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SITE.WORK DATE ID/SIG COMMENTS <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />Subf loor/Vent/lnsulation <br />Roof Sheathing <br />Shear Wall <br />Framing <br />lnsulationi Energy <br />Drywall <br />Ext./lnt. Lath <br />Brown Coat <br />lvlasonry <br />Pool Fence <br />T-Bar <br />Handicap Req <br />Deputy Final Report <br />Engineer Final Report <br />Flood Zone Certif <br />FINAL L1 ,a _)C., <br />Certificate of Occupancy \y <br />Notes, Remarks, Etc. <br />OWNl:R STJILOER DEI,O\RATION <br />I lrr.b! ir rn ' und.r !.n ry o, ti rjury rhnr I ci!n{,r fn,n r,r C.nta(,n t.t. \d hw n* rh n,ln,*int r!$r r s( 7tr.l l 5 <br />au$ c$ adl tt.fu$irr Gxl.r ,^nt C y or Cotrtrrt $hth rcqurc! a ,rnnir n, .on{Mt. ,lrs. Dnr,vc, d.m,lhh n, Rtln my <br />\rtuuc. ri,t' rr\ r$uM.c. !l$ qu'rc\ rtr rpnliur l[ s,ch pc,D' ro nbs lencd nd.nrnr rhnr or \h k h..ir:d FEgmr <br />r, rhc Frrkii,x ol llr (i)orucrr'r Lic.ncd liB lch.Ilcr 9. Comrn.ing virh Sdn,n 70(n uf D'lirrr ll ol ih. lluvt\! !nJ, <br />Pn)fcr\r)ir (iin)orrhnr lEor \lr ir.xcnir ttrrcft)fr !fr, rh. bnai for th. LEcd urcnwir An,rirl i{of S..rtu7lrrl56r!n, <br />lmli(mr rnr rFnri \ub(r{lr lppl(snrt! !.ir'l lLMlr, of to,t n'Erhm fivc huidrcJdollnrr(35110) <br />-1. <br />!s o*rcr oallE ImFny. or my c.rllht(.i wnh qo86 !s lhcn sb onvENarion. sill d, llE udl. !n rh. iltrtlE i{ mr <br />inEnd or olf.rdr for {,. (Sd. ,044. Auiim3s r.d Pmf6rnrN Cdr.: llE Conr..rols Ltffi br dEr mr qfly ro .n oqE, olrlEFqd' wlr' hiLlr o, !l!e6 tliFtr ui *lb d6 *h kl hi@lt or lEMlror rhmuS! hir r h.. orr or'0hF6. <br />pmvikn rh.r rsh uqlo\4Eflr m ml ircnLd trofid ir st li lrMw. thc t <br />'Uing <br />r in+otG'x ii srd rrhin rm rdor.ahilri\ rlt o*ftr Buitln will llr r htd.nofFnitB rhr tc trlrE dil d t iud !,irsE rlr prrdy for r FrF*oI <br />I. i\ of,mr of rh. |)I,l.nt. rn.x.lo{!cl, & r:(hn8 *irh lirn*d .onLdnh m ondrud rlr noi\'t (S( 7(}tl.ltu{B'r <br />rJ lhia:\rnC(ri-rh.