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SITE-WORK DATE IDiSIG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq
<br />lnsulationi Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry OK /O q,*( q /rl,e /1,lA r'a
<br />Pool Fence hU\*[rtl a 'lw /".r\!
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />FINAL ilz ll9 ,U.l4/o
<br />Certiticate ol Occufanry -7-
<br />Notes, Remarks , EtC.
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<br />BUILDING. INSPECTOR RECOHD
<br />olvNER BUll,DER t)ILCARAll0N
<br />Ihcr.byxlrirnru cr pcnnhy (n l,crjur, rhrr I lnr.1c |n lro.r rhc C.nt!.b6 l-rri\c lnw r(tr thc hll,)si'ig ftr\ (scc?{rrl5,
<br />Bu\nr\s rd Pnitc\si{nr (idc): iy C[t .r Counry wh;ch r.qunc\ r p.nnir k, .otrnni.r. rlrcr. nun)vc. d&n'lin' , | (t',, : tr)
<br />nru.rur.. pri{trt) ir\ i\suxncc. rlso.cqtritos rhc apnlic r ttr \uch runnir b flc nslSncd nll.nicnt rhrrhcor nrc is liccn\cd ptA[ul
<br />ro rhc |[ni\ios ol r1r (onrm.rois Liccnscd L.$ (Chr|ns 9. Conrmcrcin! lirh Sccrnnr ?(xxr oi l)ivi\i{ .1 .l rhc Btr\ir'ils\ rid
<br />a!pll.rnl LrrNrnnr subjc.h thc iftlicrDrlorcivilJ,cDrlryoff.rix crhrtr livc htrn(lrcddollfls(15U))
<br />L N .wncr orrhc pmp.ny, or nrycmplorcs wirh w,8c\ as rhcir <,tu co'n1,..\alior, willdo rhc qort rld llE (ndurc is nol
<br />inrcnd.i or oficred for slc (Sa 1x4- Businc$ and Pr.fcslions Codc Thc Conrract, s I -iccn{ tlw d(f,\ nor Etpl, k, rn .smr or
<br />rhclollny wh. h{ilds o! inrltorcs *rN!. !0n who d@s (hh qor* hnnscll or hcrslto! rhnueh hir ar hcr o*ncmnbyccs.
<br />ptuvidcd r har such irynovcftnis m nor iin.ftlcd or orcrd f(r slc lf. Ix,*cw, rh buiuhS or irqrovcrEfi n qnd withir ooc )ru
<br />ofcoryhrion. tlE Owrcr Builtr willhare thc budenotrovnl8 $arlror shc dii ml hui or nrynrc lhc F)pcn, ftn iht pnry,{ or
<br />l-arowncrolrhcItrotcny.u.rclusnrlyconracrin8sirhlrcoscdconrcroFkrcon{'xcrrhcpn'r..r(S.70lt,Bustrcs
<br />lna PlD,a$to. Codc: Thr Conlrrcrofs Liccnsc k8 docs nor ap,rlyt' rn o$ns oinropcny sh,) 6uilds or nq'rcu\ rhcrc.n.
<br />rnd sho.onrmchlorsnch!6jc.csirhaConrrucro(\)liccnscdp!^da k,rh.contrttr\Licn*L2s).
<br />-l
<br />rmexenpr lnder Secri.n- B &PC forlhisru$n
<br />tva8rE&::r(]uflilsarrlr!
<br />DICLIB6.IIQN
<br />I turcby rninn trnJs pcnrlry of p.rjury oic ofrhc fdn,sin! delirJri,n,\
<br />-l
<br />hitr nd will m.inhin a Ccn ilEarc of Coosenr hSclllnsuElir trorkcF conlpcnsalioo. a\ pmvidcd r{tr bys.crn,nlT(xJorrhc
<br />hhor Codc. lor lhr pcrformmc of rhc worl for shich lhc lcml h nsucd
<br />I hav.aodvill msintrin workerr.omp..\rrion inskrncc. r\ rcquncdbyS(rtun:t7tx)orrhctititrCodc,forrhcpedorunccoi
<br />rh. work f{r whih rhir p.rnrir i. issucd Myw.rkc^ .onrp.isdnnr insu. .c.rnicr md!.licynun$cr c:
<br />l..diryth r in rh.lcrlormE_c ofrhc workld which rh( pcrmn is issucd.l shallnol cflrpk,yuny pcr\on ino, monNr
<br />s slo bcom sh]cct ro rhc wo,kcn c.mpctrsarion laus olColil.rniu. md as'cc rhar irl sk)uklh.co . sxhF.r brlf,
<br />workqi ompcnsation pruvisions or Sccr ion l70O ol lhc Latnr Cotlc. l \h,11. firnhwirh conDly wirh rhot ptuviri.'ns
<br />WARNINC Frilurc b rcurc sorkci\' .oipcnernnr on cmflorcr ro siminll pcDhics and
<br />nu't'n. drru8cs $ trnvi.i.\i ior rhc
<br />S(rtrr.1076olrh. lf,}inC,xl..inrcrc{r d.r
<br />I hcrchy ,fln undcr Ntrxlry or p.rjDry rhar I m lr.nrd ,mvNion ofCirprd I (comnrcrcifa wirh Sccri.n ?0{[roit)irnion ]
<br />oi rhc Busincs and Profc$ion\ Code. {d my liccnsc t in lnll l6rc ud cfticr
<br />I hctuhy irfii,n undf rtmxy or p.rjury rhar
<br />nsuddisrc 1097 Ci! C )
<br />flcri Lndiu igcrcy h hc Erlonnin.c oilhesork li,r whichrhn t^-nniris
<br />AITUIANLDEI]IAAAUAN
<br />I lmhyrlllmuRlcr l}cmlry ofp.rjurt onc ofrhc tullosi.g d.clrarnns:
<br />l)cnn,liri,in l,cnils Asbcsros Norifi.rri,,n Fcdcrrl R.suhrnnrs (lirlc4l). Pln6)
<br />-Rc!uicn
<br />l,crrcrol N.rificdi0n
<br />rhd thc ihrc trif,rnhti, i\.o'r..r I x!r.. n,.onrdy sirh rll ( irt r (,ntri,
<br />horiTcrcnrc\ctrrr1ilc\ol rhi\ Ciryrnd C trnryn) c rcrrtrfrhr
<br />Sublloor/Vent/l nsulation
<br />Flood Zone Certif .
<br />f.d.nl rcgul.lions rcBrding ish.n.sr.m.vrlr'c n.rrmlicihlc to rh fmF:t.
<br />I
<br />i9ol SrSq
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