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BUILDING. INSPECTOR RECORD <br />, <br />SITE-WORK DATE ID/SIG.COMMENTS omc-Buildr Dc.lnlion <br />I hcrcb, $lm utrdrc p6rtt, o(pajury thrl t rn lrapr fam dE Ccnmcdt' Ucgtt t ? fn ti. follo*int,!..d1 (roc.7031,5 Eurinan <br />ud prcfalo Codc): AnyClty aoourty rilcf rqulc rpannrbcorcurt dtcr,lnpovG,-dmllil crgdruy dnraorg Flcroiu <br />inucG, rle Equh; rha rptiat fc nrt prrdt o 6lo e ripod risEnqtl ai8 h. d rtr i, llc.|,od Fr[uol !o tlr Frwlddu of 6c <br />CooEr.c,t Licond lry (Che.Ee, CsrrEdq rlrh ltoda 7000of Dlvblo ! of tbrEuln3.rd Prclslil Cod.) rlhll h.c <br />rho ir smF dm&onuabc 6sl fc6c OtcrCamgdo lay violriiil of Scctiil 70!1., by my rp,pllceat fc rgorda sbjcE lh. <br />lpplicsr b rclvil Frdtyoltrd ltmta 0Ehu&!d&lljr (t500). <br />I t, u ma of r1c Flprty, m dclruiwly corurcdry wl6 llsrcd cqrtnctan o cs.md fi. Fajcd ( Sac. 7o,l l, Burincrr .od <br />| ffifcrim Coao' nc'CoirrGCr Uccaro t rr ao aa rppty O rn o*!c otFop.rly wiro bulldl c lnrpovo thcrcoo , l'rd who <br />I mncrr fc nlcll pojoctr yitb . C6Ert6(t) licaud guarml o lho Cntnctil't Umrc ts.). <br />I <br />| <br />-I <br />m aanpt udd sctin <br />-8. <br />it P'C. fcthh lqroo. <br />Drto: Owna <br />@ <br />I hcnby rfirm m&r p6dty of Fjuty ilo of 6o followiri &clntior: <br />thry.sdwlllrdilrdntCqtiflorcofCmottoSolf-Inrmtorrghdr'omIm.dcLr pmvldcdfrbyScctlo!70oofthe <br />Lrbc Codo, fcthc pafqrnoe of th vclc fawhlcb thoFldt lt bud <br />_Ibtvcrodrittrulnrin*sltcn'canpqurdqrlalurmca,u rlqulndbyS!.riot!T00ofthclrborCodaforthopcfocnunccof0r <br />wqt( frwhicl lhlt pcmltfu inrd. My vortcr'cfiPctdlil hma66l6Ed FllsynmbcB <br />Pollcy Numbc 8ro&s: <br />fihb_grdo aocd oot bo crplaod lf tho pmh ir fc om hu&cddollrn (3l0ol c ls) <br />pa{ortmc of tbc rort fa ?hic! lhh L isu.4li rhdl not oploy uy panoo <br />lfl rhold bc.olrF rubjcct !o <br />lo to ar lo <br />'mpquadml.w rhrr <br />ofss€1i6 l70o oflh.Cod.,wlth thoo <br />WARNING: Frile io tffi ,ak![' mFlrdo <br />finor up to mo indnd thournd dollrr (t100,000),ia <br />thc Lrbor CodA inl6sr md r06rr't fcat. <br />omgcb ud rbdl u oployc o dmlad psrddc ud clvll <br />rdditio !o 60 u Fovidod fc th. Scoiql 3076 of <br />LICENSEL CoNTRACTORII DECITIRATION <br />t hmby r'fm uada parlty of pojury th8 t m llmr.d udd prcyldo of Chrptq 9 (mlM6int vlth Sccdc 7000) of Dlvltifi 3 of <br />th! Butina ud Profctslot Codg ud my llcarrc h in full fG lrd G{fcd. <br />Licmrc <br />Dr&: <br />I hcby rf,lm u&r podty bf pciury lhd rh@ I rg6c,fu rhlch tbb pcmlt b <br />bucd (Scc !097, Clv. C). <br />Lar&r'rNUl$: <br />16&r'! Addrs: <br />Drmoli:ifi Pcniltt-Arbano Nuificdm Pcdsd <br />_ Rcqulrcd lrtr of Nalfiqtisr <br />AI?LICANT'S DICLARATION <br />RoSuhdN (Tldc 40, Prn 6) <br />t ccnlft thar thc fcdcrrl qulaimr rcgrrdltri .rbcttoa r.movd.rrc 0ol tpPllorblc to diL prcjocl" <br />;fctrYOrrUrraa lPpllcdto ndntr.llrntto.ldo lnfdmdo b cora.l r3utomply wl6.rll Clt,,nrd County <br />to 6la uPoi thoildin&s ud Std. <br />rbovo motimcd <br />.l w, <br />18al <br />buudirt @EucI6, .rd hlrlby rcpcrartdva olthlt oty <br />o <br />Set Backs <br />Forms/Steel/Holdowns )-L94 )/Y ctv <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />SubfloorA/enUlnsul. <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 Req <br />Deputy Final Report <br />Engineer Final Report <br />FINAL 7-lo-to Wlo\ <br />Certlflcate of Occupancy <br />Notes, Remarks, Etc. <br />v.J I ( <br />f f--tt h^ blTi