|
SITE-WORK COMMENTSDATEID/SIG.
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/Vent/l nsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />l\ilaso n ry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Repofi
<br />Flood Zone Certif
<br />FINAL Al?? ltr-[TN'//'t
<br />Certilicate of Occupancy t
<br />Notes, Remarks, Etc
<br />OWNFJR BUII,I)trR DE!,CAR,\T0N
<br />I hcr.hy riirnr trndcr ltnrht .f Nriury rhar I m cx.trrtr fron rhc Coita.rtr\, Liccnsc tlr lor lhc l'oll.wing rcrv'n (Scc 70.11 5
<br />Businc\s lkt Prcl!(snn CoJc): Any Ciry or C.nnrl,which rcquitc\ r lEflnir lo condruci. ahr. nryrovc- dcnblnh ur rNn rry
<br />{tucrurc. p'iff xJ ir\ ilsoui.!. al\o r.qrnc\lhc applicr fu \u.h p.rnir ro lll., sig.cd {.rcnrtrr rhd h.or slrc is liccn\cd purulnr
<br />ro thc Frvl\n rs orrhc Cont{crr'r LiccnsLi ljq (Chrplcr 9. Connncncins $irh Sc.ln,n 7{x)0 of Divi\io..l oi rh. Businc$ tr.d
<br />Itolc$ion\Codc)orrhartEorshc i\ crrnrpr rhcrrlioma thc hr\is lbr rlrc ilclcd.rc pri.n A.] vn,hridroiSccrionT0ll5byrny
<br />drplicrn' r.rrpcnnr suhjNt rhc aptlic nr to r.ivilNnalry.rmr nNrcrhN live hundrc,l d.ll{s (!5(x))
<br />l.rs.qncroilhcpropcnr-ornlycnrnloyecs*ilhNrrcs!slhcnR,bc.n[cisrton.srlldorhcworkdndrln-imlr!is.ot
<br />i'ncnd.{l or oilircd ftn *,lc ( SN 71}.1,1. Btr\i',c$ rnd P,olisn,n\ C{xlc Thc Cofirttr's Liccfl{ tiw J.cs nol mrly lo u owncr ot
<br />rhcpn,Fny shohild\ormlyovcrrlf,tr\,.rrldwhod&\su.hworthitrscliorhcr*llorlhmughhirorhcro*nr fl,'yccs,
<br />F,vidcdrhrrsuchip()rnri(rctr.ri,clcJ.rollcrcdlnrv,kllhNcvc'.rlrhtrLldi|A.rirlyovcrEnri\sklwirhinon.)r{
<br />olco'nptrhn- rhc O*rcr Rrildcr willhnr rhc hrdu ofpniving rhd hc or sh. did tr.r btrikl or nnptuvc rhc lm,pdy lor rhc puryxxcol
<br />i-_
<br />l(lt. * """*,,r't n.r",r. rm c\.|tr\ilclj .nnhdnE *irh liccn\cr Ndrr.Ltr\ k, rotrsfl.r rrr Di!(cr (scc 7or-r. Businc\\
<br />inJ Pnnijsvr Codc lhcConr..d'sl-i.ctrrcLlsdoc( or rpplyr. rn o*mr ol'p()!cnr Rho huild\or nnFo\cs rhcrcotr.
