|
t hcrdby Nfllrm undcr pcnalryort iury rhdr I mcx.mB lionr rhc G)nrido6 l.tcnsc L,w ror rhc lbllowing rcN (S(.'l,ll5
<br />ausim* and Prorc$i{,. co{c): Any Cily or Coutrry whi.h rcqnircs ! ,.rnrir h .onnrucl. nlrcr' infovc. dcnDli\h or mp'n dnv
<br />nd.rurc. |ni{rr{] it\ is\umcc.ako(qunc\rhc,lPlicdnlfnnrchPcrnrirl.filc{siarcdrlrrcntir rln hc or shc h li.ctr*d Pururnr
<br />r, rhc ,$visions ol rhc Conkacrors Liccnscd L.w (Charr$ 9. ConnrEncinB wlrh sc.rion 1000 or Diltn , I ol l[c aosinc$ and
<br />Pn,fcssioniCodc)orrh,lf,orslE iscrcq,r rhcrfrtnn rd rhc l)rsis lorrh.rll.!cdcrcmPlion. Any!iolrrio.oiSccrionT0.ll.5by,rv
<br />!pplicanr lor i pcnnn subjcck lhe appli.rtrr ro dciviltcMllyolnor m.rcrhrn livc hundted dollrr((S5Ul).
<br />()llNt:R 8trll,I)ER l)lll-( aRA I l()N
<br />Lr ciemtl undcr Sccrn,n-
<br />{)PNr:
<br />rcnnil s is{Erl Ni y workes .o tx 1\rridr imurxNc canlcr d|nlicynunrb$nrc
<br />-l.a\
<br />o*mrorrhcPtulEny.orry.nDk'yctswirhw,Bc\i\rhcnvrleconlktrsrli(rn.$illdorh.uo* ttlErrtucnrn'i d'i
<br />lnrcndcd or.lllrcdlnrsalc(Sc.?01.,l.Busirrc$rndPtuies\ion\CGlcThcCoNrlcntr\l-i.ctr{l-iwdocsnor ldvkr owncrof
<br />lhc pn)p.ny *lx, brilds.r iq)r*c\ lhcR,n. rnd who docs sslr wo* hinN.llor hcncllo! Ihmu8h hn or hcr own.nfkivcc\.
<br />,rrrvidcd rhrr such i'npn,vc,tu$m frn i'n.ftlcdorolllrcd ri, srlc.ll ho\c\u. rlrhuillingor iNprorcn.ir hsrklsithinonc rrr
<br />ol.o Uhrnr lic O$ncr Bdikldi wiil hrvc rlE hrdc. of pr'!i'r! rlhr lt ot shc dri
<br />'kn
<br />hoild .r itrrrrrk rhc Polrdv lor rlr I]UIF){ uf
<br />l. rso*mr.rrh.rhtcn!. rmcxclu\ivclyco.tn(h8 wirh li.ctr!.d..ntx.rtrskr.ondrcrrhr EojL{ (S.c n,r'r.ll'Nrcs
<br />rfJ l"sla$strCod. lhcCotrrra.kr's l-rcnsc Lis,l,rs follrfltb rrowndr.lProP. y sho hllli!or i'nftvcs lh.rcon.
<br />{M qlr conrrrchlnrsu.hfloic.r}irhrCotrnr.t)r(s)h.cnrcdlu^urnrktrh(Cirnnckn\l,ir.n$l,rs)
<br />UOAtrES AMIDNIA.UQ!
<br />DSCIABAUO!
<br />I hcrchyolltrmrnJq r(nrl'y.l'n Uu )nn. lrhcl,Jl,,wtrrgdR.'lJrarFn.
