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BUILDING. INSPECTOR REGORD
<br />I hcnby rf,lm undcr pendty of pcrJury thrt I m ampt fm rho Cdrr&tat' Ucauo LM for rhc followin3 rcA\
<br />ud Profatlm Codc): Aly Clt .. County xhici Dqultta . Frail b colaiucf rlt.r, lrapovc, d.rnolbh c rlpdr nyr. -. ^ -ixwe, rho EqulE lh. rppllot f6 ruch pqnrlt to 0lo . rltrld ro!.tmnt on h. o, aho b lioaucd n[rumr r Uro ptr! I (.i 9l nraCdtrrltrt Ucodf:r(Chptor9, Comac&6l|th 8*116 7000 olDlvlrlon 3 of rto Burinqr md Profsiqr Codf,orrtu hc r
<br />,hc it qmPttli@Aorn ndticbrlr lcttc dlc3d cnnpdo.Any vlol.do of S.crl6 7031,, by sy tppllost ftr r parmh tubjtrtr th!rpplisr to r clvll pctulty of ffr mat ih{ ovr hudrcd dollu (t500).
<br />-1,-l
<br />mc. of Oc FlPsty, dmy mployro ri$ wrSr r thcir rolo corpourtloo, rill do tho vort md tha rtrucnrG l, not lhtortdcd
<br />or ofiecd fa
<br />'rlc
<br />( Scc.70,l.l, Burlncrr rnd Profariou Codc Tto Cootnctor'r Llcmrc Lrv do{r nd rpply !o |tl orrx}r of thc prop€fiy
<br />who boild, d impou lh60r, d who &.. nrch rak hlmdf c hf,Glf a thmdr hir or h6 wn mployG, prcvlded rhj ruch '
<br />lmPsovalou l'€ not lntcnd.d a oficd f6 [le l( hffi, th! buitdlnj or irqrcrernanr it rold wirhin mi yqr of cmtpl.rlor\ tho
<br />Orna.Euildr wlll hrvo thc hldon of ptrcvin3 Ou hc r rho not build or lmprcvc fc thr puryoc of nlc),
<br />-1,
<br />u omcr of Oo propcty, .m trclulvoly 6r&lin3 wlth licanod ot*ion ro ffiamct 60 prcjcct ( Scc. 704a, Burlns mdProfcuim Codo: Thc Coatncto/r lJcquo lrr docr not rppl/ 6 rrl m.rof propoty who builat c lnrprcvcr thcrcor , ua *m
<br />cmmcE fs ruch Foj.cu wirh r Cmrlcto.(r) llffircd Fnmr to tho Cont €1il't Lic6r. Lrw.).
<br />_l rm crcmpt undcr Sccdon & P.C. for thh rcmn.
<br />Drt.: Offi
<br />I hccby rfllm unda *-O orr.lu' -ffi
<br />_l hrw ed wlll m.lnoin r Ccrrlflcrro of Cmr6r !o Sclf.lilw fof xorkGr, cffiFrrldm, u prcvldcd fc by Srcrian 3?OO of $.Lrbc Codg for thc ptrffinsco of lli. f,qt fcwhici O. Ffrnlr L Ltucd
<br />-l hm ud will miardn *c*o' canpalaio iruumco, u nquircd by Sccrlon 37oo of 66 L&or CodG, fo. rh. pcrfomrneo of rhowork for which thir pcnrit lr iru.d. My rro.*a, omqaurtion lumco crnic ud pollcy nunbff rrci
<br />Pollry
<br />{tt00} c lcl)
<br />ir iuuc4 II rhrll not cmploy ury pcrum
<br />lfl rhoukl bccone rubjccr to
<br />in rny munar ro rr torlrrc thrl thc watcn'
<br />compcnrtion Lrbc Co&, I rhrll,thorc povLionr..
<br />WARNINC; Friluro to rccm wortcr, compmntld
<br />line up to onc hun&cd tlrrurd dolln (tl00,0OO),in
<br />thc Lrbor Cod., intdclt ud rttmcy'r fc6,
<br />covcn3o h unlrwful, md rhrll rubjcct m mploylr to oimlnd pcnrhicr rnd clvildditin to rh. c{t of mpcnldon, dmrgc u prcvidod fc rhc Scctld 3076 of
<br />lhmbylflimundcp6rlryofpcrju'ylhrfficin3withScction7000)ofDivirion!of
<br />thc Burinqr ud Prcfsrimr Codc, md my l{ccnrc it io full forcc ud cffcct.
<br />Liccilc NumbGr
<br />Drtoi
<br />I hccby rfllrm undr pfitlty ofpajury rhu
<br />CONSTRUCTTON LENNNG AGENCY
<br />th6c ir r con3rrucdm l6din8 r86cy fff rhc pcrfomancc of rhc w*k f* which rhir pcmir ilCiv. C.).
<br />Lcnd.r't Addrdr:
<br />AIDLICANT'3 NECL q,ATION
<br />Dmolition Pcmlr.Arbcnq Norillcrdm Pcdonl Rc8ulrtionr (firlc.tO, pur 6)
<br />_ R.quircd Lrttcr ofNotillcrriqr
<br />_I ccrrift thrr Oc fcdcnl rcauhtimr rcaudin3 ubcsror rcmovrl uc not rppllcrblc ro thlt
<br />cfiiry thri I hrvc Ed thb lp,plicdfi lld rutc thd tho rboyc lnfmrurlon b omcl I with rll Clty rnd Counry
<br />ud County to antcr upon rhcud St tc Ltu rclrlint to bdldio8 cnnrucrion, lad hcrcby authoizc
<br />rboYa matioocd prcperty fC
<br />Applicur tr
<br />SITE-WORK DATE tD/stG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subfl oorA/enUl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing klkd/6<- tLb.rtl tfr
<br />lnsulation/Energy I I
<br />Qrywall t
<br />GxJ,llnt. Lath illq/a<-APla
<br />-4Pbz-Brown Coat rlhk n(
<br />Masonry I (
<br />Pool Fence
<br />T-Bar
<br />Handicap Requirements
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certlficate
<br />t) <*/hU
<br />FINAL v=ga-6 R,0 /
<br />Certlflcate of Occupancy
<br />Notes, Remarks, Etc.
<br />F.I
<br />Fl
<br />fI
<br />t\.,,- 4 .tt\
<br />^a
<br />Pcrmincc 4z .lad - labqa
<br />prcicct.
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