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SITE.WORK DATE COMMENTS OWNElr BUtt,DI:I' DI:LCAR TION
<br />I hrl, alhrh uLlcr Fn,hy (n Frrury lh{ I .m.\.q'r lnm !!| Conrrrrb' tilnt Ll* lt, lh. folosmA rcNm (xL 7r.rl 5
<br />llunn.sr rd Prn.\r{ c.rlc): Any C[y or c.u.r, whkh rcqutrcr ! Fmr h r.ndnrlt. dhcr, rhttr,e.. J.m rh I rcFr iny
<br />{o(ruc, Irxtrr, rl\ rs!.tu.. ro rcqurcs rh. {ptlHnr r,r (hIf,rnrr n' lik i i!n&l sl,rcft nlll lror \l* n it.n$d PU\ui
<br />r, rh. ForrrrN .! lfu Ctnrrr(rtr\ l-rcnBl Le rchrpr.. 9. commkrS srrh S&lron ,mo ol Drvnkr .1 ol rrr BNrc ,trt
<br />It lclroni (i,!c) ,r rhar tror \h. scrcq rh.r.lion ntul ltu b.nr l& lh< rllcrcd crcnnrhrn. Any ,!,I{on .l S(rirn ?O r I t hy lny
<br />!$rhNnln{ r F.rmir \uhl.clsrlE dl,plic!d l,r r!rvrlncnalryol Nrnxt.lhd liv. hundrcddnllan(15(Xl)
<br />-1.
<br />a5 oe(r of ih. ln,|tny, ,tr nry cmPnryEs wrrh rr8cr a! lhd $L .omp.nsrr!,[ r ldo ilr w( lllrndimBlf,n
<br />, c'rlcJ .r olltr.J kr uh (Sc..ru4. tru{rcss dnd Pr trlt$iu\ Co.lc: 'thc Contrdckn r Lf,cns. L,w J($ nol {'tly k' flr o*ncr or
<br />rhc nNIE.il uh) hor!]\ or r{n,t\ rlry6i. arl *lI J€s \ah k)* hmrlf ot lErrllu thn'uEh hir or lEr owr cmllott.\.
<br />tln'lrldl rh.r \n(n nt,n,rm \ d D, lfcrhJ d . cr.J ntr {h Ir. hEs. rlE h Jr! or ury,oF rd L\ Y s{h'n oft F,
<br />ol compkrnn, rlr Owkr Bu l.r wJl hlvc rlE hur'lcn.f pmvm8 lhr tEor:hc drl ftrl h{il] r n\t { rh. |f,JFny,itrrtE I'urJl&.r
<br />l.isowftlorrhcnr'n.ny,rm.\.lu\rrcly()nrrrr'nr*1,lkcn{J!!!nra!nhr'(nnrnttrlEFor.(rlS.!7t!1.8{tr.\
<br />r hnlasr Co,l.: I h. Conr' &nr'\ I -(cr!. Lrw 'l({\ ior nlply n, a owtr.r ol |n,,p(r ry wl.i, h r U r r nrnn,lcs rhrdn,.
<br />nn{] !h!, !)irtu(h r,r tr h ltru^a* wfh r (i{u!( ri n h(.r{d ltrFUx n,rlkO,nrr{r'\Ltr.tr{lj*)
<br />_l dmcrlnW uftlq S..trotr Il & l'( l,trrh^ r.a!r'
<br />MBtr[8f.grUflllAIION
<br />DFCLARATIOI'I
<br />I lka.hy alrtrnr un&r |tnlhy dl IUJU!_1.k olih n,lL,*nE J<lr,rrn\:
<br />I hdvrn l w,llnut[ir r ('.nrliurc ol (ith.trn) Scll lo{t.ltr wortcF (D|tN{tnr, r\ li'vtl(d rd 6y S(!tn' ITrXr nlrlr
<br />lrh{ (irl..l'tr rh. r--rntrmnn.. ol rh. *{'k Lr ehtrh rhc lxrnnr a ^nkd
<br />I hJv. ,tuI srll nuurrr *ori.rr (rnr.nstunn nsrrrnr., r: rcqut(,!hyS..rlnr 17r)ol rh. tfh,tCinJc, LtrIt Ii dntLc l
<br />rh. worll,trshtrhrh(l.m r\ '\rudl. My*orkclr comtcn\nllr !r\u.orc.rnrrr Anf,y nunnw dc:
<br />c-", - L\Pre5< lrlsr.ran(4 1,l,llrr
<br />",,,",n,.*.,' P H vrl L I L tr 49 O
<br />lL alrlA
<br />_l ..n y rhlr $ r h. pcnor.rR c ot rh. arrk n, qhrh lhh I'crmil r\ A{,eJ, I \hnll no( .nrtloy ,ny Fr\nt ut M} manN!
