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<br />{nErurc. triorro irs $unncc.!l$rcqrtcsrhcaprli.nirfu\u.h&mrirr),ilcrsign.d{nrcrctrrIh h.or shc i\ liccn\cd Pu'r\uanr
<br />t, rlt lR)vniuls or rh. C( n.ttrsLi.cnscdtiw(ChJflcrs.Conncn.l.PtrithSccrionTlxx)orDili\nrtIollhcBusincssatrd
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<br />rDplrn tu rncnnir suhjccrsrhe anjrlicrnrt, r.iviltcrrhyofnor nrm rlun livc htndr.ddollir (3500)
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<br />irt.xlcd or olttrcd i{tr slc lsa.7(l4,1, Burincs snd Pmfcssi,ns cd. 'rhc Conrrs.tois t.i.Tn{ lf,r d.cs nor !Ppl, r, an oand of
<br />rhc pmpcdy wk) brilds or irDmvcs rhcMr. Md *ho des \kh work hnntllot hcr*llor rhmueh hir.r hcr owtr cn,rk,rc.r.
<br />lrovidcd rhor \uch imprcvcftfls m mr i crildl or oficrcd for eh. ll ho(dtr, rt hxilliry ot irtlrorcnr.r k ekl silhir onc )qr
<br />or.onlt,hrbn. rhc otrrcr Buildcr willh!rc rhc bnrdcn orpmving rhr hc or sh( did nor huittlor i'nPsn
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<br />arxl llDrBsi,n Co.lc: Th. Contddof\ Licctrsc tju d€s nol lprly k, M.wrff olpmPcny who tuild\ or nnProrts lhcreon.
<br />anJ wh. $nh.ls for \uch ln)jecls *ith 6 Conrrmr,n, liccn\.d puru lo th. Conlrlcror's Li..n{ tiq)
<br />Irn,(\c rtn L tulrr Srcr B & PC ld rhl!rcxnn,
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<br />I hrvc.nd wrllmtinrxint Ccd i,l.Ic of Cut$[ n, Sclf.ltnrc li)r *o'k.'\'conrfc \rridr, rs ,)n'!itlcd,nrhySc.riot:17(x)olrhc
<br />Iihn Codc. for rhc |x brmin.e ol rhc so' k ntr which rhc |1.nnir is issucd
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<br />conrpcneri,'a insurntuc cdricr nri Brlicy numbcre
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<br />issucd(SLr 1097. Civ (: ).
<br />AIILTCANIDLEI.T$AIIId
<br />I )E$y umnn udcr Fnahy of pcrjury on..rrh. rdhwnr8 dccl0mlions:
<br />Dcm.lirnr PcirnirsAsbc(os Norificarnrn Fcd.rdl RcSrhrnns (Tirlc 40. Prn()
<br />Rcrtuncd Lcrrcr of NolifKalion
<br />Ic&ifyrhdrhcLdcr r.Eulali,)n\EgJ i',8 rrh({o\ r.Nr Jl xrr mrat)flicthlc lo rhn Pnre.!
<br />ltr,vc nrnrnxrd F,I.dytur insrdbn Nr-lccnirrhrr
<br />I hrvc rcM rhi\nptltrri(!rrklimcrhdr rhc dlrvc i,nnnnari,tr, i\..nc.r lisre locon{'ly
<br />ordinaNcs trml Sture tiwr rcltllirg h huildnrt con$ru.r(,n. ukl hrchy{urhoriTc r.rc*nrxrivcs ofrhis ciry
<br />wirh rllciryrid counry
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<br />SITE.WORK DATE ID/SIG.COMi\'TENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/Venti lnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framinq
<br />lnsu lat ion/E n erg y
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />l\,4asonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif .
<br />FINAL t-/t-/7.Jde-{"*4
<br />Certilicate ot Occupancy
<br />Notes, Remarks, Etc.
<br />-l
<br />BUILDING. INSPECTOR RECORD
<br />oTVNER BUII-DI'R DELCAI{ITION
<br />I hcrchy rrltm un(ls pcDlry.r lrcrjrrt rhd L r .rcnu liom rh. G,nlrrcktr! I i.cisc Lrq lnr ih hll,iwi'ig rcxvnl'sc.7lll
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