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BUILDING- INSPECTOR RECORD <br />ID/SIG.COMMENTSSITE-WORK DATE <br />Set Backs <br />Formsi Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />SubllooriVenVl nsu lation I 1 I <br />Roof Sheathinq <br />Shear Wall II <br />Framinq <br />lnsulation/Energy <br />Drywall <br />Ext./lnt. Lath <br />Brown Coat <br />Ivlasonry <br />Pool Fence <br />T-Bar <br />Handicap Req. <br />Deputy Final Repofi <br />Enqineer Final Report <br />Flood Zone Certif. <br />FINAL t)8)tk);# <br />Certificate ol Occupancy <br />Notes, Remarks, Etc <br />OlVNER SUII,DER DELC]AN TION <br />I hcrciy alllrm undc! pennhy of O.rjury ihal I an cicmPi ,ho rhc Conra.ton t iNn{ Law fo. rhc tullowinS r,{'h (S.c 7011 5 <br />tlusincss .n'l P(ncs\ion coJc): Any Cily o. Cdunry wh(h rcqnircs ! P.mir k, c.nnrud. all.r. im|nrle. dcddl$h or rcpair y <br />{EdtrE, r,rir b irs 6suMcc. iko rcq t s rh.,tl,hin( tornEh [rmir kr fiLa tlncd d.lcnEtrl rhrrhcor sh. r licc.td PuFrer <br />I', lhe lorhiqr ol il[ codtr.cntr s Liuctrd tiw (Chryrd 9, conrmcBine *irh S.c.on ?0s) of Divhnrn .l ol rh' Rurnrsr 3ntl <br />Pn)L*R,ni Codc) or llul h. o. ihc ls ctmfl rhcrcfro$ rnd thc hi{s lnr rhc rlL3cd crcft ion oyvn,btunolselion,0}l5byrny <br />lptlicrnrlorapcmirrubj.ctsl)tr.mlranlloa.i!ila.mlry"lhormorcrhnnrivchunJEddouds(S50O) <br />L d\ ownu ot rhc l,n,Fdy, or nry c mtloyes wrrh *rt.s rs rhc'r v)lc (mt]ctrs3rion. will do rhc qffk d lhcdturm n B <br />n{cndot orol!.t.J tu srlc (Se 7(114.llun0cs mJ Pnni$n,r\ C,ilcr'l |te O'nrxcttr'( t.iccnsc Llwloes.or xlllyt)!nowncr I <br />rli 0$Fny wlr) iuilds o! inrtnN$ rhcfrm. and who d({s su.h *rti I inNcll or ltr{ll .r rhough his or h.r own cnrlirvccs <br />I'l,vi'lcJ rtur such inpovc.rDr l m 'i <br />i u cn]!n or ollircJ li}r qL. lt h)w.!.!. ihc tnDU,ry or ihPtuvcmd r v'la] * irhm otr. vcd <br />ol NDnldion. r1r Ownd Buildcr will haw rh. hunLn ol pmrin8 rl r h. or shc lil tror htrill or rFn'rc rhc FlPoly lr rh. N[x\c of <br />I. $ opncr.i rhc popc.rr, rncxcluqlclyconltadi,'3 *rrh licctr\cJ co0tri.kN lo lon{ru.r r}r rtujc(r (Scc. ?044 Bsinc( <br />rBl Pnra*DhC.d.r TlrConlr(ktr's l.ic.ns.liw d(t< nordt'llyr. uo*ncr ol F)Pcrlywtu' build\ ori nn,vcs rhcrcon <br />nnd who uonu..kli,r u.h Fl'jccB w[h . ci.trrcto(s) h.cn{'l prr\uxnr tr, rrE Conk..ttr \ l-{cn* lrw) <br />-l <br />mcrcmg udcr Scclnrn-, A. & P.C. for rht i.ason <br />r!o&tEB5:co!.lfENl4.r!oN <br />DDCLA RATION <br />I hcrchyaliirmunncr |xndryol Pcqury ncol lM n)lk,wirr! 