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SITE.WORK DATE ID/SIG.COMMENTS <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />Subfl oorA/enUlns ulation <br />Roof Sheathlng <br />Shear Wall A I <br />trll>rt lO ff LrnFraming <br />Alnsulation/Energy <br />1a2f-rSl )Y,/eDrywall <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 Certlficate <br />aFINAL <br />Gertlflcate of Occupancy <br />Notes., Remarks, Etc. <br />IT <br />, t - -A bt ^t - <br />I <br />t7t <br />u-r nII <br />BUILDING. IN.IPECTOR RECORD J4 <br />I <br />D@hrltim <br />I hcrcby rfilm unda_padypfpcjurythal mcrdp fomrhcConrrcro'LlmcLr fcthc follwlng rcon (rcc.?031.5 Buinor <br />ud Prcfaio C:ic): eay Ciy c Colaty *hich rcq0ls r pcrmlt to coorEuct, dtcr, la4rcm, dmolirh or rcpdr uy rlrucre, Fitr to lu <br />itffic!, rlD rlq{lH rh. 4pli6t f6 nrcl panrdt o lllc r rigncd ,rrtffit lhlt h. a ,t L limred Fsut to tho Fovldm of rhc <br />C6mdc'tLlfficdl* (ChrytrXCmdnlailh Scci6700o of Dlvfilo 3 oftlp Buingr od PrcfsimCodo) crhrthco <br />rho i, scnrpt th@fiont nd thc bdr fa tho dlcscd cqtrprlo Jttry vlollio of Scdo 70! I .5 by e, ryplist fn r pcnDh rubjeu th. <br />rppliflt to rcivll p{rdty of nd ru! lhr llvc hm&cd dollm (3500). <br />_t, u mc of tho prepaty, a nry anployG rifi ?!t6 I rhclr rclo conFledon, wlll do tho ,ork ud thc rtnrchm h ror tnrcadcd <br />c ollcrtd fc rdc ( SGc.?0+1, Buhcr, lrd Manim Codc Thc Cqttl.t6'r UGno Ln do.. nd .pply to ri of,nff of rho Fogqty <br />who bull& q irnFos rhcon, md wto dm rttr rotk hldf I hdclf c lhtugh hit a hq M mptoycc., pmvldcd rhrr mch <br />Irnprovcilattr enotlntardcdrolfcredfcrda t4, hmcru,lhcbuildlngorlnpmmt ir bld wlthin mcycrofcomplaloq Oc <br />Ouna.Builda rill lrrw tto bodo of povlnt rhrt hc or th. not build 6 imprcrc ftr thc p{rpqo of rdc). <br />_I, u ma oftho propcrty, m cclulwly mtncdn3 wlth llarod mn.ctffi to sti$ct Oro Fojcct ( 36. ?O44, Butlno sd <br />Pmfsim Codq Thc Conflrclor't LI€uc Lly do6 not lpply to ltl m.r of Fo,pcty who bull& c inrpmu thccor , end who <br />cmbrctt fd ruch projccb with r CrnEeto(r) llmod pu6ut to tho Conrrctc'r Licdrc Law). <br />for thir ranon.(n. fl'.-y^-, <br />I hmby allim mdapcodg of pqjury oo <br />_l harc md wllt mrintaln r Ccr{fiqra of Conmt b Sclf-InruG fs wdkfl' 6mpqrdio4 u prcvldcd fc by Scalm 3700 of Oc <br />bbor Crd6, ftr thc pcrfmca of thc *ort for rhlch tho pcrmit ir hncd <br />I hevc rd sill mdrtaln ratcn' conpauetio lnrunncg rr rcqulrod by Scctlon j700 of tho Labor Codc, for tho pcrfomrnce of thc;o* ftr which rbir pcmdt l, blrd My ;odcm' compouetlon lmime crrrlcr rnd policy nmb6 .r€: <br />PollcrNmba: Brplrt* _gtrti*torn "ir*l- <br />thlt ln ir iruc4 irhdl aamploymy pcnoo <br />lf I rhilld bccoil€ rubjcct ro <br />in my mlnn6 rc rr to <br />thc wfikcfl'Olt <br />ofSecricn 3700 oftho hbc Cod., I provlrloor.. <br />0o <br />F.ilurc ao tcc@ sdkd'k ud rhdl rubjca m mployr to aimind parddcr md civil <br />rdditim to tho st of compaurdon, dm3a rc pmvldcd for rho Sccdil 3076 of <br />LICENSED CONTRACToRII DECLANATION <br />I hcrclr rllimundrpcndty ofpcjurytfuI mlicancdundapmvitim ofChrptr9 (ffioclq with Sctim ?000) of Dvirlon ! of <br />thc Buino ud Prcfaim Codq ud my limo h in full fm md offer. <br />llcaodc LlquNumbcr <br />D.tc: <br />I hrcby rfim udrpddty of pajuy thr *m€ of rhc wo.* fr rhictr rhlr pcmit ir <br />Civ, C). <br />Lcodcr's Addru: <br />A'TLICANT'S DEEI.ARATION <br />&moliti6 PmlB-Arbdls Norlfi6d6 Fcdcnl RcSuhtioru Cfi0. {0. Put O <br />- <br />R!$rlrcd lan6 of Naifiqdm <br />_I cdrlly $d Oc fcd6d reflaim reprdinl lbcrtc ml m nor rpplloblc to thir prcjcc! <br />I utify tha I hm rad $ilr rmliqdm rd .trt6 thrt thc $orc infomdm b ffir I lEr!6 ro ccnply wlrh rll City nd Cetrty <br />edstdc lrw' rdaint ruthoflz! ,rpr66trtivcr of thh Clty ud County lo 6tc' upon tha <br />mmdmcdpmpflty <br />tr r86t <br />4 2A ntl <br />\Snmc(dm): <br />b.l <br />"ll1lf7 - .Xr4E h, > <br />4-?_rf> 4O_*r,< r*a.\v2 Y-loL! A <br />I