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SITE-WORK DATE rD/srG.COMMENTS O\}N}:R BUII,I)ER DI:I,('ARATION .',II'o.bammundd anah) Ip.ruD rhd ImG\mF lDmrhc(id'ad,,n'Itrffil.e lor rh. rolLsut 'o$i!n 1Il r
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<br />r. rh. FovisioB of df, C.ntr.rors Li.m*d lis ((nry6 9. Com'ndc'ns \ h s.dhn 1000 olD'rtrnnI oljh. BuriiN lnd
<br />Pn! a*iom Cod!) o. rhal ,torrh. i5.tcmpi rhscFomMd rh. b6!B l-,r I h. .llc8..j ctmp' nn An) t'olt"o^ofsd'$n 7orI5 by any
<br />rmlrlnl for ! Fmn subjd. lh. tlpli$nt ro . .n
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<br />I ,.mh, of not mt. lhd lir. hun&d dnl&! I ltoot
<br />I,Iorn6ollhcF.rE1y.oirymploy6$ith\r!aBslh.rhl..omr.Bdn,n.uill6lh.*trlorrh.rnflEirh
<br />inhd.d or olf6.d for s]. {s< 70,14, Burind Md PmrdioN ( od. I hc Con.nck i LicN !-6w do6 nor 4,ply lo dn oNnd oa
<br />rh. F)15! rir hril& or in'Itrr 6 llEFtr t rl $ ho d€ sh $.* hrmr.lf or h6rlf or rhn'3h hB or ha oq, or,thr6.
<br />Fo\ dd rhrr s.h mFnldd. m mt hlorLd qo,H rr st rl lr,{6s, rlE hrildns o nlnffi 6 $U qnhnw tw
<br />.frois'ldiotr ltE {xr( Bu'ldq \ix har! dE hrd.. oI F.\rB dn or{Edii , tn'tl ar nF.\t ln. rmFit forlrt Flit rof
<br />L do*Eorrh.FFD, macrdN.h coddlu ulth licaE d cod'ei6 k,.odtud rlE IFi.tl (S< 70r-| &trnK
<br />lnd finG.ir ('od. Tnc Conl.sloi3 Lic@ h* &B mr 4'Fly tu & ou'r6 oa F.Fry {h. b{il& or impm\6lhqFn.
<br />rnd +no con!&13 for !!.h I'trjds$ilh ! Co.tEclo,lr) lE6ad pu6u r lo rh. Coflrelmi l-ic.s lr*)
<br />I tun.r.nF uftl6 Sdion
<br />l)rr€ (rir.r
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<br />UECTAAAI!]!
<br />I h{a.h\ rmnn undd penah\ ol Fnn oE.frh. n,lL\rtr,F Jdltrirtr'ni
<br />I h.v. and \ ill mimain i ('d ifrar. ol ( .l1gl lo Sclr-ltuuE lin sort6' comtEud ior. B Fovid.d nr b' S4non 17ul of llt.
<br />lrtxtr (-de ror rh. pdfomm.. oarh. *o lor shkn lhc Fnil t su.d
<br />I h.rc rnd q rll m.idlin no.I6 c.Er6{ion iturk., s r.qu!.d t\_ Sd.n 1700 ofth. Iior CorL. lor lh. Frolrlr,e ol
<br />rh. $n.l for shrfi rhi! Fn B sf,d. Mt l'.,td' onFdion iNurmc c.fu ed Flt' numb.r ft
<br />I ccnilrhd '. rh. porormm.. of rh. uort for shich this F rn i3 r.\u.d- l3hill mr mrnrr_ lny t r$n in.ny nanM
<br />$ s !o bc&m sh.d lo rh. qort6'c.rrrEdhn |!rt olcrlin mu. .d.*r rn if Id'ukllt oftrut dtoilE
<br />lorld omFM ion pnrBirN ot S<rhn r 7m of rh. l,tor c.d.- I JrlL fonntr ilh comoh * nh rlsr pr.! 6FN
<br />wARNINC l-!'lur. ro (u. $o.t6 comFnsnion co\6dg. ri unlrrtul. md lll tubJal d @ptn'( tu cinrntl Fstis.trd
<br />.ivil fi..s ul) h on. hund,.! rhoNnd dolls ($1ff),00o), in rJliion ro rh€ corr ofconrFnsrion, d,ml36 6 prcvd.i ror th.
<br />sdion 1076 orrh. libo. ( odq ar6d ..d dionr.!\ lc
<br />1 2)/.
<br />I Hlv.lIm undd po.n] of Fju,r_ rhd I m li..rsl !'d6 protinn orch.tra c (comin8 rili ScrEn 7000,.f Ih Gaon r
<br />of rh. BuilB.nd ProtBnB Cod., ,n my k.* 6 o tull forc. rd cll.d
<br />to/s/r1 *_y"-rZ.E.t.
<br />caliIallcIIoB.IEdDrNclGEugI
<br />I h6.r,y .llm unrs Fuly oa Fjuty rhd tkr n t .od.IEli.n lsldins .sdt an. tb. Fftffi. of th. *!rt 6t \ hrh
<br />'hi3
<br />Fnn i!
<br />h.u.il (Sd 1097, an C )lrnd(i Nm.
<br /> PPLI('ANT D'CLARATlo]I
<br />I hd*'y .trm undq FEh r of Fjur) on. of rh. tollo$rn3 d.cleal $n!
<br />D(mldh. P.mn3.Asbd Noulicnrcn linj.nl icsu hrrd (IdL ,llj, Pd6)
<br />R.qut.d Ldls of Nolifi crli('n
<br />I cdrit lhd rh. f.darl cBdnioB Elr&Ds slEnor r6mr.l s. 6ot +plk.t'k b rha F)Fcl
<br />- l.diryfiarIl . cd lhis lgplicdion dl tl clllllrh.!t !t i.aomrhn soncd.I.sraro.omply*ilh tllCny! lCou y
<br />ordinrk6 ud sr.r. l,s Etrilq ro hiildirr .drB.tu.rio[ ni hfthy &ilFriz. rrrddldiv6 6l lhn Cil] ud Counly to drs ulEn fic
<br />rtnl. nEtio,!.d FoFry td iE 6lirn F F6.
<br />App0on,orl,orsrrtr.,rE: *)9.=*.6-*t*> n',J:/ly'f+
<br />Set Backs
<br />Forms/Steel/Holdowns '2-2D -17 -JJ.9d--,
<br />UFER Ground
<br />SLAB Floor '2-2,o-t7 .J ).<1
<br />Subf loor/VenUlnsulation
<br />Roof Sheathing
<br />Shear Wall 7-4o,/9 J,kW
<br />Framing
<br />lnsulation/Enerqy
<br />Fyryall
<br />Gxt /[nfJ€th 1-t-r4-l)rl dor
<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 />5-Zt-t6
<br />FINAL
<br />-Fr
<br />A?>t-?,b
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />BUILDING- INSPECTOR RECORD
<br />G--,
<br />Erection Pads
<br />I
<br />dts)
<br />ir)
<br />t.i.@ Nudb.r
<br />-
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