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SITE-WORK DATE ID/SIG.COMMENTS <br />Forms/Steeli Holdowns <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />Roof Sheathino <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 />/r{ <br />FINAL ,(|L 4 \ r+-It) <br />Certificate of Occu <br />Notes, Remarks, Etc <br />OWNER AUILDER DELCARA'f ION <br />I hcreby ailjl n undd p.nahy ol psjur-! lh3l I m exdnpr 6on th€ Conr'acroN Liccns. liN lor lh. rolbsi.s t@n (se 70.1 1 5 <br />uusiness and Prol6sion Cod€)r Any Cily o, Counly Nhich rrluirs a p.mn !o coBtrucr, alrd. i6prov.. dmotish or rop€n uy <br />srtucru. For lo il! i{suMc.. .lso Equir6 rhc al)pli.dt lor su.h p.mn b nlc r siBn€d srordndl lllaI hc or sie G licd*d pu6uel <br />ro rhe pmvisions of rh€ Conrracroas Lrc.n*d l,rv (Chapr€r 9. Co'nmcncnr! \irh sdrion 700tr of Dilirion I oflhe asin.s and <br />holcssionsCodc)orlharheorshcb.xcrnfl(hdcannddIlrb6lslorihcalleg.d.rcmption A.yviolalionors*rion70ll.5byany <br />lpplicanttoraFDnsubjEsrhearplicanttoacivilpcnaltyofnotnorerhanlilchund&ddoll4($500) <br />I, s olvnd ollhc l,oFny, orDt cmplor€* wnh waU.. s lh.n sle conrpdBaliotr. rvill do lhe\o* ed lhe srrudrt is n.r <br />i m(H or ottqed fo. ele (Sc.704t. tlusioG ed hof6sions Code -rhc conr,.lof s t-i..N t2rv do6 oor apply lo M oMd oa <br />rlE popdy u ho hilG or i'nlrov6 rh66( ad * h. do6 slch work hinself or hdsclf oi rlmush his ot hd own onploy.e. <br />prolidcd nlal such impovdno$ e ml inr6d.tl u ofrstn for salc I I ho{ds. thc buildins or nnprovdicd i. eld wirhin on. ,d <br />ofcompLrion. the Ownq Buildg siU hrve $€ budcn olFovins lhal hc or s1l. did @l l ldor inryo1.fi.pmpcvturth.pulo*ol <br />-1. <br />6 owncr oflhe plp€ny. d cxclusivcly coniractins silh li..6.d .ontacro6 ro coattud th€ ,,oj.cl (S( ?044. A6ins <br />sd Alfsioncod.: Th.Contractols Lic.ns€ Lrw do6 nor .pply to ow.d o I prop.ny uho builds or inpo!6 lhd@.. <br />and vho conrruls for such !.oj..ls with a Conhclo(, licds.d pusudr lo thc ( onlBclols Licmc bw). <br />_l ur .xcdpr undn S<to <br />]!1latr[85]g)!lt[Nir!.1!9!DEt!!!{l!o! <br />I lulby rfln$ undcr !.nal1yol'pqluryo.colrhc aolkJsinE dc.leations <br />-l <br />hav€ ud \ ill mainbin a Ccnin.alc ot CoEmr to scll lNur. lor sor t.B coNrensllion, a F.ridcd for by Seclion lT00 orrhe <br />t,abor Codc. lor li. psfomanc€ oalhc sorl lor {hich th. pnil is isued <br />x har. ind sill mdimiin r orkc6 co,npmarion istrr.nce. .s r.qoned bv S(liq l7L$ or rh. lrhor cod., ior r lE pdfonnan.c of <br />U;7;D OtolSo*+7t> <br />"'",",.*..(a1y'9a9@ /O, <br />lc€nifythal i.lhcpelonnaoceofthevorkforwhichthisrEmil is <br />$ a <br />'o <br />bu:o'ne subjdl ro rh. *o*as' comp.Mrion l,wsoaca|aomi,. <br />trsucd. lshil orrf,[L()) n <br />'har <br />il I should b€.onE subjsr ro rhc <br />{.116 .onlpmarionpoi3ioBofsdrionr7mofrhcbborC <br />lV ltNlNO Failur€ to Kurc \ork6s'cotopcns ion cov@!€ <br />rhouqnd dollars ($lO(J,rxl0). <br />I h.'cb rllnn, uDd.r p.Mlr! ni |c'ju\ rlrir I rr l.tD\.J oachaptd 9 (connnocinr ivilh Sc.lion 7000) orDirisn n:l <br />ol th€ B'6in6s .nd lroasFns Cod.. ud <br />'ny <br />|cdse is i <br />O <br />t_/?/D, <br />( r)Nslxl( rx)N l r.Nl[\r] \(;1.\( \ <br />I h.Eb, arm unda pdBty ol pcjury thd lhs. ii a ain^.tion lqdirS .8try lor lh€ pqfommcc ol $. wort br Nhi.h lni! Fmit is <br />tsu.d (Sn 3097, Civ C.). <br />AITIICANLDDCLAAAIIA! <br />I ndr4amm unds p.nahy olpdjury on oflhc followinS d(leations: <br />Dc6o lil ion Pemis Ashsros Nori6cario6 F.dd.l Regul, ioN ( l ill. 40, Pd6 ) <br />Requt d Lllrdof NoliE.alion <br />-l <br />colilythat rlrc l€dsal lcgulationi roNvel ar. nor,ppli..bl. ro ihh projst <br />is con€(. I asre lo conlljly lvith.ll ( nyard Counrr" <br />t- <br />r.r,r6dtrivB o I rhis cily .nd connly ro 016 upon rh. <br />BUILDING- INSPECTOR RECORD <br />Set Backs <br />Subf loor/VenUlnsulation <br />@t <br />I