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SITE.WORK DATE ID/SIG.COMMENTS Oh6-Brild.i Ddlsnid
<br />I h@b rtrtm uidd Frdty of pdju, ih.I I m GxdF fm $c CdE-lql' Licd. L!* fd rr'c foll ins B@ (3e ?03 L5 B$in63
<br />-d PEfdio Cod.): Ary Ciry 6 Co{ y *hic[ rquiB . Fmii lo @h.! dlr, ihFotq d.moli.l' q EFi s, rrEl!r., Fior lo il,
<br />iree..Lo Equid dr.4rlial 16 $.1Fnn 6 61. r.i8tl.d r1tu! lhln hc r rh. ir liffi.d ptEur lo dE Flvitiot of th.
<br />Cdn-l6'! Li@.d L$ (ct4ia 9, CqtM.i't {ith S..ri6 ?0oo of Didrid 3 or lt. Bdnd sd PEfdic Codc) q th.t h. q
<br />rh. i, .r6pt rhGfroo lld 6. bair fd lh. .ll.g!d ddprid .Any violrdo of scdi6 ?031 .J by my .ppli.xl fd . p.mn rubj.a. t.
<br />.pplidr ro . .ivil F..lr, of n.,t llm thh fiE h6.!r.d dolld (t500).
<br />-I,d
<br />om6 of $. Flpdry, or Dy plor.6rirh w.86 arhlir$lc dhFrsrioi, wllld,o th.rdt Dd lh. tftclw. it nor in$d.d
<br />d oilcEd fa..lc ( Se.?04{, Bdi6 &d Prcfadm C.d.: Itu Cd{ri.t6t Li6c tn do€ nor.pgly to ( omn oldc ptuFry
<br />iho bsil& 6 ir$.oE tq6, hd *ho &€ !u.n *dk hitulf d hodf d thmSh hit o ha os .mployd, prcvid.d lh.r .ucn
<br />itnproimoB e nor Intodld or ofi.rld fc rd. If, hoi,.v6, O. brildnS or inprordnd it told *ithin onc yE of c6npl.ri@, th.
<br />Om6-Buil{t r rill hM lt. hrda of prclira $1 iG 6 ihc ,or boild d imFDrc td UG purpd. of t.l.).
<br />_1, B omd of d!. F.FV. h aclBivcly c6|r*rins wirh lier*<l 6r.ftro.r to @lruct ih. Foj6l ( S*- ?04t, Bu.ird sd
<br />Prcf.,lid Codc Ih. C6m.todt Uff trw &a ,b( rpdy to 6 M6 of prcFty rho buikL a i pFG lhGM. &d who
<br />.6tr&r fd tuch prcj*lr wirh . Cor...ra(t) limcd p!6uer ro lh. Corrr*|(! Li@e L.w )
<br />_l m amF ulda S*li6
<br />WORI(ERS COMIF.NSATION DNCIARAAION
<br />I tdb, amm lndd parlty oaFjury oc of lh. follNi.S dcclnrio]
<br />_l h.s 6d eiU rnilttin. C6ri6* oacdmr lo S.lf-L!E fd *dtarr.mFErtio. a Flvirt d f6 b, S*ti6 r70o of lh.
<br />hbd Cod., fd $. Ffrtr&c. of th. i!.t f6ihi.h 0& Fhir ir nted
<br />_l hrv. $d eill iiIlin wa*d' @"F!.ri@ itltlme, ! Eqlird by S.ai@ 3700 of dtc rtb6 Cod!, fd rr. F fm.ncc of lh.
<br />*qt for phich thir Fmit ir i'3r.d. M, r tdt' .6F !&o itltlIue 6id bd FIic, rmhd &:
<br />(Thi, Grid i.nd nor b. corDlctcd ll lhc Finit lt
<br />Z(c.nit $!r in th. FtolMc. or dE ro* fc
<br />&@. rubjcl lo rh. *da ' @mD. ri@ hs
<br />ld on. hu&cd .bll4 {l l oo) d
<br />*hich thir Fhit ir is!64
<br />700 ol lh. Llor Cod., I rt ll,-o
<br />WARNINCT F.ilw !o rce *dtd'corntbrii@ @vo8. it
<br />nD- up ro d. nu(H lhded .bll6 (3100,000).ii rHnim io lh. .dr of 61Par.tid, dlrrB6 a ptlvid.d f6 lh. sccrid 3015 of
<br />lh. hbd Cod., intqBl Dd d6n.,t lB.
<br />LICTNSED CONTNACTORS DFCLARATION
<br />I h@b, !flim undap.n.lry ofFj{ry lt l t n lio!.d unrt . prvitio of ClDpl( 9
<br />lh. Buindr Md Prcf€ri@ Codc, Dd ny Ii@. L in fuu fd@ &d .iIcr.
<br />lh Sedoi ?0o0) of Divnid I of
<br />(/- b
<br />Ihr.by.mm uldE06.L, otprju.,{ $d ir. @ir!di6l6diis.s6., f6tbc
<br />inlcd (S... 3097, or C.).
<br />of lh. wt fa wiid thnFmitit
<br />AITUCANELDECI.AMIIAN
<br />D.mlirim ?mlt -A$6ra Nodft .ri6 fcd.r.l R.sul.{oN (1i{. .0, P.n 6)
<br />_ R.qriEd L.1la ofNodlic.dd
<br />ed C@r, ro 6r., lpoi rh.
<br />rhovc tMddcd Prlpcity fd isF.lid pu?d6,
<br />I
<br />rto,b
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subfl oorA/enVlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Masonry
<br />T-Bar
<br />Handicap Requirements
<br />Deputy Final Report
<br />Engineer Final Report Evrrt
<br />Flood Zone Certificate a F\Ef,
<br />EEO I tnio
<br />FINAL UAMC 6-43. 2 )0, 556. 667
<br />Certiflcate of Occupancy
<br />Notes, Remarks, Etc.
<br />BUILDING- INSPECTOR RECORD
<br />Brown Coat
<br />Pool Fence
<br />I
<br />--+-
<br />If-l E
<br />I
<br />i-
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