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SITE.WORK DATE ID/SIG.COMMENTS OIINF.R AU[,DEB DELCARATION
<br />I h.rchr ,utn hJ{ Fnrxy,rf Fqury rhrt I m crcn{r ii"n rh. Conrr.(l(,r licn{ lj* Inr rk n'llNns rcrv,n (SR 70.ll J
<br />Rusn.s !ft! l'rolc\{on Ccld: Any C(y or Cotrr y *n.n r.tuncs r Frnir nr on{o.!- rlr.r. qftlc, rl.odlNh .r r.rrtr dy
<br />sNrrurc lrltrnt!r rsEft.. .tnr rcqnF\ (k rt i. ntr \!(hFmr lo lil. r s'!md {alcR'nr lh.r lror shc ! lKcnEi N^lanr
<br />r! rh. F,v(n,nr r rlE Co.r.rktri Lrcnsl L.* (Clh cr 9. CotnmNinE wirh S(lM'7 D of D,visnrn :\ ol llr Bu{m\: rnJ
<br />Ik,rcs$n\ Ci{.) (tr lhrr h. or shc Ls cr.nll !h.r.ton dnJ rh. tu\Lr rd rh. llk8al cr.nflirtr Any vnruu'o! Scclr'n70:ll5 bt[y
<br />applud rnr r llcmnhuhE\h rhc al't)h..n! t' !.'v,l pcn'[y sf Ncrhrn ti!. hutulr.d d llu:(S5m).
<br />-l-d\
<br />owncr ofrh. F,rxny. rr ny chph,rBs w h wrE6 r\ ltr.r sk .lmt nvrrm. rnl.b rh. erf,l rd tlE sE-lum N n ,
<br />nrcftkil nr nfircJ ntr sl. ( se.1]44, auslrs a&l PNI$\sns (ii.: l h. Ctdrerr'\ Lr.h{ ltr* d(t! h l .Jfl, n' { owtrr dl
<br />ihcln)Itnt wh, tintk or d{n)G rh.R).. l wlr' &$ \hh s hnn{lt or h.rsll nr rla'u8h hi\ .r hcr own cmtl,y.cs,
<br />lr',vrlcd,lErnf,h mJ'nnrmdrrflx orcni.r.l or dll.hl kr *L. ll. hNcv.i lh. hurllrU .r u{'rEmnr N n'Ll sirh$ om y.u
<br />otrunplclr,n. rtr O*kr Bufl.r liu haE rhc hRLnnl|hru,3 0! lr or \h. Jrl kr hu d d nf.'rc rlE InitrnJ, ntr rtE lurlrM ol
<br />_ l- r\ orkr d rn lfl,Fny. 2m .klunv.ly (onrrad trr{ r h lc.tr\.rl r onrracr(n n) ., 'nnrulr rh. flr+d rs&' 7rx4, lru:m$
<br />rnl lh{6\i, Ctrk. I hc (nntarroi r l.rcnr l.!* d.cs tr.| rptl} li} in .wkr i, n!'fcny *ho hur Ur or xnpntrtr rh.r.on,
<br />ioJ vh, Nnr,e.l,r\,.h[xoirr!*irhdC.ntlrnirrfucnkdlrursunnik,rh.Gflkntr\Lrcnrlrrr
<br />_lrnd.htro ., Srrrrn tl &PC l'trrln\(,* .
