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SITE-WOBK DATE ID/SIG.
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />Sublloor/VenUl nsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<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 Certil
<br />FINAL 3$-zt llc11 'Nett2a'+2P
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc.
<br />OIINEII BUILDER DALCARATIoN
<br />I h.r.hy iflnm unlcr Fnrhy ,,, a.rtury rlDr I an crcqlr Inrfl th. ( onlr&1o^- Lx.i\. liw (tr rlr LI
<br />lru\rn.{ and llo,trion (ixl.) Any C } or CNnry eh.h r.{ur.. r lrlnnr r, (,nsro(r. .lt.r. rnDnrvc
<br />{n'dr.. I,itrn, [\ trsu.nkc.n\"rcquF\rtkrntr]nrntr$(hFirn n, ril.r \'!tr.t1iltaltnr rhrr lror $.
<br />n' rlI lf,ovArn\ ol rlr C.ntr.rtr \ l-r.ci\.J L'w ichrpro ,), CotrrftR r* r h SNhn 7Xx) ol Drvtrrtn l
<br />Pntrdnonr cd.)o,rlDr lf, r{l[ r{crcmfl rh..ctrd,ninr rh.ha\n nn rltrilcscJ crcn n)n Anyri,l,ii'n.rsc(notr7ll.rl5hyMy
<br />rpth.lnrlr!Fnn suhlc(krhc, rlMtrrn, ! lrlpcnrlryol n nx{.rhm rrk lrntlrc.lJ.lldllg5lxr)
<br />_ L rs osftr (trh. Frpcny. orrycmployes *nh *.r.s !s rncr $k $nrr*nsartr,n. w l.l' lhc worr.d dr lrEtur $ ft,
<br />,dr cn r.!l.r.,l l.t {k ( Sa 7tl1,1, Bulms nn'l Pn,l.!\xrrs c(rt.: I IE (i'l|lr,(n, \ LitnF L'* Jdr nnr dfl y h rn oqmr o,
<br />ilk FIrd, uh, t{rlds nr rtr{B)vcr r,rNnt. un sb.tEs ut krl h'nsclt.r h.rsc,l or rhn)u8h tur or h.ro*n.q'loyc.r,
<br />F,vrl.'l rhar such nrlln'knEnr. e ail n'tLL{ or oitc&l nn sb l( k'e.vc,, r|- hlll]nu mtrr(mi Nn,!*rrhroM }e{
<br />ol $n{ tlir, rlr OsBr Bn'}]d s l Er. rlr b{nLn .l [Royirl3 thnl lx ,tr $. Jr! dn h!,lt o! rfink lll. F'IInr 1,, rhc lntrtrie oI
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<br />I rm.xcm0r tri,,.r S.r.on
<br />tltrRxFRs c()tll'ENslal(,N
<br />DECI,ARATI('N
<br />I hrr.hy rllnmtrn(l.t tr rirv!'r Frlftyokol rh n)ll'!D,r n.rLtrrrnn
<br />_l hn\r inrwrll nurmfihtrC.ndi.rrcol (h.\.nrt' S.lt]ln\rr.l(, workcri.o lJrulti,n.rs [orrlcdli'rt'ySe..rtr,n.!'7(Xrolrhc
<br />lalln Orl.- l,nrh.Frl rtumro! rhc k)lt ntrrhtrhrhc Frnnr i1NnrcJ
<br />_lhrvcd.J*'llB,'ni,'nro.rsrohl.nsarniNurrec.{\r.qutr.Jhys(ikr1r{r0{frhclrt'orCi'J.,(trh.tr.rar{ur.ol
<br />rh. *rnk tu. *li(h rhrs Fflnd $ 6seJ My *ork.^' .on!x {rx,n nunn.. rear !, Ir,lEy truhl'.r 8:
<br />Cmcr:-
<br />-l
<br />(.nilyrhar l h. I'crlomanrc ol rtu wort,it wh(IrhN lfrhn ( Hncd, t \hrll not c.rahyanyJ{rY)o in.ny slnrcr
<br />v, Nt'tr(nE b/.d rr rlE u)lkdi (!mFn:d$n Lvsorc.nl,tre. anl4rcc rhat iiI \h)ull hc.om $6Fr brhc
<br />workcK' (omF.nqr h,n l,ovrsonr or Sc.llr 1700 .l rtr llhtr G{c I rlBll, n,ihw h (,md, s h llr,s nn'vLlhns
<br />WARNING: l'6rlurc lo slr k cn'.or{rn\.ton lo\cra8c 'r lnLwtul. snd \h.ll rtrhr( tn cmr ottr ro lin nal FE[rs ! .1
<br />rN fiE\ !p h om hutircn r['ura Jollrr\ Itl(t)-uDl, 'n
<br />rJd i{ t! rh. $s of c.mn rslirun. d.m3.\ I In,lllcJ ntr ih.
<br />S..xon 10?6 t rhc Llhr Culc. ar.Ei nnd ,kft t's fft\.
<br />LICENSFT) CONrta (-IOR
<br />DECIjAAIIO!
<br />I h!rcby lirm uklcr tEulry ol txqury thd l .m htosn unJcr pn,vsi,n or Ch,Fs 9l()mmnc'n! w h S.rrrr 7](xJJ nr Drvrsir t
<br />ol !h. B!$ncs atul Pn,fcssons Cod.. anl my licngs r tu|, ,ncc on .fic(r
<br />Lr.trk'cltrs l-i(cn'cNnmtf,.
<br />I:q!,:IA!JgI(IN"LENDINC.6!i!!CI
<br />I lEr.hy aflnn uBhr rEnrlry o, rErJnry rhd rhs. rra roo(ddln ltndnf !8cncy i,tr rhc lqlornELc ol rne wort ld *hin rh's Fnd (
<br />$ cd rse. Jrr97, crv c.).
<br />AI&&INLDEgdSAIII}N
<br />I ho{r ltrmr uRlcr Fnrlry I !.4ury m.ll& tull)onr3 ,le l,raxon\l
<br />Dennnion Pcrhn$Astrios Nooigr.f [.d.Bl R.gn[rb slTitl. /(l. Pd6)
<br />_R.quu.d Lrrr{ ol Nrli{lrrh
<br />I(. 'ly rh. h li'l$r,rc! hfu lnr
<br />^ 3.uJtrU !!tr(x .cBr rl .n r ipntu rhk r, rhI pn,i.(r
<br />_l(d y rhd I hi* E,J rhn rt'tl(.r(', r l sllt. th.r lh..hr\r
<br />'nhtrrulDn
<br />h cotrc.r.I r8rc k,odtily snh ru Cny rtul Cnunry
<br />onlnpnrcs JnJ Sr.rc Lnw! (Lrirs b horuos .on{rudio.. uri h.Ebyau'h,,. rcFcr.larircs ol rh5 Cil, inJ O,rnryh cnr.i utl rrlr
<br />dlv,vc h-nrinEJ nrn8ny ntr 'n\Ir\l!ii nurn,s\
<br />Applicenl or &.tr| Shmlu('-
<br />P.mil.. Em..rrirl,:
<br />BUILDING. INSPECTOR RECORD
<br />COMMENTS
<br />UFER Ground
<br />Ext./lnt. Lath
<br />(-onlnclor-
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