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<br />SITE.WORK lD/slG. i COMMENTS OWNIR BUILDER DElr('ANATION
<br />I hd.t y ,rm undd Fnslly of r.rrury lhn I o d.mP liom rh. Conra-loB l. ic.e L.s ld
<br />'h.
<br />foll,sirS .Nn (5(.7011 t
<br />Ircin65 !.d Prcfsnrn Cod.): ny CiU or Cou y which r.{ut6 a FnI lo co.xtud, !1t6, introvc. .lqtulilh or EP.n dy
<br />n'!c1u.. lnor r. irs Buan.., aLo r.qur6 th. .lplicMl lor sucfi Fmn lo filc ! lisftn nttod rlld h.or slt i li.sa.d pd@rl
<br />h rh€ Eor6iont of rh. Conr*ld 3 Lkds.rl t $ lch,pld 9. Com'min( $ nh SalFn 7000 of Dirisi,n I of lh. Bsi.* ud
<br />Itofsio.s Cod.l.r thr! lE or $. i! dcnpt rh6c&on od rhc b&sis lor th. dlqlcd .i60io. A., liol.rionofs.drcn 70.1I 5 brd,
<br />!lDI'+ for a ,,cml .ubral! 'h. sprlicsnl to acililpoatlyofnol oocln n nv. hunrlr.d dollrsIl5O0).
<br />- l. & o*nd otrh. FoFn], .,r rt .nDloy6 virh *0$6 s lhcn Fl. comp.saton. *ill do lh. \ t !d d. sME b tut
<br />i.rdlcl d.lto.d ,or elc (S( 701.1, tlusirG dd Prolsns ( ck In. Co.r.d.rs I Em* Las &a ml .mly lo D o$E of
<br />'h.F)r'd) uho hril&or nn0ror6rlE@tr ed sho &cifths! hims.lfor hdlfor rhouShhis o.ho ost.nploy.6.
<br />trorid.d rnll ru.h mrmv...! s & ml d.nj.d d, olrsc! rlr sk ll, h.wd, rh. ttiuns ot rprorffi is $ld rthin orc 16
<br />ol.on4Jl.1i).. rrE Os 6 thiLl, will h.Lt rh. hrb ol FlvinE rhd h. or sh. rtil d tlilll or imFov. tnc Flpdy tor llE purrr ot
<br />l. s ou nd .lth. FoFrr.. M .rclBncly co,r.lcrins * irl' l'(cns.d contkkrB lo .oNlrucl lh. proldl lS{ 70{4. U6mN
<br />aid ltor*ion ( od.: Th. C..lreclofr l-icos.l,a* do6 nor aFply ro M osn6 ofrrop.n, qho build!or 'mProl6 rhdo,,
<br />lnd trls ed6ds for $ch Foj.ds snh o C.rnI6donel licoN.d ,{rsur tu (h. (}nhrdoii Li.@ t w}
<br />I m.r@pl unJd sftrio.
<br />D.re Orn.r _*oirKFrii' coitPENs rtoN
<br />DTS,AAAIIO!
<br />r hdcb nmm und6 p.n.ny of Fjuo rN olih. followln8 dccltralioN:
<br />, I hrv. dxl rill rai.rdin r C.nilic{. olconmr h S.ll-lNuE fm edtd conFtsdio.. a F$ridcd lor by Scthn 1700 oltlE
<br />l*or Co<lc aor rhc Ffo.iler oarh. $o,l id utich lh. pan ii isu.{
<br />Ih.t a.d wiu moi.rain $ ork6 comFGarior idur&c. s r.auir.d urL Serio. 1?0o of lh. llbor Cod.. for lh. Ffoil@. ol
<br />rh. tr.rl lor $h{h rhi! p.rn ir Bsugl. Mr wo'l6 'o p.Bd'on rBLrMc.cnid MdFlc) numba s.,-* . KE *@k(A/u . /
<br />pu,rc1,{umbcr, L6Gt}-2V93,*,*- 7/r/A{
<br />I .6t ily lhir in rhc pafotuc of rhc eor\ for $$th rhi. Fnn is ecd I shall ml ddoy tny pss. in o, odN
<br />$ a ro b.{o6. $bjd lo thc md6' .omFGcion Lss of c.liiodi!. 4d ,aE lhal if I sholld beo,E 3ubict lo ttF
<br />sorl6 coopcefio. prcvtioE of S6lior l?00 orlhc ldor ao&. I slEll fodh*ith 6n l, *nt rb* FolbbN.
<br />WARi NG: Frjlur.lo sE $0116 comFsdion corqac. a uihwlul. .nd rh,ll $bj6t 6 dploF lo aihioll D6rXi3 tt4
<br />.trll ntr.1 u! nr ok hun,I.n rnolsNl dollas (tll)o.0or)1. $ add'l t) rhc .oi ol ronrNnsrlon. &$a!.r ar plovJcd (tr rhr
<br />Sebon:1076 olrh. ribr C rnts6r &d arorq-.- \ f6
<br />I tdcby .rrn undd p.nant of poiury rhd I m ltdB.d unils F!! 6ion of( lupld 9 (comm.ins $ ith sc1iln 7000) of Divisior I
<br />of rrE llrbs ed Pbrsiotu Co&. d mv li.e is in tuI for.. {rd .fi<1.
<br />.".*.*, . -F I "n"v 6a2sj /
<br />".', . S{: {{aaa <.'r-cr..x
<br />callla!]cllaulEll)llc-dcrrcr
<br />I hdlb.v.lfm und.r Frlry olFrrory lhd llE ir ! olEruclbn lddins.sdc, lor dE Flomrc oarh. *srl tor {lich lhi! p6tni i.
<br />isu.d(56 1097. Cir. C ).
<br />taUn r Nam.
<br />ilI&l(ANLD&cLl8 Ixr!
<br />I hd$y aifnn undd FnaX, of pcjuiy o.c ua rh. follo*in8 d(ldo! ions:
<br />Don6hion PnnirlAstErd Nolifico!ron l.n6al R.rulalnin! (Tn h 40, Pd6)
<br />R.{!tcrl trlr- ot Nonfieio.
<br />I agen, (nnpl,'s hill(iryardC unr,
<br />dir6 olrnisC y d ( ou.ry lo drd !po. rrr
<br />ator mdroo.d plnFn, aor iNlErior
<br />\pplic. r or.\gsr Sipn.tu'( )<
<br />P.flnile Dnrtprt'l): *u ("tr-
<br />-"'{tl@
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subfloor/VenUlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drpvall
<br />Ext./lnt. Lath
<br />Brown Coal
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif.
<br />I I r)
<br />FINAL ll 470 WDt\Certificate of Occupancy
<br />Notes, Remarks, Etc.
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<br />BUILDING- INSPECTOR RECORD
<br />DATE
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