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SITE.WORK DATE ID/SIG.COMMENTS OWNi:R BUILDER DEI-CATATI('N
<br />I lr.ct4 .,Irm uLLr JEtulry ({ Fllry rhrr I .h ckmJ, ti$m itr Codr.nn l,i(rnr ll* lnr rft. t,ll,*ur8 rrqri.(Sa 70ll t
<br />llurin.s dd frn.(i,n clilc): An, Ciry or Counry wh'.h r.qutr ! , Fm r, onrru.'. .lrd. rn{rtrr. &frnNh .r EFn M}
<br />nrue!trc, Fr! !' nr Nlu.R.. !l$ Equr.s rlF . 'lrur ntr {f,h Fmr t, ril. r nSLn nrkmnr rhd lr dr .lF 6 l(.nBrl tuu.' .
<br />t, rlr pnrvr$n\ ol rhc (inrutr's l-xcnrrl L* (Currs 9. Colftrinr * h S&riD 7(xrr ol D,vsil)n I nl llE BusiHs .ft.i
<br />I'bti$on( C,{.) or rhNr lE or sh. ,\ .rcmtr rh.rcli man! ih. h.rir ntrth. rllqcdcr.qion AnyrtrnlrtrholS(rontull5 byrn}
<br />!pth(.nr nn.Fm luhF-hrlE.f,rl'.,nrior.'v'lFmXy.ln m,k rhr. fiv. hunhojd.llrr (lsm)
<br />l.usosErolIhcpnllEny.ormycnployccjarrhw.B.\arrhcrsor.(onp.nerxJn,r *, tlr wdl:il rh. ntuiu. B tur
<br />ur.ui6l or'lflcEtl l elclse.rll4r, Burcs mJ l_tt,ac$rnr C(rL: Tk O) rrkr'\ litnt liw d(.s n{ .f'r,ly l,' u .wM .f
<br />rlr nn,Fdy rk, toJdr or intn'w\ ttrtun, lrl eh) d€r uh y)* hrm(lIor h.rsl, nr lhmulh hr or hcrowncmnL,ycc\.
<br />pn)vrlcll lhnl surh mrn,Emnk E D mrcDLl,r olr@1 nr sl. lt h'wr. rE hlltr3 rtr uqFtrnr ! alll *ihr.E Fr
<br />oI srq'Lrr4 ilr OlE. Bulkr *lU hlE lh. hlicn .f tnnuf lhll lr .r {E dn nr hri! ,r qnE dE InlFny li, tlE lrlF,s ol
<br />l. A rwtur nf r)f, roFn y, ih .1(l!!vcly uonr.( r'n! w h li(nwl .dnk!.rB r', .on{ru( rlr pn'F(r lsc ?04,4, llulNs
<br />rrn lhlk\qrCd,c:ThcCont.Lttr'1t-ic.nscI-r*Usfr.pplyb.nolncrolI'oIEdt*h'llu'ltlro mnrr!.rihcr('n.
<br />dnJ wr$ (,darr ,' tr \uh F,r.k * h r Ci'.tkk,n r ) li.nd ldhMr t! rh. Corkr.t{'s t.i.nc Lw)
<br />_l rm rr.hpt !d.r S(rr
<br />I h.r(h, rtlirm utolcr p. lr, olFlury ox.l rh. fi'll,wtrB &{lnr[a
<br />-l
<br />h.y. ,n *rll D'nrM . C.nd.I.rc o, O,nrd n, S.lr'lrurc l,n sItd! .onFnqrx,r. { Fovrlal l!, b, s&r.r l7(n dt th.
