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BUILDING. INSPECTOR RECORD <br />SITE.WORK DATE ID/SIG:COMMENTS <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />Roof Sheathing <br />Shear Wall <br />Framing <br />lnsulation/Energy <br />Drywall <br />Ext./lnt. Lath <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 tifr ?&, ) <br />Certificate of Occupancy U\ <br />Notes, Remarks, Etc. <br />ttl <br />-. <br />OWNER AUI LDER DELCAI{A'IION <br />I h6.b, aflim lads l,aally of !.rjur.v thal I &. cxdnpl from thc Cont..to6' Lic.nsc Law nn lh. rolbrvinS ,@n (S( 70ll 5 <br />B$i,6s and Profsion Cod.): Any Cny or Couly snich r.qut6 a lEmii ro co6tru.l. alr6, inprove. &nolish or ep6n dy <br />etuc1uq |,idrto ils issr&cc, also ieqo ire thc appl ic i.! aor such p.nnn to fil.a sig.edstatmdl thfll h€orshe is li..nsal pr$anl <br />ro rhc preyisions or rh. Cont0cro.r Lic..s.d br (Chrpr6 9, Comdd.inE snh Sdiion 70(x) of Dnision I of lh. Busind dd <br />PrcfcssioNCode)orrharhco,sncisqcmptrhseftomrndrhcb6islorth€aUcsed.i6f,{ron.Anyrioldrionolsc.lionT0ll5byany <br />arpli.ad for a p.mn subjerslh. applica lorcivilpc,allyofnorhoreUanfiv.hon&.ddollds(1500). <br />I. s oMoollhc pmpdr, ornyanplo)6 wilh *aB6 6 th.t sl. compcNtion. rvrll do thc worl ad tc srx.lm is oot <br />inh{H or oirced aor el€ (Sc 7044. Busins sd Prcl6sions Cod€ 'l he ( on ack 's l-icde La* do6 nor .pply !o an ornd or <br />rh.ptup€ry s,ho trildr or nnFov6 ficon. ,nd who do6 su.h \od( hinBeli or hc$l I or rhrou8h his or ho oro .opnry.cs. <br />povided rhal such i.nlr.v@rs e mt i.rdd.d oroflir.d for el..la. hoN36. thc hildins or ifrpmrmr is $ld rvhhr on€ tqr <br />olconuldioo.th€(hvnsltuildsrvillhavelhehrddorlrovinsthllieorshedidnort ld or imEov.lh. AlFly fo.lh. p!ryoscor <br />_1, s orw6 o i rh. rropdy, e exctusn cl, conradinB wirh licnsed conrfldots ro consrrucl th. rroj(r (s( 7044, B6ine <br />and trDlsion Code: 1 he Co tacrols Liccnse La{ do6 rct apply to e !* nE o r propdy $ho builds or improv€s thqeon. <br />dd who co.rEcts aor such prcjdls with a Cir.trdo(s) li.msen puB@r to rhc Conrncrori Li.tuc l-as) <br />-l <br />@ crcopr 6dd Sdion-. B. & P.C. for lhii lEen <br />Drt.: Ortr€.: <br />]!oa[885:COurE!SAU0! <br />DICI,A!AI!g! <br />I heleby.iltm under pcnahy olpEjuryoocoflh. rolbtria8 dsluanom: <br />lhav.ddNill,mirtainaCcnificareorCons.nrroSclf-lnsuGiorwdrk.re'conrp.nsabn,spmvidcdforbyS*lion3700olllE <br />tibor Codq for thc Dsfomrmc€ olltu sork tor which th. D6mil is Gucd <br />_Iharcand{illnainrainwo.rsco:np.carioni6uanc.,6r.qon.dbySdiotr1700oflhcl,borCodc.forrh.Poaomwc.of <br />rh. Nork aor which rhis pcmir is isued. My *ork.^ .oinpc@rio. iGormcc cni6 ud policy numbcr t <br />I cdilrthar in nE psformanc. of thc wo* forvhich thisplmit is issu.d- I sh.ll nDr dnploylnyp.uon in anynrn'6 <br />$ ar !o b€.oo. subjdr ro rh. wor[6' corrFerio. laws oacalilomin, ed aSrc rhar it I should b€(m{ subjer lo rh. <br />worl6' omplMrion provisioG ofs-tion:l?00 olrhe t$or Cod..l snnll lonhrilh co'npl, $irhlhoe pmvilions <br />*ARNlNc FailoE ro suc uo*6' comp.Nrion co!€6sc 6 unl.Ntul. dd shall $bjet e oplotd io siminal prEhi6 ad <br />civil fincs up 10 o.e hundrcd thousdd dolle ($100.000), rn addirio b rh. cosl olco,np.6arion, dhag6 6 trovid.i lor rh. <br />SN.'li.n 10?6 orrhc tixn Cod. inrdcr bd <br />l2itLrnBrM.f <br />I h@by.fito und( poalty o t pe'rury that I ron licqscd und6 pro6io. olChapid 9 (commmcioS wilh Setion 7000) oaDivision l <br />ol rh. Bu5in6i dd ProlsioN Codc. ad 'nylicme is ifl tull torcc dcfi{t <br />7//2A/ <br />I heby am.m undcr pcflally ol p€rjury thar rhdc is a conslruclion lendiis asdcy fo. rh. pdfomanc. ol thc uorl fo! s hich tB pdftn is <br />isu.d (Sd 1097. Civ. ( ). <br />AIILICANIDfq.AAAIION <br />I lE$y amm und6 pdally of Dgjury on€ of lhc followin! dcclealionsl <br />D.molition P.nnir$Asb6ros Norific.t ion rcddal Re3ulat ions ( rilE 40. Pan6J <br />-Rqun.d <br />hrd oa Nolificarion <br />-l <br />cslily thar rh€ f.dsal r.sularioE nsddinr 6b6los EnovEl &e nor appliebl. ro thir prqc.l <br />i.. anJ shr. thd lh. abv. inlomalio. is corst. I asrE to comply uirh ,11 Cnt and ( ounly <br />fthis Cnyed Coum, to mt6 upon th. <br />^," 7l-,t/-tB <br />ion, md h.r.by.ulhorize r qrBataln 6 o <br />--}(*a Zz'><< <br />.- <br />Subf loor/VenVl nsulation <br />PolicyNumbs:-Erpir6: <br />hldu-