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DATE ID/SIG.COMMENTS OWN}:R BTJILDEI' DI:I,CARATION
<br />I hd.try artrii un& Frry ol Fjury rh,r I m crcnfl 6oi rh. (blnradoB t-i:@ Irw rorrh. follo$i,8..a,.lsa70.rI5
<br />UuJns !d Proasion (irj.) Any (-ry or Coudt shth r.qntr6 d Fmn lo oddd. s. inFo\e &mlislt or Ep6r rh .
<br />'l4doe Fnr ", '1r isM.. i\o rcquB rh.4dEd lor $cfi Fn lo filc. nsn d ndoEr rhd tE oi nE i licar.n p!m{n
<br />Io lh. r,orisioN oflh. Contarors Li.avn lj* (( hrptr 9, Conhocins s h s.ction 7000 oaD,vt$.I oarh. tlBinds .nd
<br />Itot srnrN Cod€) or lh.l IE or $. is .!mF rhcrdrom od rh. hdri! for rh. alL*.n.(nllrion An, violdion ofscclion')0! 1.5 t'y dnj
<br />q,ph.mr for r Fn'r rbjdr rrE rrrlicet nr !cirilp.nrlrlof mr m{. rha nrc hun&.d (lrlls(ism}
<br />l, &\ osns of I h. rroFny. or Dy .mrk,rc wirn war6 a rh.ir en. mnrpdsnon. $ ill d. rh. tro* dd 0E slrrlw i< n{
<br />iddr,al or o lIs<rl aor idl. ( S( 70.14, BurinB md tto li<rcB Codc llr Contrky r Licmr lis &6 nor .rply k d o\ n6 of
<br />rh.ImF! * b hILl o, ur{mrc rlEoa ,ri *ho &a exh *o{ h'lMlf o. h6-lf or rh^ru*t tir d hd o*n .hphr6.
<br />Forilnl rhd $ch mFo1ffi G mt dd'd.i or.fidrd fo. sL l[ ho$6r, rlr hilditB n in{"*._-od 6 $ld $inm om j6
<br />ofcorr{ rF( $. o$E lrlitb *ill haE lh. tudo orfm\ilts $i hc s5. dij d hild or itr{roc.lh. IroF} fd th.,nq$Eo,
<br />l. E o$fr orrhc Frpdr, m dcluir.ly ro rrluB r h ltaGj.odracioR b.onrrucr ilr Fojci (lir 7or-l- &8'6
<br />!d ltl'bsin ( o&: Th. ConrrIlois Lic€M L.* dc mr @lt r. D0$.6 of Fopa!' $h. b{iktr or inrove rtd(n.
<br />md who Nnrds for !u.h Fojd3 $irh i ( odrado(3) li.sEqj puBuln ro rh. (i'nrr.cu r l-icc@ lr$,
<br />I M.rmr, uto:L. sdri,n
<br />Drr.: Ornc:
<br />1loRkriis-con, Pirlta^ rxrN
<br />IECI,A8^IIOI
<br />I lE.tD .ili'n uid.r Fsxl of Fl!4 oft oarh. folh*n's &dsdirtri
<br />I hrv. drkl *rll ,nrimrn ! ( d ia,.d. of (i\.sr ro S.ll lctrr€ to M,k6' .on:Fsdrn. N Fovdcd for by Srtun r 7(tu orrh.
<br />Il&tr (id., for rh. Ffonnk--. d r rh. so* ntrwhichth.psnil ir L$u.d
<br />Vl h.rcand\illn.F ain *.rt6 conFErion iMr, ..6 r.rtutra! b sGib. !?0oofrh.libo, (ir!., for ih. Flnmm. ol
<br />rh. $o,t fo. *hich lhis p.tr is isuqj My trorkG .onFMion iNurMc. .nid rd Brh(y numb6 r.:
<br />cuF I TTG- 071 -{ 7 - 1'2,( .o ,.or*,' l:16
<br />I c.niithd inlh.pcf{runccof lh. so fo. *hi(h lhls p6nit Lt N!cd, I shlll not oploy any p..$r in any men(
<br />s e ro bdoc ubj.t lo llE *nr6 @.rra!d6n lrst orcdifo@ !d qr rhri ,t l lrnukt h.(r lutrar ro rtr
<br />sortd' snp.,srb. prst si(rc oasdkn .! 700 of rb. lihor Cod.. I ttLll fonhsnh lripry I'irh rbos F.r s.a
<br />W ,ININC l'rilurc to *@ *ork6 comFcsrion covdag. ii uihwtuL Md shall subF d aploF ro aimin.l lEDftis sd
<br />civil nncs up to on. hun.lr.! thousnd d.llds (lllrrr mr€MIion. .hnuscs ss r,(triddl tor lhc
<br />sdr0n t076 0f rh. l itrr ( fri. inr6d .'ri
<br />DECIJEAIIOB
<br />I hdtb .rm uftr6 pd[l.lt of Fjur_v rld I m lkas] orld Frldon ol CnrFd 9 (offirrj $ nh Sdion 70()(] ) of Ur Bion !
<br />ol rh. B6ilB,.d kof6ioB cod.. dj ny licde i! E tuU loc di.lfd
<br />.n,*,r'^< (-1C /oo t67
<br />7? (Y
<br />CONSTNUCIION I r^TnIAG CEACY
<br />I h6tt, rrm uBr6 FuXy of Fju J.. r hn rhd. ir ! @dru.rior lsxhls lsdy for rlr Frotu. of rh. *sr for *n.h rh6 Fni !
<br />isu.d (s*.1097, crv. c.)
<br />aftu(aNl-lc(Jlaara!
<br />I h.dy lfm unld d!rh, of Fiury orc ol
<br />'h.
<br />followin! d.<lErioN
<br />DnRnndn Pd'r}&b6r$ Ndlin. ntr r.<brl R.suhlnB(Tnk {0. Pan6}
<br />Rqu&d l.rrd oaNotiiulr,.
<br />I cdir\ rhd rlE f.d..rl reuL'irN Errdin8 ab.snB.dord d. d spplf,rbL
<br />'o
<br />rhi rroF
<br />lc.1r lv rh.r I h (rcadlh'\ il) (alio tr:u \rarcrliirr1rd\trc rnlnrnrrbn Ncnr'(r I alre lo.o'nply s(h rll( 'ryand
<br />( fLnly
<br />ordinacs afll Slat. l!*s Eldi.8 lo .,rl hs.t_ .ulhrn. (FB.r'lalir6 of rhis Cil, and CouDly t! drq upon lll
<br />ab!. mrion n t'nrFnJ for
<br />ApDli.itrl or.\r.tr1 shnnltr L+ -tZ
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUl nsulation
<br />Roof Shealhing
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Dtywall I I/Ext.4nt. Lath laltb r\UttL bY-frown Coat I I (
<br />Itrla so n ry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />E Final Reportrnee r
<br />Flood Zone Certif
<br />FINAL \l,i\\g u4t0\)
<br />Certificate of Occu pancy
<br />Notes, Remarks, Etc IM.l,v oV q r3 lb
<br />I
<br />BUILDING. INSPECTOR RECORD
<br />SITE.WORK
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