'l..hmri(nN: <br />-l <br />ha!. d'l will mrtan a Ccnifi.lrc ol Conicnr b Sclf ln{rrc tur workcs (nnlcns idn, !s lnrvidc! lir $y Selhn :r70O ol lhe <br />I itu Cotl.. tor rh. p.rfomr of rlr wolk li)r whih rh. l.mn ( ssuc'1. <br />{, n,," ,n.l * r, n"'n*,n *",kcr' ('nn trqr r'n rnqtrJnuc, $ requncLl hy scclnrn l?OO ol rhc l:lnjr Co,lc, n)r rhc ocri. odc. dr <br />ih. *nrk l'{qhrhrhr nrm 't nsocJ M } *{rlc^ omP.nur0n mrur"n. c dtrrs &l Ix li.'y nuhb.r r <br />c <br />1., t) <br />-l..nily <br />rhnr in rhc pcrtarhrn c ofrhc wo* nrr whth rhis J'crmx 6 rsuc,l. I \hrll nor cnPlo y !!y li.(on 'n <br />diy nr.nncr <br />$ s r] hcok- uhjcc( 6 rhc work rJ."nl|].trsrri,,n laws olCalibmin. md.!Nc (h!r raI sln U h..unt $bF!r lorh. <br />worken (onFnvr ion pbvlqons oI Se.]$n l?&olrhc utxtrC,xic,I \hrll, li,nh!irhtoh y *irh rlnr$ I'fl)vn i0n\ <br />IVARNING] rd,lurc ro $.urc worltc^ .a,m0(trs.ri lovcnec is unhwtuL rnJ (hdll suhicr lrr.nll,)fr b cnnrnal l{na[ics rnJ <br />c'vil lircs up k, onc hundrcd rlDuend dollds (SlUr,(xlO), i <br />Sccrrn 10?6 ol thc L.lxtr Orlc. inr&cn rtui oaEy s fccs I <br />\/lu lzo20I <br />I l[6hy llltrnrundcr Fn{l'yol Frjury rhar I nin nccnc,l ufrlcr pn}lnnin.t I)Goninrtu'ng qirh ScdDtr 1Xl0) ol l)ivilon :r <br />ol rlr Burin $ anJ Prncssionr (irJ., rkl hy hecn\c 11 n l l br.c uJ cfitc( <br />044 Qtoz <br />CONSTRUCTION LENDING GEN(:Y <br />I h.rcby alttrm under neMltyol ncrjurt rhr( rhdc is acon(rucli(,n kn,lo3 t!.hry lor lhc Pcdomtuc ot thc votk tu qhichrhr (rmn is <br />tsu.d (Scc. 1097. C,v. C ) <br />alur ll-uEel^Bdu{rN <br />I lfrhy.llim uhlcr ocnrlry ol Frjrtry otrc.l'rr lollowins nc.[rrh.ns: <br />Dcmol or Pcrnnrl^sh.nos Norilicton F.dcral Rc3ullli,)ns ('l lc40, Pur6) <br />R.!uirc,l l.(cr ol Nor'lLdiI <br />-l <br />cdrry rh,t rhc lcdcral,cBUl ions rcs,il,ng ash.{os rcrNvllarc nor rpd(ablc ro tht B,F.r <br />Xl.dr ),hr r r..^'.',rr,r.'rrd.(J,k,d,r.'.'.rr',r'..'h.r. tr,{n r1, <br />,',r.1.n"n..\ J*l srd. L$\^Lr'ri r.hd'l,l'np. tl.rru.'nin. d ht,.h, r. h{rc <br />n corccr.I asr.d ro coDrly wilh all Ciryand colnly <br />nurv.i ofrhF Ciry lnd Cornry h cnt.r ut'n thc <br />rl Y. Nlrknnal f'oNnv ntr r\tf.l!{l <br />wnfiD <br />IWN <br />t ftrcis AJL,IC$:- <br />^,., Yra lzd9 <br />=