,,m.'uhr., rr, rl* w, fl\,u,hnn.rrr{li*.or('Jlrl.{nu.d..ld!'rthrr'lI.lin'uhArtr\uhriIr,rh
<br />wo cii'! mp.tr! tr tr)v n,n\ol Scrrtr)n 17(xrol rh.l-!hn (ixlr, ! \ ll,l(flha[h(DPly qnhlh,stn'vsuN
<br />WARNIN(; l,irltr.L nr a\urc sorlcrr u'qiar'trrk,r (orturc ,\ utrh*rul, r <lrll {bFr .r .6p1,'rr l,) flnunll FuhE\ {nJ
<br />crvrl rin.\ np tu.N hunln'J tlinMnJ Joll,r\ rllo0.(x$). nr uJJ n,n n, rln coi ul cdmt'cnsrln'^, !am3c\ r\ rovrlcJ tur rh.
<br />S..rtrnr l{r7( riiltr lJlin(iilr. n cN!r ,r,tr'Ev r lc.\
<br />z/zor-/z
<br />DEIIJSAIIN
<br />I l*tr-hyrlli,nu d p.nJltyolFrrury rhar I anr lnrnd oliFiiifficharrrn e r$mnktuinr wirh ScuFtr ?u$) olbNi$dr.t
<br />ot rh. Au{k$ rhl ft.|.lrtnr (ir!. ,Dl ny llms N in tull t,tr.. dil cia.ll
<br />,,.,,..,.,.,,t?? ,n.,\"Ntrn,., - ?<z/(c
<br />^*' zr/z/z-au ^^*,*/.. 4ttx+-,.+
<br />(-oi.'sTLtr(-Tl(h_ l-l:N Dll(; ,rGfN( l'
<br />N\uil.Sr. 1097 C,v C.r
<br />txndcis Nunr
<br />-
<br />AIEUSANLDECIAIAIj9I
<br />Ilr.nt'yrllinnunl.r lr.nrlly.lt'.Uuryomrlrh.,nllounrrdcrluraxon\:
<br />D.ur!(i,n lrcrntrs-Asli'{o\ Noxli(arrn li.l.r.l R.puhr.ni (Tnk.lr. Prn6l
<br />_Rrqutr.J t!t.r o, Niff,alrrr
<br />-l
<br />rdrlyrhar ltu ldlc rr I rcSu lrxoDs r.s{dnr8 r$c\los rcd,vll& i.r andir$k rr lhN F(,lccl
<br />)fl.cnrlr rhd I h,h rc,,1rh" snlh!rrrtr, r'rl rJ. rhd rhc ih)vc irlornDln)n rr u.r(r,I laN brohtl) wdh illCiryand coutrry
<br />onlnrfr r\ .nd sr.E Lru\ n,rtrry h ho'ltlm! r, 'n{turxm. nl lrEt y !uth,,. rcF.snrar Dcs .'l rln\ C'ry.rl Counrt t! c kr uF rlr
<br />lhr. nf,nrtrtrF, r"n nyt'n n\n(nonItr,F
<br />ArDlienl or ,\,..nl sismrne xxn /1ct 4 ro rt r.,
<br />.Z zr?-/
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq
<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 />(I
<br />FINAL L\t n\xtJ(4,
<br />Certificate of Occupancy I
<br />Notes, Remarks, Etc.
<br />BUILDING- INSPECTOB RECORD
<br />Subf loor/VenVl nsulation
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