<br />(' !\ h, h..dntr uhrd k, rh. worl.ri L mpcn$tinr li]s\ ol C!hli,m'r. r ,l rSr. r[d 'I l ntrnru E_onx suh]el r' rh.
<br />k{kcN r.DI'( net k'n lx'r,io \ {, S&Lo, l7l$ o, rhr trhtr (lrrc. l \h,ll. lndh*rh on{iy win rh,F In,!(r)n\
<br />wARNtN(; t rrL h \-xr. *orkch ohp.nulon lovcrJrc ,1nnllwlul. rtr.l \hJll.!lrr(r sn.nri,yc. t' rlmDl ttux.1d
<br />z-Z5 ZI
<br />IECIAEAIIA!
<br />t h(rchy lrrtm !n ls Fnrlly or l'crjury rh{l I rB l'!.rRi rtor.r ,x,vrNn .l ctuOc! e ld'mrxr-.ins e h S&ri,n 7o0o) .l rlrvan'n I
<br />ol th. Burrcsrd l'nrcssi,nr C,ilc, ,r.l my lr.t\c is D lullnlirc lrlcllc(I.
<br />ry 1.n..'u4 s-/ 2,
<br />CONSTRUCTION LENDING A(;tsNCY
<br />I turcb) i,rilmuntl.r t*nalrynt ttiury rl! rhd. I a rnrrd(r Dn t".]'n! dr.^_y htr rlI Frl,rlmt ol rhc vor lrnr vhf,h iha Fanu r
<br />$sncJ (Sc(. 10e?,Crv C.).
<br />lJBlc.\ Nnx:
<br />-
<br />lxtrdci\ AJ.lrc$:
<br />-
<br />APPI.ICANT DF(:I AII,\TI(TN
<br />ILn$yrrimn .rrnsll,oi,).rruryoncol rh. I'n['*rn8.lt(lrir0n\
<br />Dcnhl n, l'.rmh-Ailr.ros Nnxlr!'u! lj.Jc.!l Rc8uLrnn* l'l"lc.x,, I'd6)
<br />Rcqumd Lerl.r ol Mn i.il$n
<br />-l
<br />r'.n'|, rlur r,L' lcJ.ral r.g{td 6nr E!.ntrne arh.st'srcmrvrlr. 'r, {'plr kro nI{,.tr.
<br />Wii,nn rn*"*^rnn dtrlicar'on urr ,rc rhar ur .h,vc nntrfrsrr Fconccr t osK tu dmnly w,D dlr ciry and cosnry
<br />r0n.,'rlh. ryJUrhtrr.r.rrcrnrrrtrc\olrhh(r!JftlCoonr
<br />ihrt mnrr&rl poFn, tu ,nr
<br />At{,1i.!nl0r '\!rnl Sitnnl re 2.1
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Rool Sheathing
<br />Shear Wall
<br />Framinq
<br />lnsu lation/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 />Engineer Final Report
<br />Flood Zone Certif .
<br />FINAL I 'ltlzt OWM
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />-,
<br />BUILDING- INSPECTOR RECORD
<br />IDiSIG.
<br />I
<br />I
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