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SITE.WORK DATE COMMENTS OIVNB AUI,DEf, DELCARAT('N
<br />I h.Eby iftirm undcr Fmlry or 0djury rhd I D .r.npt lmm rlr Codrdo6 l.iltr tr* Ior rlt folt',h, E sn ( S.. ]tu r I
<br />EKin.rs .d Pror.$hn Codo Any Cit, or Counly ehlh rron( . Fmit ro orn{nrr. dtc, irpmv., &mlnh or EF .,Ly{Mu.- FE ro irr irsller. rk RtliB tlr qTlid ror trh Fni! b nb! iitftn ( crnt rhtt tc or slE 6 ric.nr.d pwo$l
<br />lo rh. Imvisi,n! ol rlE Conr&lois l-i.tnrn tlq (Ch+rcr 9. ConENins snh S<rh. ?m) ot Divirion I or rr'. 8urifr$ .id
<br />Pt'fcrrbnr On ) or rh.| h. or sh. is cichpr lhdrfiom drd rh. b.rii for rrE llhrcd .r.n{'lion Any vblnb. .f S.dirn 7Ol I I hy .n,
<br />rl'plirn ft, rF nir rubrdr rlr +rilkrdto.ciritF lryolft mrE rhm rir. hunlEd doltet (g5m).
<br />-}l o"ffi,,1rrE F,rnr, "r n, cn{h}rci r hraFc(r!rh.tr {k lntrqFnsr$n. y ld. rll *'rt !d rlr rMG ! hr*'d.irdl ,r o,LEd fd eL tsd 7itl.l. Bur6r rid Phf-ri,n\ Co(l.: Th. (.onr.dd r hcn* L.! d8 mr rpply k, .n oemr or
<br />rh.In,Frr, wk' hrildr., ii$oB rhcEn. !d *h.h! rh xnt hinEllfl h..Elto. rtmulh hn tr hc. o*..npbye1
<br />p.t'vid.n
<br />'h.r
<br />sh i'lhkftr,t. E B'| intc.d.n s olH rDr sL lt h,EB.lli hrildhs or inrpmEmnr ir slj vithi. m )i,ofontljinitO*EBuild.rwillhErhhr{tioaFrirS.lEorrhddnnh'UslqnrdEF,IErytmrltFImor
<br />-1.
<br />rr owmr of rh. Iop.ny. m .rcluliwly contr*r inS riih la.nkJ c.nrrrm r. d,nrtu1 itr Ftd isd ?Oar. Bu\iB\rd thtsir( odc Th.cbnrtuntr s l.iccnr l-0w docs mr rDpryro sn ouncr of pn'rErl y Bho builds.r inu'rcEr ltEnr...d *b 6dBlr fn rkh rFF1. wirh r codtuonn tarncd n{Bud ro rrE Co.rturM r Ltc.y l,$)
<br />'Yl*,i-"I
<br />o.,,., J e.$n- ,,! t , -t>--<.u'<-llrrttit&s c(tnrPt s]lT!(rN
<br />DEgITIAIII'd
<br />I rxrby rmrmrnd.r rEmll,.rF,lryomorrhc toll'*i.r &.L6rir)ns:
<br />-l
<br />hrv. in willd'trlth! (tniaEar. orconkirr( Sclf lnrurc (nx 6a snqEneli,n, s t bvikd lor by S6rhn lTllr nl rlr
<br />tlhv (irl., ,m rlE FnG.m! ot rh. nd r( $irth rh. Fmi 6 nrkrl
<br />_l h.!r lEl $ill minhrn *orkc'\' comllcmrti('. inruhft.c. ,r rciruiEd hy s6ri'i :t7(xj ot ttE titFr (ii.. for rrE rE tolrjEN oa
<br />Itr *mlar*hihthirFm i\ isqrn My *rt6 d'nltndbn in\urrftc c.ria a,n play nlnh.r El
<br />11J:1rr.niryrhatinrlEFnrBk.olrtEsor\ftr"hrhthisF.mirrirrEn,IrtEun.qrhy.nyFR)ninrnylME
<br />s !t b tE-m subj.Tr to ttk *orts mnFnrarion l,wrofcnlitmi.. rd alr rhtt,ft sh'uLt lE6m iubj.lr io rrr
<br />uorl6 mn{f,n-rim Foririo.t.l Sdion l7morrh btrr ('odc.I tull. ftflhr hdrml'ly *nh rh,c pn,viri'N
<br />WARNINC: Farlurc ro e.m worl.F .r,tr{xnr.thn .$hr+. ir u.h$lirL !d rh.ll obi( u.rlq'bF h aimrt F tis rn
<br />.nil liEr un ro oE h! rrcd rhonsnd dnU!^ (llm.mo), !n rddirhn k, rh. on of cotr{xtrario._ dlmr.r s pmvd.d for rlEY:?l;ffi I
<br />^**,,lLsst:yl4v/<Lr( aN\in corYrl"acIoR
<br />DIiI;IAMII9!
<br />I krbt !l,nm uflll Fmhy rFrrrrh.r I d li$<n udc. rmvnir ol chofld 9 i.ommBns *irhSerion 7(rDorDieniotr l
<br />.f thc Busiftsmd P(,f.$b.! Cui.. rnj mylitnE i in fuu f rrn.fiNr
<br />c(lrtsTRUcTr()N I aNDrN(: r(:rN(a
<br />I lErtrty rm.m ul!.r FMty.r F.jllry rhn rrE. h. @n(ddb. Hin8.g.ry r(, rhc FformRr orthc worl fDr utkh rhis Fflnir ir
<br />n\ucd rsd.3097. civ c r
<br />AP'T ICANT DECI TII TI(IN
<br />I ho!h! ,ltrm unlc. Fnulrt of F.Irry oft or rh folt'$i.s d..l, ii
<br />D.mnnion Pcn k Aihi$ Notif..lion l.1tcial R.luhrirns (Tirh!{). hn6)
<br />-Rcquncn
<br />kltcrof fd ifrdirn
<br />I .E!iry lhd llr f.dcrl EBuljrN rSdding,rh.rtx rcnlv.l !E mr dpplE.hk n, rhc pnrFl),/#,:. 'rj rh. lhi\. rckr rhFrpl!lt rninrfit{rrrdinr rh. nhrc Irronrurir!r .ltrr I {R loG,nlt'ly wirh rll Cirt.d Counryr'6.rn srr!.1.r\ Ebr!3 to l[i!i.3 connMbn, !,n rkDrlrnc\ , rhr (-ir) in'l ( .xnry r) .nr( uF,nrh.
<br />uh{. nrnrnnrcd prnncny ntr inrp.(lnn I'uF'{r
<br />^pplkrnr
<br />or
<br />^E.nr
<br />slrrroE?#
<br />p.di,FEmipr,nt':
<br />Ao-SSe_lr*.ouo-
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />7-zs-/7 +1.+.td
<br />Shear Wall
<br />Framin
<br />lnsulation/Ener
<br />D wall
<br />Pool Fence
<br />T-Bar
<br />Final Re ort
<br />En ineer Final Re rt
<br />Flood Zone Certif.
<br />FINAL I -l0 - l'l ,r\.UtJt'l
<br />Certif icate ol Occupancy V
<br />BUILDING- INSPECTOR RECOHD
<br />ID/SIG.
<br />UFER Ground
<br />Roof Sheathinq
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Handicap Req
<br />Deputy
<br />Notes, Remarks, Etc.
<br />z1z/z
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