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SITE-WORK ID/SIG.COMMENTS
<br />Set Backs
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subfloorn /enUlnsul
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall ../ --->t,Ext./lnt. Lath Lr /4
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif.
<br />FINAL
<br />Certifi of Occupancy
<br />ty}tefRemarks, Etc
<br />Os6'A!ildo DaLf,tio.
<br />I hd.by rtrrh uid.r p.Blty of pqjury thrl I m d.opt 1016 th. Coorr.r6t ' Lien!. t w lor lh. fo llowitr! .atoll{tcto, I t r lrind.
<br />.nd Prof6lioi Co&): tuy Crty o, Coliiy which ,.qurB r pah ro oNrtucr. .llq, imptovo. d.mlilh or r.P.i, ky tm6r., Prior ro u
<br />nruno., illo r.quna rE rppliqit for .uch Ddmn ro nl. r rigrcd !nh..r $.! h. or rh. ir liccEcd plrtur ro rhc Pbvtriou oi th!
<br />Conrrdor'rLi@.d!,le(Ch.trq9,Com6..cirgwirhs6rio.,00oofDivirionIofrlEBuina.rndltoaalio Cod.) or rhrth. ot
<br />!h. n d.mPl th.r.fiom rnd rh. b.rii for lh. rU.B.d a.oplion Ary vio lrtio^ of Serion ,0,I 5 6y .ny .prlianl for . p.m Nbjccr th.
<br />+prisd 6. civil p.rlty olnoi mr. t rn fiv. hunrlr.rl dolhn (1500)
<br />-1,
<br />s ohd of th. p!op.ny, or ny .hrloyd wilh wlgq ! thcn tol. .omP.nnnon, will do lhc woil Nd th. ruciu. n ior int.nd.d
<br />or ofracd for {1. ( S.c. ?0(a, BulinBt ud Profstion! Codc Ttc ConE ctolr Li..B. Lrq dos not rpply ro .n o"ner of lha plop.rry
<br />*ho bsildr o. mprovd oEr@n, ud qho dos lBh worl hio.lf or h.n.lf ot tn.ough hi! or hq oh .nPloyd, Provid.d thr .u.h
<br />imp.o*m.nt!& rct iirc .d or offqcd fo.d. Il, howcvcr, {r!buildinS or ingtov.ncni itlold wthron. yar oacohpl.lion, th.
<br />Om.rBuilda sillhrvc !n. burd.n olproving thrt h. o! rh. no! build or i6p.ovc for 6c purpot. oarl.)
<br />_1, s ownd ofth. pror.rty, .6 dcluriv.ly co6u.din8 whn lic.E.d @.tlrcroB to @Bha lh. proj.cl ( S.c ,044, Bqin6t rid
<br />Profdrion Code Thc Conmctocr La@n!. trw do6.o!.pply ro r. ow olProPoty who bo'ld! or rdp.ovo rh.r@n, rnd who
<br />onhcu ro,
<br />'uch
<br />p6js wnh t contrdo(, Ii.d.d punuir !o nt Coir.cioar Li@.& L!u)
<br />_l rn .x.mpt unds S.ction
<br />!986!$!qIAENiAU9!-DECIAB^ION
<br />I h.rcby rlii.n undo pcMhy of pojury oo. oatbc lollowin8 deluto.,
<br />_l hrv. rnd will m.inrri. r C.dili4G ol Cod.n! b S.lf.lBur. fo. srl6 @mp.urioi, r! providcd 16r by S*tion I70o of lh.
<br />lrbor Cod.. aor rh. p..formnc. of th. wort for wiich tn. pdmn it i,rru.d.
<br />vl4rvc rnd will B.iirlin wo*. omp.B.rioi insunnc.,.r r.q!ir.d byS.ciio.I7ooof!h.!!bor cod., io! th. p.dortui@ of lh.
<br />eo.k for which thE pc.ml n i5ru.d My work.6' conp.n!6rion ' udna o(id iid po [cy iumbs .c
<br />PolicyNumb.r Eipirca
<br />Ghir t.clion nc.d nor h. compl.l.d ilth.p.rnn n fo! on. hundrcddoll.( (1100) o, L$)
<br />_l c.nify rhrt in 6. p.dor ne of rh. eo.k for s,i
<br />b.cr6. ebjat b rh. m 6. 6mp..{ion l.w! of
<br />comp.n rion provirio ofSlclion 3?00 ofrh. tibor
<br />kh rhi! pdni i! i!!!.d,1lhrll ror.nploy my p.don ininyninndto.! to
<br />a o )
<br />WAiNIIiG F.rlur. io r..ur. work.. .omp. .uoi cov.[8. tr
<br />--
<br />uil.wtul, rnd th.ll!ubj..r.n lhployq !o qini lp. h,s.ndcivil
<br />fiis u, lo on. hrndrcd $ou!.d dollN (ll0o,0o0),in.ddnion !orh.6 6f6npcnsltiol\ drh.8c! d provid.d for rh. s..tion 30?6 of
<br />$. L,bor Codc, i.tc'dr ind rno6.y! fq
<br />LICf, NSrn COIYfI-ACTOnS Df, CLAIATION
<br />t h.raby rflirm undd t. hy ofr!.ju,y ttr I m lieD.d u.d c provirion 6f C hrprq 9(@En.nch8*rh S@riot 7000) olDilition I ol
<br />rh. B!.in.!r ud Proldriou Cod., &d my lic. . i in tull for@ .nd .ffar
<br />?1'7 815
<br />)rr.Trrr.r.n* /'".
<br />coB$BlcuaNI.!!@&tucIlII
<br />I hs.by!flirfr und..r. lry of!.rjury Uur th.!. t. @unlcrion l.ndi.8 r8.ncy for lh. D.doimn.. oith. worl fo.wnichrhi! p.rmn i!
<br />ntu.n (S&.lo9?, civ C)
<br />A$LICANI:ji..DECI,A8AIION
<br />D.mohion Pqf,ir!-Albcrtot Norifi doi F.ddrl R.gllrtiotu Gnh 40, ?ri 6)
<br />_ R.qur.d rrx., of Notifiotio.
<br />_l c.niry rhlr rh. f.ds.l r.suhrion! r.gldrB abaror rmnl .,. nor {pliobl. to rhi! proj.ct
<br />rhit rppliqrio. lrd ruta tut rh. lbow infornrrron n @r.ct I.grd to.oBply wnh rll city rid couity
<br />ro buildinS coN!ructio(rnd h.r.by ruiloti, r.pr6cirllivca olu! Cityrid Cou.ty to .ntd upon th.
<br />rbov. h.nrion d prop.ny for
<br />rpptiorr oriilcnn,g
<br />(->rlot
<br />BUILDING. INSPECTOR RECORD
<br />DATE
<br />Forms/Steel/Holdowns
<br />1rc.8. ch$ 3 c- | o
<br />,l-=\ 1019)
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