<br />lrli, C-r1.. lir rlr. FromE. nr rhc wort fu *hrh rh. Frhn s Eru.J
<br />lhlvc lnl v,ll mDr.o *o*cr! ()mFnr.ri,n nilr.rEc, i\ r.nuh\l by Ser tstn .17(tl ol rh. lrtlr C(i.. 1,tr rhc Frli)lfutuc nl
<br />lhc woik nn uhrh lha pcnn{ t! NsNd MywortcB .omnen\llton Nurin!.ratrrr u,F,l'.rnunlir s:
<br />Poh, NuEh..,_
<br />I (d'lyrhrr
<br />'nrh. Frl,,mL..rrh. *. ld $hrh rhr !'crnd n !\kl. l \h:U n .r{ oy .nt Fq,n 'i rny nuEr
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<br />^r, lr1rnr lol'Fl k) rlr krlc( .{n{En\rri,n hwr ofCrlnami, url rlrc rh.l,tl rh,ulJ tr..m ruhFlr t' rlr
<br />wnlkdi ohJEnr Dnp$vri,nr fSN1!r.17(X)ol r lititr C(rL,I !h.ll. t)nhrirh(,npl, w,ihrhElrovtrirr
<br />11ARNING F lurc r, qlr HrLr .,'mrEnerr)n.ok,l8c,! onLv6rl. .nl th,ll hi--' rn cntl]rrr ni dhrrkl ry.
<br />rUn. Jtrmtc.,. ,lr trlcJcNrl tuh ur r' otrc hunnren rh n\,nrl (lolhr\ rsl xr). m rnil trtr' r' rlk !o{ 'n c.
<br />S.dn'n .r{116 ol rlE tjhtr C,iL. Drcr.{ ril . oBy'i
<br />I h.Et) r nnuBLr F..lryol Ir luryrhl l o lFn6l rvu,n ol Chnrd 9(ommetnS rnh S(t)n ?(xU) olDrvD{'n:l
<br />, rh. liu\D( &l lnni*onr ctrL. xrl mv l!.n{ r o ltll ,,tr( l c,l(r
<br />D.r.
<br />-
<br />Co turor
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<br />Cq!iIBUqU0!-LENDTXC-&CEX!f,
<br />I lE.cb, rriirn unlcr rmlryol Frjurr rhi rh.r. is r.ondturrr. LLl[8.8.8y lor rlr F.f(nlmr i)I rtr knt t, *tit rht Fnn B
<br />is$cn (s( 1(rr, crv c ).
<br />ATIIICANTDECI.AMIIA!
<br />I tIn{'y rlim undcr Fnaxy ol Frjury oft.l rh. tulkiphs nc.kr.'onr
<br />tj.fr,hon l,crmrrv^{rdos N$trf(rrrn [.Jcrrl l(cAohr(,.s lT l.,It|, Prd6)
<br />_R.qur.d tltr.rof lltn ..ri)n
<br />I rd,lyrh.t rhc l.dcful rcrubti)N mgddm! .rh.rt.r [nrvrl ar. norrmlrahlc t' rhn I)Il,t{r
<br />I (drlyrh! I h.r. rcrrhN.I,p[.(u' nd nlr. rhrr rlE rhr. tril,nnuritr' tr (omLr I ,SN i)ro llly wir[ !ll (''ry.r{ (i{rnry
<br />! 'rft.\ Jtr,lSrrr.l-xs\ cl(trir k)ldin! con(dert[ dl hcEhy [n hnr! .ctrli.trrarrc! olrh
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<br />y rnd coun(, k,.nrd uF'nrtr
<br />.h,vc mnrirkrl In,Fny ntr F
<br />^pplicsnr
<br />or
<br />^Een(
<br />sirmPs 1 z ')
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />S u bf loor/Ve nVln su lation
<br />Roof Sheathino
<br />Shear Wall
<br />Framinq
<br />lnsu latio n/Ene rg y
<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 />Enqineer Final Report
<br />Flood Zone Certif
<br />FINAL &tc-zt w.lL
<br />Certif icate ot Occupancy
<br />Notes, Remarks, Etc
<br />BUILDING- INSPECTOR RECORD
<br />'
<br />,,",t tlzl2l
<br />*", t1l))zt
<br />I
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