<br />vlhi\c d{rlln'd JmaCcnri(JlcnrconEn usclt.ltrrrcfor*ork.*.nnrrcn{rion-tr\ lhvidcd lor hvS.trion 1700ofrhe
<br />tjtxtr Codc. nn rhc 0crl mutrc oi rhc *ork aor shi.h rh. l).rmil is hsu
<br />Vl hJlr rnd q'lln$irn(n sorLE^'! t{tr\rrn{' rn\u',trcc, us rcquncd bysccri{nr:1700ol lhc tihorCodc. ror rhc 0crr'orencc or
<br />P,fi,.! N."t",,- Tegg 1q7 i-e(Lf ,p -?- 11
<br />-lcc'(ilirhrr
<br />if lhc t)crlninuncc ofrhcsork hrwhich rhi\ p.nnir is isnr.J. I shxll tr.r .N ov itrv |tron h nny rrtflrr
<br />v, Nk,b..onr sr$jccr xrrhd qork cn' .o nD. nsxr ion hs\ olCrlironrii- itrd lgNrhd il I should h.(rr{bicn r0rhc
<br />Nort.rs.ompcn$riqr|m)$ion\olS$riotrl7(XlofrhtlrhtrC.dc.lshrll.fi)n[wirhcoDPlv*i(hrhoi-Oovhio.\
<br />IVARNINC Failurc h *.urc wort.F' co nrp. n\rr n r .l)vcrrs. i\ unlx\rrrr. rl]d \hrll \!hjc.r rn ctrInorcr h d' kl iEmlric\ rnJ
<br />rlrc cosr oi cofrp.n.0rion. dnnrscs rs.'rll ll'r.\ ur n) o . lrtrrlrctl (housrnd dtllxr\ (Sl(X
<br />\r1, 1016.iltr liiritr(in[ i'r!r.! n(lr,
<br />u*", Q'4 L{
<br />DECI,AXAITON
<br />Ihc.hyrifirmundcrpcnrlryorrcrjryn l ar liccn{ri undcr lovnion olChltrd 9 (comnEreins sirh scdion 7(rD) nrDirtion l
<br />of rhc Burincssud Prciessi,n\ C.dr, ind nry ltens i\ in tullf(r.rdtclltcr. -
<br />ve(41'
<br />i\\uc lsec :1097,civ c )
<br />l-cn(lcis Nrtr'c:
<br />-
<br />bfldd s Andrc\\
<br />a_
<br />{
<br />(I)NSTRUC ION I FNDIN(I A(;I.'NCI
<br />I ccniilrhrr lh vud rhis{!pl
<br />oi(lilraEc! and Shrc t-rwsEldin8 lo
<br />, rid nrk rhdr rhc ihtrc irl{n'n ir 1\c.n.cl lrgrtrkt.on yrvirhrllCir!itrdCoutrrv
<br />ing..tr{fl.lion. hcrcbyrurlmrnc l.frc\cnrrnt( ofrhn Ciy 3trd Counlyr. cnrcr nl'on rlf
<br />-l.rnifyrhnrlhclcdcralrc3trlti.\rc!lrdirE{sh.{o\r.nr!xlnrcNlUrPli.rhlcr,rhi\Utilc.t
<br />,\trpliunl .r ,\[r r Si[n lu
<br />L,'!r+ L+D,'"- q -k t7
<br />COMMENTSSITE-WORK DATE ID/SIG.
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/Venti lnsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq
<br />lnsulation/Eneroy
<br />Drywall
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Report AFlood Zone Certif
<br />x.v/,)u)TooL D.P/4, / bfth/"/I 1"6-tv
<br />I U V.....,
<br />FINAL 7-/o /8 a,'49,r7)
<br />Certificate of Occupancy
<br />Notes, Remarks, Elc.
<br />BUILDING- INSPECTOB RECORD
<br />Ext./lnt. Lath
<br />I
<br />AIIL&ANLDSCIAEAIIAN
<br />I lErny 0llm lndcr p.iilty olpcriury onc orrhc f.llowinS dcclnmrion\:
<br />D.nnlilion Pcnnirs AstE{os Norilicilion Fcdcral R.Sul i(,nr (Titlc {1. Prn6)
<br />RcquiEd l.Icr of Norif calion
<br />rhrr Drnridr.l p'o|{nv r,tr
|