(i'nt(ntr\1,'.cn\cl,a*rnf,\norapplyroanotrkrotroFarehobunJ'ornntnr!.r'h{.du <br />ro'r *h. ..nr6(h rd \u.h troFl\ * h r (i)nruro( s) lienscd l'Ur{unr t, rh. c(,nrkkr'\ tr.trx l rs ) <br />Irn.:\ctrrt'r un,l!, S,!rit r <br />.!rlJ3$iB 9IIIELIAIIAN <br />UD(.LA8AIION <br />I h.rcbyxl,i utrd.rFnrlryof tr!trryotrc.lrlrl()lk)snl!dc(l rdi s <br />I lrrc rlwilln$inllnrrCcnificd.ol(!nrcnr loScll l$nrc fo!worli.r'comri.nsdi,)n-n\ rovnh l,r by surri,n .17rx) ol (h. <br />I ilor (lrlc.,ff rhr Frliirtrrr(! olllr wnrk ntr *hi(h lh. !.irnrl s issucrl <br />_l lrh rnd rnI x' ifirh sorko s .rnnFtr\rri,)n nNurdk., trt i.qrn.d hy S€r i.. ]700 oI rh. Irh.r Coic. tu rltr tr,turnurc .l <br />rh. so&n shi:h rhi\ |{nnir k n\x.rl M,workrs romtansri rin\unnecc.rHa Fnf,ynun$.rirc <br />( Micr <br />_Erpnrsr _ <br />ff,ledirtrhd io rh. t.n.rnu8c of rl* *utn{ rhihrhrF nir ,\ irskd.l sh.lt mrGryhylnyFr$n in lay '8 6 <br />r' !( lo tdonr qha!1rorlE u,l6 .o'qEnsrl{ l"sr ofcoliL,mi,. {d.Er finr if| sbuu h.aant {t'F.r lo rrt <br />*odss' .rqr srbn pmvtbn! 6l Srri.n :11l) of rhc L.htr Co&. 1 {ell. rdhxiih on{rly uilh rlnc Fnririnstt^tlllNc F.ilurc ro suR errLrt .onqrnsri,r $h8. is unbwft:r. .rd sh.ll <ubrc.r !n @pl,Fr lo oin'ul Folir.rd.i!il 6mr ur lo om huntlEi rh'urlntl &n[^ (lloltlu)r. <br />'n <br />andnhn k! rhc.r <br />SsJ i.* ]076 of rlE lilrn (ixlc <br />'nrcE{ r[l nn{rxr'\ 16 <br />,.*. llli I to zo <br />^pprhrn, <br />DECIIAAIIO! <br />I lrEby allirm ulxl.r FNh, ol F,jlry rhd I .m li(srcd unds Fovisi,n ol ODprd 9 tollmrin8 w h s.d itn r(xtrr or Divirim .l <br />.f rhc Busims rn.i Pmt $rns (txk. !n n, li..m F nr tuI forc. utd cficr <br />l-ien\c.'s 0 <br />,,,,, ,tiw.o.t9 <br />g LSrlb) <br />COISIBUgUgdI.INDINC.AGENCI <br />I hcrhy rlltn uidcr Ftrulry ol F.jury rh rh.E ir u q'nsrucrir,. Lndin8 sgcky for rhc pdfonMmc or th. uork artr *nich lhh Frn <br />hscd(Sc. .1097, Civ C.) <br />AIILIIANI.ISILABAITq\ <br />ItNr.hvnllinrtrNltr li.ulrt Dl lrrlury nrr ol rlE l()lk,*rnA dcchiirons <br />l).r,l tr I)cn i\ A\h.{o\Ntiifi.rri.{l'rdrrrl Rr!uldn,n\ildlt.11r,Pan6, <br />R.quiE.l lllr( 0! Niilidu! <br />I .un'f, rh.r rlE fcdcrul rslhr ion\ rsldin3 .sl!do! r.m!'l xr. nn q,pli.at lc t, rhN l^ F <br />I rdny fid I hlr. rcrn lhN iurltrr Dn d rlltc lhd tlE ih'E inromErion n corRl I rg( t, .o'rnly $rh .ll C y J (i,unry <br />onl'n!n.!\ rrrlSrrrr lr(\(br'ry n,6u'l(l,aILon! rtr!tr r'i h!rc6)r.Fc*,rnrsofrhi{Ciry.dG'unrylocnr.ruF <br />Jlr*c mnromd IllDlrr] l!, mlt.r <br />,\p irmt..,t,tml Si*MloR <br />A.l"* K tJo.- t c-- <br />t hllz"t <br />BUILDING- INSPECTOR RECORD <br />I