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srTE-wqRK DATE ID/SIG.COMMENTS OWNER BUILDAR DELCARATION
<br />I hcr.hy lllnm lnlcr pcmlry oi pcrjury rhrr Lm gc'rpr tonr rhc Onrra.km Lir.nsc trw tur rhc Llk'wmC rcrs,n (src 70.11.5
<br />Ilusncs\ anJ lrdl.si,n C,rl.) Any C y oi Cortrry *h'.h rcquns n lf,rmn nr onstru(r. rltcr. mJlr(nr. d4frrish or rcp!tr any
<br />nru.lL{c. nrrtrl,) its issuan(c. al\. rcquncsrhc annli(lnr n)r \uu[ ocrnirb nh r sBrd srarcftnr ih,r h.or slc L\ lic.n*d tmua
<br />b rhc pn,vnin\ ol rh. Cohta(kr'\ L'r.nscJ Ljw (Chapr( r), ConnEnc ! w h Sc.hn 70tlo I OivN n :l of thc Busimss NnJ
<br />Pnrcs(nNC.dc)o.rlrrh.orshcis.rcnlrrh.rcftonr{drh.t'risn)rrlr,llcfcdcrcmprnnr.Anyvi,,loin,norScLihnTil-rl5hydny
<br />apnliestrr ri,r a pcrmn \u$je.hrhc applic,nr r, a ovil Fnalrr ol nor ntrcihd,iv. hunJcdJollrs (S51D).
<br />l. 6 own.r of lh. pruIEny, or my cmployccs w(h *a3cr as thct $lc .omp.nrarion. *ill do rhc w,rk aJrl rh. rturh
<br />'s
<br />tur
<br />i crlot or oliircJ tu \alc (S( 704-{. llusincs\ rn'l Prnt\i,nN Col.: Th. Cotrra(tr s l-r.ns. Ilq &ts nor aff'ly t, in ow*r .f
<br />rhc,!,'l*ny vh hurllsor nr\B,vc\rh.B!r. lBl!htlf,\ \u(hv'* huNltorh.ncll.rthrculh6tr r hcr own cmnn,r.cs.
<br />pn)vklcJrhrr such mri,Er_mr d.,in irn.nJcJ or.ficrJ l raL ll h)rcri rlE l'rillirB or in{'orcmd $ n}ll wilhmonc ycs
<br />Dl .onll,hlDn. ltE Owncr Buitld *ill nivc lh. turdctr olpoviru llul h. or shc 'ld nol huil, or rqrorc lhc 0fl,1s1y nrltE puqx,s oi
<br />_l- a\ osncr of rhc pR'Irny. ,h .x(lu\ntly contdile wnh kctrscd ro.tadn h (n{dcr rh. t'n)F_r (S.c ?044. Ausrc$
<br />ahd hr)fcssi C(ilc: Thc CDnta.ntr's L(ch* Lar docs nn NpFly n, rtr.vncr ol l'n)ncn y wl!, $url'ls or impov.! thcrcrn,
<br />atr'l who conta.*knsochpdFchwnhaContacb(s)hcnscJtu(uantk,rhcContacrrsLrcnscL.u).
<br />_l amcr.htr uiJcr S.crk,n_, B &PC tnrrh,\ro.son
<br />Dol.:-
<br />troatrEBf.cou8ENlalra!
<br />PEqABAIIAN
<br />I h.rcby rllirn utulcr FhalrlotFjuryonc otthc tnlbws8 rt .l{rli.ns:
<br />I have Jrl willui'rain a Ccn,ll.dc ol CoNcnrt, S.ll Insorc litr *o c^' .onll).hrari( , d. I'brdcJ,ir hy Scctinr:llr0.lthc
<br />I-alxn Oilc.lr rhc Fnnrmrnr. oIrhc work ntr wh'ch rbc lcrh i\'rsd.
