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BUILDING. INSPECTOR RECORD <br />SITE-WORK DATE ID/SIG.COMMENTS <br />Set Backs <br />Forms/Steel/Holdowns <br />UFER Ground <br />SLAB Floor <br />Subf loor/VenUl nsulation <br />Roof Sheathing <br />Shear Wall <br />lnsulation/Energy <br />Drywall <br />Ext./lnt. Lath <br />Brown Coat <br />Ivlasonry <br />Pool Fence <br />T-Bar <br />Handica p Req <br />Deputy Final Report <br />Final ReportEntneer <br />Flood Zone Certif. <br />/A <br />FINAL -,t C/\.w1{,}\ <br />Certificate of Occu vnc <br />Notes Remarks, Etc <br />OWNER BUILDER DI]L(-ARATION <br />I hscb, amfln unde poally of lsjury rhar I d .xenft lio,n lh€ codadoh Li..*e LaN lor thc aollowins .€mn (S( 70l l 5 <br />Bosin6s dd Pror*ion Code): Any Ciry or Couflry Rhich rcqut6 a p€nnl' ro .oN'ruc1, ahd. impov.. dmolkh or Epat ey <br />slruclue pnor to hs ia\uanc., also rqtut$ lh. applicant lor such p€flnir to file a sisned s6md thal hc or shc G li.asd psu r <br />kJ rh. pmlisiois of tfic Contlcrois Liceised Law (Chaprd 9, CommncinS snh Sdion 7000 of Dilision I ofrhc Bsin.s d <br />Proa.sion! Code) oi rhar he or shc is €xemfl rhs.Eo'n ed rhc b6is io, <br />'h.allcgcd.xdn <br />ion. Any violatiotr oasetion 7011.5 by afly <br />appl ic&t aor a pann su bj.cts rhc applic a roacivilpenakyoinolnDlelhufiv.hundr.ddollars($500) <br />-1. <br />N oNnd orlhc prcpdy. or nry€,nploye6 Nilh \va8cs.s rlEir slc comptrario.. will do fie solk and rh. sde is mr <br />inloded oroll'...d for elc (S- 70,1,r. B6in6s dd l1oftsnrns (one ft. Conrrarlofs Licfl* Larv do6 nor apply to oMqol <br />rh. pr.rdy \yru' builds or irnprey6 lhesn. md who dos su.h $,orl hhs.la or n.Nllar rhhugh his 6r h.r osn . Vlo) G, <br />pnided rn.l such ihprovmr d. not inrdd.d or offd€d lor ele. rt ho$66. rh. &ildi.r or imlror€han is$ld\lthhonclw <br />ofcompldion. rhc Ownd auits will havc rhc hrdo or prori4 rhd hc or shc did nor hrild or nnprolc rhc p,lpdy tur lh. srp.* ol <br />l.6 o{n€rofrh. p.opary, n c\.kn.ly.onrad i.s s(h licc'acd .onllrlou to (Errud thcloj(i (S(.7044, &sn6 <br />and Pnkion Cod. Th€Conlradoas ticcnse LoN do6 nor arpltto d o*n6 oiFo,r.nt *ho buildsor improvdrhc.on, <br />aod who cont.ct su.h piojdrs slh a ConrE lo(s)licc6.d pu6ud lorhc Conrractr's LicenF Llrv) <br />_l m er.mpr @d6 Sftrio. , B. & P.C. for this Mon. <br />D.lc: Oro.r: <br />Il2lt\!B!,1l.!!ll!!l^Ill2!u[qu&!-ra! <br />I hrchyltnntrnd.rpetratyolr6i'r^oneofrhcnnbs ratldld^rions <br />-l <br />h,\edd\ill <br />'.ainlain a C.nilical. ofcoNe <br />'o <br />Scll-lmure ror \rcrk.c comr.nelion, a Fovid€d for br Sar ion l T00 of rh. <br />t-abor aodc. lor lhe pEfomuc€ oirhc wo,t ior Ntich rh. t)$nir i! isucd <br />No'krs cor.pssalion prolisiotrs of Sdio. 1700 oi rnc L,t r h$nh cohpl, $ nn rho$ atu!isions <br />WARNIN(; F0ilur. t) scctr( $orkra c.n,pcnsariu, co\ <br />.Nil fines trp k, ofe hund'L{ rhous. d tlolla,s (5100.(r(xl <br />d nlall subrd an onplor,er ro criminal poEhi6 and <br />utrJfl lculr\ oll^-.'ju,\ rlr.n I m lL.rnsL\l pnrrisior orChaple ! (commcoci0s Nirh S.clion 7000) ofl)ivtnrn l <br />oa lic B6inss md P.olsioG Codc, ad hy Iicosc is i <br />?f,"n /NC <br />(oNslRt( I.loN I LNDTNC,\(;UN( \' <br />I hd.by alim und6 Fnally oa Fjury lhal lhEe i. r oosrtucrion lnding rgo., for U. pdfon@cc of rh. work aor wnich rnt pdnir i3 <br />i$u.d (Sd 1097. Civ C ) <br />AIrI,ICANLIECIAAAIIj}! <br />I hdrby.trm und.y p.nany of psjury o.e oa rh. follo*ins d{laatn os <br />D.mohion Psmns-Asb6tos Norifiotion Feddal R€sulations (l itl€ 40. Pan6) <br />R.qrt d lr(d oaNolircaion <br />I ccnirythat lhc fcdealrc3ulatioB regddine ab.sros rc'nov,l,'r nor appli.ablc lo rhis trol..r <br />-r <br />cdiayrh I hav. rMd rhiappli.ar <br />ordinancB d Skl.l-arvs rclrlin! lo <br />ah.\.mcnrioicd p'll.ny tu i <br />,\ppli$nl or ,\g.trl Signilme <br />1 <br />Erection Pads <br />Fram inq <br />/g <br />L.nd.as Addre <br />= <br />I <br />It-