<br />3nd il.(r .u B.r\fu\khpn)].!GsirhaC. ruct,n\)liccn{d N^un[ t)rhc Conrrdoir Licc.\c lrs)
<br />I rrrx. ,t, uidcr Sc.rnr .8 & PC lirl
<br />tt lllto
<br />I ho'rhyrllnn,u .rDcNlr!of nr4u'voicof rltt,lld\nrxd(
<br />lhrrrMwill rnnrir Ccdrli.rcolConscnlloS.llrlNUrclnr$.rleri.omntr\rri(n,.rsfnividodturhySdlnrS?lx).lrhc
<br />lrtxtr C{xl!. turrlt pc onnrkcolrlt u)* fttr $hi.hrhc ltrrnlr i\ t(u.d
<br />-lhrvc.ndwilln
<br />irhirql crrconD{nsali$inrurJrcc.rsrcqunJbtscdn :lTlnoIrh. LltttrCod..l.rrhc pcrfonr!,ncc ol
<br />rhc sork l.r $hich rhisrcrmiris issucrl My*orkcn co'nncnsain,tr inrurrn.c oricr drl Irni.J_ umh-ttc:
<br />Cntr
<br />-
<br />Poli.yNtri Er
<br />-!rfnr\!!l rnny rhrl nr rhc psr'oijruncc oirhc work lnr which lhis rcmir is issucd. I \hrll tror cilPk)y.try Nron in in] mulncr
<br />v, x\ k, t*.onr ubj&r b rhc trorkc6'.onr!.nsnttr'n laa\ ofCdlinrni., itrd l'8ec rhar ii I sbuld iEo'rc shrcd r, rhc
<br />wurkc^..rtreri,nrtr.vhio.s.lScctionlT(X)ofrhclrtnC.dc.l\hill.l'onh*irh.omplywirhrhorl,R,vi\ions
<br />WAltNtN(): l,rilurc h scurc *orkcF co pcnssrn,i colcmlc i\ lnln*ful. d \hnll subj.cr ar cnrployc! lo qi,nin p.nrlit\ ud
<br />.lvil ,nr! np t, otrd hun'i.cd rhts nd dollx^ (SllX).(XI
<br />Sc.ri,rn.ll)76of rhcIxhnCirlc,i'ncrcnn LlIoniry\ ltcs
<br />,). m rddiifn ro rM.r! (rr. damr8.s r\ tnrnidn n)r rhr
<br />altJo
<br />Ihc'Lbyrinn'u .r pc xlryoI,r'rrtrr_rh lrh lnrN.d r trd$ tiro\i\i(rl (L, trr.n.in! \ th Sr(ri(nr liri{)).1l)r\r!trnr I
<br />ol rhc BD\incs nl frnr\\i.n!Codr. rnd ,y li..n\r n in fulln)rco 'ilrllc.r
<br />Licctrsc Clas:-Liense Numncr:
<br />D.l.: Contmctor:
<br />c() SIAIJCI]ONIENDIICJ(iIII1:I
<br />Ihcrclry.llirm ndcrpcnalryolrcrjuryrhlrlhcrcnrconnrudionkndinsuscncyr rhc p.rrorn rc.rthcwork fo *hirhrhis pcnnir i\
<br />nnnl rscc 1097. Civ C.l
<br />AIELTCANLI]ECIA&uI9N
<br />I lmby dlnn undf pcnalry ol J)cttrry onc oI lhc n,lhwtrr dcclarnrt,ns:
<br />D.nmlirdr Pcirnirs (h.{os Norili(ation lrdcrrlRcEul.tion\ ( litlc 40. Pon6)
<br />R.qund brtdof Nor'h.8idr
<br />l..nil_vthotrlr lcdcmlrcCUl ions rcgardirs lsbcsros rcmovrl.rc nor trPplical'lr l. rhis pn,j(.
<br />tslccnilyrhlrIhrvc.erdihslpFlicrrionnndsarcrh rhcrlnlc inrorn ion i\..mr. I rErc ro conDly w h Brr clry arl coonry
<br />onli'[mc\ rnJ Srrrc l.r$\r.hringt' hrild rN.onnnrrrn)drl hfcbt durhorizc rcDrcstrrrlircs ., lnn Cirylnd Coriry ro cfr$ utxltr rhc
<br />uho\c nr ionql po,rdy lbr iost .ii,n, IurF'\c!
<br />ADpli.nnl or A*enl SiAnaIur.
<br />e ilqr
<br />blt ltA
<br />BUILDING. INSPECTOR BECORD
<br />Brown Coat
|