|
SITE-WORK DATE ID/SIG.COMMENTS OWNEtr AUU.DEX DELCAI ArcN
<br />I rrehy .ltum ldlr FMh, t'r FrJory rh.r I m .x.mF rnim rlE (l'nltuk'F Lr.n( L.w nn rh. lolb*lr8 E,b. (S& 70.11 5
<br />Aunn.$ url Pnnc{$n Cd.) Any Ciry or (\utrry whlh Equirct r rE rl, !o 6.{ocr, rlrd, i,{hw. &mlirh or qrir dy
<br />ntur@. I'rr h nr ! sr. lko Rqo6 rlr lpphr! turuhFrh, roukrri!F{ n.rmr rh.r lEor {r ! lithrrl Fr{d
<br />r{r rhc F,vrtr,n. ol ltr C.nir..lor! LEcrrd ljw (Ch.pr., e, Conmn.in3 * h Serk,. 7fin ol Orvrrn I or th. Busircs .nd
<br />Pn .srh! CnL) d rhrr h or tL s d.mar ih.itfnln (rl rh. h.rlr fd rlE .lh.tl .r.q'ron Any v{ .r m ot S(r.n 7{l.l I 5 by my
<br />.pt r..nr {n . Fmrr rubJ.ll! rlE .rf,lf,er nr . .rvil FBh y or mr m)c rh& hv. hudEJ ddlE^ (35m).
<br />_1,r\ o*Fr orr& FbFdy.,r ny.m0hF wnhw.!.t.irrEr$Ldl,lfEtr{lon.*!!Jorlrqxi!nltt{EiR!nn
<br />dctriol r.n.Ed ritr s]. (Se.?0,1,!. Bu!r( .rd Pn{.sk)n! (lrL: TIE CodBloa i t-r..s Lw J&r n, .lt ly lo !n owr or
<br />rh. nnlFn, whr hu .k or 6tmEt rlrE[ lri wb&.r s-hqnthmrclf or h.rclf or llNuth hn or h.r o*".ndoyftr.
<br />poqLJ ih,r 1Ni ml'okmd\ I ri ddh! tron.Fl tur qk ll. lrlM. rl: tndlu{ d qFNmd 6 $U erhrtr F{
<br />ol cont'hu, rtE O*Er Butlt r *{l Mr rtr ltunLn.l Fl,tuB rh.r lE o' {* Jrl n t ll, or urFlE tlE In{Eiy ftr tlE F[F)E ot
<br />_1. r\ o*mr ot rn pnln.dt, ,m .r.lui 'v.ly $drar m3 * h i{n{d .odr.4,6 b .dn{d.1 rlt Imj.tr (Se 7(x,1. Buws
<br />al th'larvr (lrlcr 'I lr Con[&rD.i l-rcn( L.u 'ld. Dl.ttply t' s ovmr olprcItny slr' buihll or 'mPn,v.! thcrd'n.
<br />rxi *hl $ zirl{ruhF,Frt* h. (i,rnnfn lr.nGl tlo^unr h rlr Grktutx 1 l-..nE li*J
<br />lmctchfl und.rS{!i,n
<br />ruaf,EBr-.cAlTEEMAItqN
<br />OECL IATION
<br />I h.rchy .rl,rnr utuLr n ndty ol nsjury om ol lh. followuS d.rleti,nr
<br />I h.r rrd wru nEdd r Ccn if.nc.l G'.E.| t' S.lllN!rc ntr k'rt6 urmcndrr r I'.vral ft, byS&rh.:i7mof rh<
<br />l2htr Cdlc, htrth. Frf,rmBc ofrh. *urk f(tr whrh rh. fEm s tr.u.d
<br />_l hrw .ul *'ll mhr.h *ort.^' .onFngr$n iEu,rEc, r rcqumJ by sd rn ]rm or rh. L.lDr CdL, tr I lE F irne. oi
<br />th. ktrttq whrnrhrFmn r! Rsudl My worlc^ $mFnritr). iniuruL. rrbr.fl! fblay.!mb.r c:
<br />Polky Nrn$.r:_
<br />l.cn,fyrh.rin'h.Jrrtbrfln.c(nrtu*o nx *hEhthnFrmrr n nsucd,I rh.ll B, ctr{'k'ydyp.R,n, My herr
<br />$ rr t, E$m \uhFr ro rll mrl6 !r'n{Enut&. L*t ol C|linrlrL !,ri +r ift:r lf I rlDU! lxaod thFl lo llE
<br />*o*.ri.onrIin\rintrpn,vtr(,n:o,S.(tronl'rrX)orrh.lix,(irl..l\hrll.nr!hwIhc(
<br />WARNINI;: l.{,lurc k, ccurc srl(cB ll,mlrni.r{n
<br />cp rin. un ro or hu lr.d rlruqrn dola (tl ol6niEnqrn,n. dm!.r ..
<br />3 7
<br />DECI.^IIATION
<br />I lEEhy rram unLr FMlty ol JErr[y lh, I .n lE.in unj.r F)6,r of Cirlrs 9 G nrlri*o8 * h Sdbn ?u)) ol DNtrtr ]
<br />of th. Buift* alxl Pn csqrnrCod., lrn mylrcns tr m tull loru rni.ter.
<br />CONSTRU(-TIOIT LINDINC ACFIICY
<br />I h.fthy atlm, unJ.r Fnrlry.l p.luryrl,u rh.ft r r $hnd(rrn L.JrB rf.nr, ktr lhc |Erfomncc ollh. Rnk ntr sh(h rhls lf,mn (
<br />r\ullrse.. v)g'i C'v ( )
<br />AEEIICANI.DECIIAAIIA!
<br />I hat{t, itrft url.r Fnrr, of Fiurt oE or rh. roDoe68 .LrLnrbnr
<br />D.mUbn Pcmne^rb.iot NdifEIr,n F.&nl R.phrionr (Tnk !ro, Pd6)
<br />-R.quu.J
<br />L.rc.or Nori&aii.
<br />I dfy th. rlE L&nl EluLl Fn! E8nlo! .d.noi Emv.l e d .rDErr,L k' !fi! poFr
<br />_l c.nify thr I hrvc Ml rh'r .0r .d$n .,n (rr. th, E.rr'( mr.tuDn !r oftd l.seroo8lPlrwtnrlCiry. cody
<br />orJnrR.\ dl srar. II\ nlrlus n, h!
<br />rh,!. nrnrknkrl nn'F-ny tur nrn..otr
<br />rh! c'ry &j Gruhryro.da uFr rrE
<br />Appli(nl or ,\r.nI Si,rMluE s/iz/n
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUl nsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framing
<br />lns u lation/ En erg y
<br />Drywall
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engrneer Final Report
<br />Flood Zone Certif .
<br />FINAL ih.z,/tZ --.Mu;)
<br />Certilicate ol Oc 6rlpandy 'C\J ta.
<br />Notes, Remarks, Etc.
<br />BUILDING- INSPECTOR RECORD
<br />Ext./lnt. Lath
|