<br />I h,!t rnd w'11mri,n.o work(a r.mn Ds.Lntr 'n$ntuc, as rcqntrcd hySc.ri,)nlTUrol rhc l-rhor Co'lc. lnr rh. Fnnlrun.c ol
<br />rhc un ntrwh(hthr ncrn( rs rlsNJ My uorlcrr .onlll.n\rrbn ir\uraRc.nmcr u lrn'ry uhh.re.
<br />Lrl(y Nunrbcr:-Ertrc\
<br />_l.cdilirhrr i', rhcp.rlorman(ol rhc work ntr whihrhisFrnn i\ isxcd,I shall kn cn{'l,ry.ny lcrsnr .nynrdnmt
<br />i, asr', ttconE suhl.rr rJ rhc wi)tkcrs (onpcnsdio.l{ws ol Cllrlornu. aRl a8rcc rhar il I ih,ull hcrom suhFer h rh.
<br />workc^' r.mp.nsaron povnn,n\ oi Scrr i()n .1700 oi rlE lf,htr Cnlc- I {BlL ndhe h (omply virh tb$ novsions.
<br />IVARNINC: ,railrc n, r.ur *orkcri.om!.nsarion.olcraac i: uildwtul, itul $sll snhAt .n cmpbycr lo.rihin.l IEMIrrcs and
<br />c'vil linr\ oI t' onc hunJrcJ rhoo\an'l Jollrs (llUl.O{X)), ,n aJJirnn r' rhc on of comlEnsauon, Jamecs m providc'l for rhc
<br />S&ri(nr.1076 ofrhc l-ati, C, c. imcrc{ anJ adonry \ li.\
<br />LICEXSEO.CANIBACIOB
<br />!&CIdBAIION
<br />I hcreby o,ltnundcr pcnllty ol pcrltry rh0l I am lEctrEn lndcr povirion oi Chaprcr I (Lommm,n! wnh S(lx,n 7o{rc) ofD'visB)n l
<br />.i llr Bu\incs rDl Prni{ion\ Co'.Ic, l my liLcnr is i', lul nnr anJ cficcr
<br />COX$AUCIIONIENDINGICINCI
<br />I hcrcby !flnmurdcr JEialryufpcqurythat rhcrc N. lonnrudNn lcnlul3 a8cmy Inr lhc pertirrutue olthc *o li'rshrhrhnFrdir is
<br />isurJ (S.c. 1097, Civ C.).
<br />AIELICANTIIECIdETIION
<br />I hd$y .nim undcr Fnllty ol Frrury trrc ol lhc tullowin8 dc.ldd bns:
<br />Dcnriri(,n Pcrmh Alhcdor Norf,carR'n FcdcBl R.!ul i(,nslT lc40, Pan6)
<br />_Rcquired trncr ol Norillcaion
<br />_l.cni,irhar rhclidcrrlrcgdhrn,ns rc!trdinBr\h. oticfr)v rc nor .mlr.hh r, th,s poFcl
<br />_lrdilyrhnrIluvcuJdnsrF.ar()nrinl.rharrhcah)v. lohurk t.oIB-..l.Ii3@ro.\,mplywnhallCnya Orunry
<br />ordirrn..s 'lSratcl,a*srclarinshhuil'linsron(ru.rion.r l hcrch, rurh,i2c rctrc{ r{rntstnth(CnyandCitrnlytocnlc.uF th.
<br />ihnr nrctrlkftd F'!.ny l;r msI..ri,)n purF)scs.
<br />ADDIi(ant or Arenl Sisnuturc- l[lc
<br />-
<br />P.mlle En. (prinlrr-
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq
<br />lnsulation/Energy
<br />Drywall
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certil.
<br />I -r
<br />FINAL n \g 7A \*wt 7
<br />Certilicate of Occupancy
<br />Notes, Remarks, Etc
<br />BUILDING- INSPECTOR RECORD
<br />Sel Backs
<br />UFER Ground
<br />Subf loor/VenVl nsulation
<br />Ext./lnt. Lath
<br />D.Lr_
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