<br />\tol(xERs coi\lffl\s^Tlol
<br />DTIIABAII9II
<br />I lrnhv.rltrn,u l(F_trrlr,!'rlirlr!!,n-or,heli)ll)tr r! J.(1,tr!rixn:
<br />_I hik rnl will tuinrlo r (tdilirr. dl Con*nr r, S.llln\ur. n{ u,nlo: !'nr.nr rnr.a\ Itl'llliil,rbySer n.l7molrlr
<br />Llh, Grl.,,!r rh. F n,ll*-.c otrh. $rk tur ehrh rh. F mil $ r{rc,1
<br />$\," .r *. ..r." *",k1^ (.trqxtr\rr trh 'nlurrcc. a\ r.que.d t y s.rr n rTrx| .r rhc ttrhor c.!tc. r'tr rh. p.rr,rrofr. or
<br />1li{fi,1l.{*hkh'harEmrr\rrnlM}e,xlo.'!nvrn.rrr,n,nurtuctJrkridF,[]numh(r*
<br />,*-, €{eN1+
<br />P,,h, y N*,--, glo4gl/I)lze \14a I t-\r.1*' _\6L l>t /Ja
<br />_l r.dify rh{ 'nrhc lcrlonM $ ol rhc sork ntr whrhrhh lriin r n{rJ,l \hrllnd cntloy {ny I'.rotr rrnymlnmr
<br />v' !\btr(nnruhFdt)lhc*o lyiconr(n\rrtr,n h*\otCrfiomu, arii,gar ihr! , \lr)uU tEo r srhFl r.rM
<br />wor[.^ L nnrFr\rx.n nr]v\k'n\ .r S(rxr .17(X) .l rhc t -rk, Cidc, I llull, fifh*f h .on! y * h rh'c Iln Nnns
<br />WAllNlN(i I'r'lur r, *-rurc aork.A'ronFtr\ n r (,vr'a3( ,r nnh*tui. nnJ \hill $hrd ..r .mpLrycr ro qinnMl F-rulrr\ rn'l
<br />Uvll ,]tu\ uf n, on. hr,Jr.J rhuu\mJ nollr\ rtl{Xr,lxu ,tlJ r{ t, rlr (on .l romF-nltkxr. Jrelc\ ,\ Pn'v .'l n{ rl'c
<br />s.(non.111760 hr l]lxtr c
<br />n
<br />DECINK TION
<br />I ncrby allto nnd.r Fnr[y ol FiJUrr rh{ I rnt lktnel u.d.r Fliv\nr ol Ch.llo 9 llomaxn.llu s h Sc.rnn 70tX}, ol Dfbtr,! .1
<br />ol rh. Bn{m$ atJ Pnn6!on\ Cixl.. &l my l(or N 'nlill l,!h. rnl.lic(r.
<br />"lq
<br />!]ox$altcut l'rE$rltc-tcENir
<br />I hcnhy rlftm!nd$ tE.dlly I lEqury rh.t lh..c F a on{n'(ltr Lndins rscnry lnr rhc !.nnrtu'rc nl rtu worl Lr sh(h rhr rErm,r N
<br />s\ucJ ls.r. .r(})1, C,v C I
<br />AITIICANI.IIESLASAIIA!
<br />I rrRtr,l]nm u,'J.r !.n.ny ol Frlury orc.1lhc hnn,win8 J&laraion(
<br />fr.B'hM Pc.tuirl^\h.dor Noriitrrn,n I.ulcirl R.ItrlnLons r_f h ll1), Pad6)
<br />_R.qutrcd L.licr of Ndlrrcsrinr
<br />_l..ni,yrhd rh. rc.lcrrl rc8uhtonr arddrry a\tE{ro\ rcn,v,l rrc n aidt.t'k t' rhlrIn'Fcl
<br />llflf..nr,,*,,,"**,,,n's.rrk.,irJ0r{.,h.',h.rtrnrlnnnm,in'!\.otrN, I nFc r, onrry rxh rrr c,ry r cnun,y
<br />, ! d dn.c\ dnJ Srr,. Lw\ rLr 'n! r' h ,Un! r {n{d\ r dn. rl h.r.br .urhtruc .q'c{nrrnr! ol rhn Ciry anJ (,rnry n . .r uF,n rlt
<br />Jli)v. nf,nton.J nnlrd, ktr 'n\F.r
<br />,\ppli.rnto. t((nlsil trrc
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framino
<br />lnsulation/Enerqy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />il^Zi
<br />FINAL 5'lt7t uafiffa MYY
<br />Certificate ot Occupancy
<br />Notes, Remarks, Etc
<br />BUILDING. INSPECTOR RECORD
<br />,.,"|il \ la p
<br />Pool Fence
<br />Flood Zone Certif .
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