|
BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE tD/stG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subfloor/VenUl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Requirements
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certificate
<br />E,.
<br />FINAL !LU
<br />Certiflcate of Occupancy ;;s4'rro-36;6r
<br />Notes, Remarks, Etc.
<br />OMd-Duildn D.cl&.rion
<br />I hfrby.fllm uidd pa.!ry ofpajury lh.r I h d6F fm $. C6trcl@ Lkdr L.* fo. rh. followi.s r.aoi (rcc ?0ll 5 BGii.$
<br />hd P6fqrio Cod.)r Ary Ciry 6 Couily thi.h Gquic! r pmit lo c6tE!cr, .r, ihprolc d.molirh or rcp.t M, nrucrur., p.ior to iEitMc., .lto tqutd lh. rpPlial fd rutl! p.mn 10 6L . riSn rl nrcmat dr{ h. or lhc n Ucdtcd ,uBusr ro lh. prolirion! of rh.c6r.ddl Li.tu.d rf (019l' 9, cmdns *irh sccie 7o0o of Dilhioi , of $c Eurii.r ed Prof4i6r cod.) or rh.( h. d
<br />3h. ir .x.,n?i th6d6 id rh. b&n fd $. rI.&d a6pii6 A.y ioliio of 5..116 701 I J by by rpplksl f6r i p.mn rubj..ir rh.
<br />lppli6r ro r citil p.nrlty of nd ho.. th!. ntt hurhlrd dollB (1500).
<br />_1, 6 Md of lhG FoFny, or dy dnploy.6 ?ifi w!86 s th.ir rol. cohF!!1i6, *ill d,o rh. ret lhd $. nrudlr. n ool inr.nd.d
<br />d o(fd.rl fd ,.1. ( Scc 70,14, BaiM hd PrcfdioG Con Th. Cotr.rd! Licar. L.e d€ nor .ppl, to M o*nd of rh. prop.ny
<br />who b{ildr 6 ilrp.Mt $ffi, Ed *ho dct luh wd! hi@df 6 h@.116 rhrclth hir d ha @n Ghploy*r, povid.d lh{ !u.l
<br />imFovffiB E nor iitcnd.d or ofrd.d fs r.1.. lf, hwqa, $c buildir! or ihprov.imr h told wnhin .i. y.ar of .ompldio., rhc
<br />Opnd.Blildr will t!v. ih. bu.da of prcvin8 Onh. or !h. nor build d inprov. fd rhr purld. olr.l.)
<br />_1, ! *nd ofrh. proF ty, 6 ac,qiv.l, c6rt tinB vnh Ii. .a @ihc6 16.odd rh. Foj.cr ( SGc 704a, B!!i.6r ud
<br />Prcfation Codq Th. Conr&loc! Licd. llw &.. nor ipply ro & @.6 ol prop.ny eho buil& tr inprovB rhdcon , Dd *ho
<br />coiF!.G fd ruch prcjcck *nh r Cotilcro(, li.d.d puBuur ro lll. Co.roddt Licds L!* )
<br />_l u .xcm$ !rd6 s.cri6 .4. & P C. f6 thit r oi
<br />WORKERS COMPF\SANON DECLAi,TTIO)\
<br />I hftby ifiim und.r p..!rry 6l Fj!ry o. of rhc foll@ins delmtiont:
<br />_l h!e. 6.1qill h.irriin r CdrifioE of Cdr6l !o S.lf-luuE f6 *orkd' c6p6ririon, s rrclid.d for by S..ri6n l?oo oflhc
<br />L.bor C!d., lor $c pcrfolmcc of 6. wo* ftr *tich rhc p.mn t iou.d.
<br />_l h.v. sd will h.ind. wdtd' comp.tu.do ii!dec.. a EquiEd ty S.. on 3100 of $. L.bo, Cod., fo. rh. pcrfomonc. ol ih.
<br />*ork for qhich thir pdn i, isu.d. My wtrtd' cmpdurio iNutuc. ceiq ed policy nlmb.r arc:
<br />(Thir rc.rion n..d nor b. cmpl.Ld ll fi.r h for On. hund&d doll& lt,cs) or l.s)
<br />Llbor Codc, I $tll, fonn
<br />dolla (l 100,00o),ir.ddiri iJ.a ld rh. S.cri6n 1076 6l
<br />LICFNSED CONTiACiIORS Df, CLARATION
<br />I h*b, rmm undn p.n.lly of pdjuiy thn I m li@rd unda provirion of Chaprd 9 (.mmoci.s
<br />rh. Burind, $d P6fdn6r Co&, &d ny licd. it i. lull fftG ed.lfcl.
<br />pdforu... olrh. w6k fd *hich thk p.mit it
<br />AP?LICANT'S DECLARNTION
<br />D.tnohio P.6in-Arbdlo Noffic.dd F.dcrl R.Sul.tio8 (lnl. a0, Pln 6)
<br />_ R.guir.{ LmB of Noiiicitio
<br />lh. a.ddlEgul ior r.gediDS sbqt6
<br />I hiv. 6d tiit .ppli.{16 Dd !61.
<br />ordinu.e sd Sbt L.*r rcldn! lo buildlng
<br />0
<br />I
<br />1097, Civ. C.)
<br />I
<br />-
<br />I
<br />t-
|