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SITE.WORK DATE tD/stG.COMMENTS <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />SLAB Floor <br />SubfloorA/enVlnsulation lt -aRoof Sheathinq ?t/?-/2/trfl{,frWU <br />Shear Wall <br />Framrnq <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 />Enqineer Final Report <br />Flood Zone Certif. <br />FINAL 5//t/2r pry&rug <br />Certificate of Occupancy I <br />Notes, Remarks, Elc. <br />OWNf, R BUILDER DEI-(JARATION <br />Fnalv ot Fjurv lhd I m crmd tum llr Codr..loE Lkru L.w tor llE fouovitu t@n (5€.7011 5 <br />Co&) An, Cny or C@my *'i(h Equi6 r p6,ni to @iu^Er. .Id. intFD!., &nDbh or r4.r o, <br />iqscq .ko r.tuiB $. +plLd aor sh Fnil lo 6L t rign.d lldmt lhr lE or nE i! li.qscd plm,'l <br />E Cotr-toi ! l.&N.d t * ((lEFd 9. Comtring r S<rion 7m) of Gvni,. I oldr asil6 rd <br />th.r t or rh. L.rdpl lho.6om md rh. L.!i! aor th. rlLg.d daFion Ary viol ionofsElion7011.5byuy <br />$bjdt E.rrplicullo.c'vilFrtyoIn mr.th& fit. hu H &,ll,r {IJ00). <br />Fnpqry, or my mployc wnh r *6 d 0En $k conFrs ion. *iU & tll s6l ad llE sudE i ml <br />aor eL (s< 1x-{, BBiiB Dd ProrBaB Co&: Thc Codr&rMi Laoq trw rtE Dr +ly ro e orE of <br />ill or in,,nE rlEEn. ed *lF dG sh m niru.lf or ha*laor thmu8h fii! or hs own cflpk y6. <br />imFo\dd. e u{ idcrLd rofiral Id $t lt ho\ltB, dE hidns d irqoEer ir hU rrhi! @ }d <br />DuUq will hdv. th. buldr ofFoviu lhd lE or .n. dil d h l or itrsNE tnc Fopsly tor tlE FrFe of <br />Fop6ry, u dclEiv.ly conrrrliry virh lica!.d conrr..loB to con rucr rlE F$jrl {Sr 7044. Busind <br />Tt. Conrra-ror'r Lic@ Llr do6 mr +pl, to o o$n6 ol Flrcry qho buil& or imp.ov6 th6or, <br />fff su.h lnlds *irh r ( onra(.rl s) I'cd\cd pu^umt b rhc c.nr rois l-'cor* t-ar) <br />-.8 <br />& P.c. forth! ..en <br />.uQatrllls (.ollllxtarlQ! <br />ITECIJIAIIA! <br />F.any ol FJu., om .l rh. follo$ in8 deLrd iod. <br />MidD. Cdirri. of Co@l to SclllBe G, wt6'@mp6.b& ! Fb\1d.d aor b, s<rs.l70o oattE <br />t6f.mMc.ofrh. $ork for*h'.hlh. Fhir s ssu.J <br />Minr.in Borl6 conp.din iN,m., e GlliEd b, Sdion 17((l of rlE Ldor Cod.. for lL Ffo.lm. oa <br />thi! pc,nit G is.d My worl6 compdN.lion iNumc cei6 rrl policy numbs uc: <br />tlE tEfo'l1r.e of rh. $6rI fM *hih'hs FnI n i{&( I.n I mr anploy Dt Fs. i. ey .1.E <br />lo rhc wortd onptuion hwr of ( rlifomi& ud rgc rhd iI ! ihould bdom. sbjal lo th. <br />FrvtDc ofsdion l70O of thc l,t . Code , rtull lonh*'nh condy snh ltss pro{rioB <br />r. su. mrr6' ftmFd@n @!619.6 oLwtul. dd .hdl sbjd o @pllF to simsrl FatB &d <br />o* lM<lrld tlbur.d .blD (ll0O,00O), in .ddnbn rc 6. cor of @hFsliotr dDrSq - Flvid.d lor th. <br />lE l,iq Codc idsld od io'Ey r t6 <br />Aprlo.l:_ <br />ucEBs@_cqdrlAcma <br />DICIJSAIIq!F!!, of Frurr rhi I 6 [<d!.d u,xl6 Fwioi of Chrrtd 9 Go!ffiog *nh Sdib, 7000) of Divabo ,1 <br />ed I'mt6h6 Co'1.. ud mylicw is in tuu forcc a,l.r€l <br />colirBu(Ilal{-uillllc-aqlilcr <br />Fdy of FJur. rhd rb@ b . @dtudn. bddB .3ct for t,E Ffm. of <br />'lE <br />so.I 6r $nEh fiir Fnr n <br />Crv() <br />AITIICIITLD}:CUAAIOX <br />pdlhy ot Fju,y orc of lhc follo* iry {k Lr.lioB: <br />Albdror Noriiclrion Fqlall R.suLlioN (Tillc 40. Fd6) <br />th. r.l6al r.lrl,rsB EgedinS ab6iG .mor6l {. no' +rh!.rlc ro th6 prer.n. <br />I hflc od rlis.rpla.lon r irdc rh. E.tov. <br />'.aon.dion <br />scorel I rsxc lo 6dpv $ ih .11 Cdy.nd (nu y <br />liws Eht,nsIo huildins .on$EctioG i l hqchy aurhotr/c Err6orar 'v6 6llhG ( <br />'r <br />y ed counry to did upon rhc <br />Fop.ny for iBFclion llrFG <br />BUILDING. INSPECTOR RE xa <br />UFER Ground <br />1,,&! ^dd} _