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SITE-WORK DATE ID/SIG.COMMENTS oWNf, R Bt]II,DER Df, T,('AR 'TION
<br />I h.ftDy ifl-'nn trnd.r rcnrhy ol perjury tn l run cx.mpr amn th. Conk.cror' l,'c.ns. k* ror rh. ftrlo$in!,d!dn {S.c.70lll.5
<br />ttlsincss .nd Prof.sion ( od.) A.y ( iry o, Gunty Lvhich rcqtrtB a p€nnil to .oBtrrd. rlld. impov.. ddrolis! or rcp.n ,ny
<br />struclr., lrior lo ns t$ff....ho r.qunes rhe lpplicml for such pcmir to file. si[n.d stal.m.nl rh.r h.or.h. i! liedr.c pusnanr
<br />lo rh. r,FvrinJns ot IIE conr..r.as Lr.fted lis (('h.prd 9, Comh.n.ins Rirh s.ctioi 70ix) ol Dilision ] oalh. Dusines and
<br />l'ofB3ions G\d.)orrhar h..rsh.6.xcmpr lh.r.lior and nr b.3k for rhc rll.E.d cr.mprion ntvioli(ionofSdi.nTn\l :bt;nv
<br />inDli.. tu r n.!nril suDjfth rh. aptlicai o !cnilpcnalryofnol nnr. rhan fivc htrndrcdd.lld((1500)
<br />I,.sosn.rofth.proD.ny.ormycmploy€qilha!!.srsrh.t$l.comp.nsarion,*illdolh.iorkdndrh.srtuct@snor
<br />in!.nd.d or or.r.d lor sl. (S< 70.14, Busi(rs.nd Por.sioB Cod.: Tn. conr,0doi! Lic.ns.l,s do6 not.pply ro.nosn.ror
<br />rh. pmpcny shr hritrls or imlnorBlh6@n. ud wn doB skh wort hims.lfor h.rs.lro. thro Ah his o. hd o*n .mploy.6.
<br />lovidcd lh.r n'ch irpr.wnls e mt inrdldcd or ofi6.d for$k.lf. h.!.\q. rh. bu,ldin* or i6pro\tm.nr i3s'ld *irh'n.n. xu
<br />.fcompldion. lh. ()B.6 Btrilda \rill har. rh. huidm .f tm\ing thrr h. nr sh. dil n.r huiH or improE lh. propgly lor th. purpoe ol
<br />I. d .*..' orrh. pmDdy. am .rlusiv.ly conkncl in8 silh lic.ns.n co.nridors ro coNl rud rn. poj.cr (S.. 7011. lrBnrd
<br />.nd fFf*h.CodcrlhcCont.croasLir.ns.I-a$d.6noraDplybmoen.rorpror.nywhohuild..rirpro\.srh.r..n.
<br />.nd trho..nrmdsrorsuchtmj.dss,irfi{Coirndo(rlt.nscdru(umrrorh.conr.doasl-ic.N.liLv)
<br />l nc\. r|i trn(i.' Scdnn
<br />l),r. (rsncr
<br />t\()RKIRS' ( O]uPUNSAl t()t\
<br />D.ICIAAALDI
<br />Ih.'cbv il''n, trnd.r |]cnalr\ o, tnrtr'r oN.lrhc nr.(irg rlc.l.r iffr
<br />Ifiav..nd*illmintlintrC.nific.t.ofao.loS.lllBor.lorworkds.onD.nsrrion.I,ro!id.daorbysdion11700.rrh.
<br />kho. ('od.. lor lh. pdlomnc. o flh. rvorr fo. whi.h lh. p6f,n a! iso.d
<br />Zat h.,. ona * itt .oinoin *,t .u compcB.lion iB!hnc., s r.qun.d by s{tior r?oo or lh. trbor (bd.. ror rh. p6lo'n.8. or
<br />th. snrk lo, trfth rhs !m is aurd M\ "orr€B' comBErr ion iBurinc. cadcr ind Flic, nushn ir.
<br />.""., &Itsror q L^ s
<br />,",'",',^r.,1? $153aj: p]:=L,r.* g lj l k
<br />l..nlryrh.l inrh.lcrromi,t. orrhesork rorwlrich rhispcmil is ns'ed. lsnnllnol cnrplov rn) p.Fon itr anymanocr
<br />$ .s b b..ohe $rbjed ro rh.rolkd ..mr.B!rio.li*s orcalir.mi.. and isrc rhai itI should hcdln. $,btd h rhc
<br />Norka .omNnsari.nnr.rnnns.rs.dion llT0oorthc litDr Codc.lshall- fonhs hcohrlyNirhlhoi.nmvi\ioos
<br />lvAiNlN(; f.ilr. ro qor. \orlc6 .ohp.ns.rin.ov.rry. ( unl.lrul. .nd sha,l3ubj..r an mtlor.r o dininillxtukid,n
<br />civil fitrcsuproon hu.dr.d rhoN.nd dollad (t10O.000), ih addirion t\ rh..oi oI.omI.Niridl .mr!.r as [{\id.d for rh.
<br />S.crhn 1076 orlh.lnbor (-od.. inr.rer and anorn.r s L.s
<br />/,--<:4.,-4;:-:,.,-- -LI( EffiD ('oNlR ctl)R
<br />aEC!4B]!!!Q!
<br />I h.rebr.mnn undd p.n.hy.rrriu'r- lfial I tu l(.ns.d undq prornion ofCh.fl.r o(conmcncins Lvilh s.crion 7000) ofl)nnion I
<br />ot
<br />'h.
<br />Rnrin.$and PFLsrion3Cod.. arl my liccnsc ii in nrll aor.. ann cit(r.
<br />r.iccnsccrrs: I? (la c- 7-?q< >-= c<
<br />Q-r t lA-L+f c- fz F qanzuic<s
<br />cotE!B!Ell0!_tE!p!xc_4c[!(t
<br />I hfthy amrm und.r p. llyofpcrju.ylhalrhs.is..oBlru.lb.hnnine.e.ncyforrh.ndronnin...anE*orllorshi.hrlri.D.r:nitil
<br />i$u.d (S.c. .1097, Ci! C.)
<br />I cdriayrh.r rhc fcd.ril r.Bul.rioN r.sddins sb6ros r.nFud.r. not applic.bk io tht poidt
<br />t-{ cn'ry rhrl I hiE E.d rhs
<br />'pplE.t
<br />ion ..d srd. rh.t th. .bon hrom.xon ts cofl.cr. I agre ro comply s h .ll (- y ind counr,
<br />Amnc6;nd Srar. ti*r El,rms io buildins .oNtrucr i.n. rnd hd.by.urhoriz. r.pr.s..rrriv.! ofrhk ( ilyrnd Co{nly ro orn up.n rh.
<br />rhnt. mdrn,ncd roFny ror ntp(li.n p!ris.,.
<br />-nrr,,-,,..nr;..*;.,". /t '-r'^r/a1 n* ol. /- !'
<br />-P.mi,(r,n.(prrno: 4YVi-:\V
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />ln s u lation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Itlason ry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif .
<br />FINAL '2-1"|9 :s-tft+/'tci
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc.
<br />BUILDING. INSPECTOR RECORD
<br />APPLICANT DECI-ARATION
<br />I Edr*a6imtrndcr lt.oilly of p.rjur.v onc of lh. followine d(lrrationsl
<br />D.molilion P.!mits.Asb.stos Nolilic.rion F.d.r.l R.8olrtions (TarT.40. P.n6)
<br />Rcqut.d I llid oaNotifi c.iinr
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