|
SITE-WORK DATE ID/SIG.COMMENTS OWNl]R BIJILDER DELCARATION
<br />I lE tir ttfm u.dd Fn I, of Fjury thn I m .rdrf, iom dE coffioE Lkae l.* foi th. rolbrdB '@n (sa70rl5
<br />BdilB !d Piol6.M Cod.): Any Ciy or Couny uhri! r.gun6 . pGmi ro .o(rrucr, drd, inFove ddrolBh or r+.r dy
<br />nruduq Fi..ro iri nru4.. .bo r.quG rhc 49lrdl tor $ch D6mn r. 6k. rrrd rioE{ rh}'}bo, . }lrc.G.d pted
<br />b rrE ForiiDB orl,t Co.r(rq! I.i..ns.d L!* tcnrFs e. cowins "irh F*n.. rooo .lh"i."-r ,ii,r'. g*in"* *a
<br />Potdiom Cod.) o! thlr lr o. lhc i crmpt Occ&on dd tlE b.rn tor rh. rlks.d cronFion. Anr \ iohion ot S6rb. 70.1 I t b o)
<br />rl,li@t lor . Fnn $bJdr tlE rppltur lo . ci\ il parh, ol mr mr. rhr. fiv. nun&.d doll,B l!50o)
<br />l, a o*E orrhc FrFrt. d hy drployG *nh s.s6 s rhcn sE @n'FEiiotr silld' tlr rst &id dE ldulw ! ml
<br />iddrl.n or olIaql fo ..L (s6 ?044. Bril@ &d nof*io Cod. Th. colnBioi! I-i.@ lr* d,6 nor @ly ro o orffi ot
<br />li. FEFq *'lD boilld rEoEdEa rn wb.tE$hr l hirollor lE*lfor tlmud hi! or lE or! drhys.
<br />FoviJ.d ih,i tu.h idFtqGt c rc' i od.d n ofiod 6r {t. lf, bo\6q, tlE bitl,.s or inproffi b $ld wihn.rc }r
<br />of.oiq,l'rE! tlt(xd &d& * lB\!llEhd6.f Fuins tL lEm jlE dirl hjildd !rF!w 0E FoF!, ft{tlE Fr.rpsof
<br />L aorEof llE Fopqlr. s.r.lci!.ly .ontr..l i.8 wnh licc.n co 4do( to coNtulr ih. F.jd (Se 7ola. UcI6
<br />!,n PDisi, Cn.lc Tt Conhrro, . t.r.@ L*'doB ml .rrly ro e o*n6 otFoFly wlb h{ild! o. hprcrd lhdmd,
<br />lnd gtF m'rrat3 lM such F.j.rls wilh ! ( onl..cto(,ltmal Dluur io rn Gnu&1or! l-icro L.q)
<br />I mcrnrB un&rsdlion ,ll & l'( li)rrhs r.enr
<br />D.l. Onnd
<br />Mlitas:cautEtraftariDlgJ&llla!
<br />I h6.hy amrm unL,q !qEl) ofp6)ur].Eolrh. nn6\mx d.(hr.rN6
<br />I hlvc lrj will u'mdn . Cdifrd. of Co,ed to S.laltM. f.r FrId 6nFdio.. a FriLd for by Sdirn Uoo of rh.
<br />L.tor Coda for rlE Ffo,rw. of rlE eort lor s,l'ih tlE paf,it aE i$u.d
<br />I lurc rrd r ill dinllin *ortd comrEBllion iBurmc., B r.qon d by S(t Fn :r 700 ol thc lrhrr Codc. for rhc Ffomec ol
<br />thc *ork lor *hi.n lhn Fsn it isEd My *'od6 ompddn. iffic c6ir !n Flt} numbcr r.
<br />I (diryfid n rlE p6fomN. olrlE worl aor shrh rhir Fnn B 6ual.I rh.ll mr dnplo) yF$ninitlME
<br />$ a ro b.o@ lqer ro rhc *6n6' Nn,pqEdnrr bE of ( .lin ii( lad .sr thd it I rnout b6.n. 3ubdr riJ lh.
<br />wort6' .omF&ri.n pr.vsioN of Selion 1700 olrh. libr Cod.. I !h.ll. inh{nh onply $'rh rb. prcrilbB
<br />IVARNINC: rnlm lo su. sMId 6,rFsion N!e+. t 61,$ful !d 3hnl slbFl o dplotE to ai,nind Funi6 rnd
<br />c'!,1 lin6 up to on. hun&.d lhoNnd dou6 {tl a comldMio.. d!tu*6 a !.o\ d<d for rh.
<br />li(rrr 11076 ofrlE hl (ir& hrdd,,xl,
<br />E1"\rr
<br />I hschy imrm onJd p6dy or pdjury rhar I m I bkJn of (n.rr69(omnfti.8 $dh Sdion r(xj) of Dnisi..lt
<br />.f rh. B6iBr d P,!aaio6 C6+, in By l(.e 6 D alll lirr rrj.fr.(
<br />L..Mcras. $n,.,., Qllrr
<br />1$l.i3Liz-vw=
<br />I hcb! .llm !,<E Fr.]|, of p.rjlry rhd thq. a ! colurdbn bniio .gc, aor rlE Ff.l]rl.r oailt mrt 6r x'tih rhit Fni a
<br />iqql (S<. 1097. Civ C ).t nda r \m.
<br />atrrtcSllD.uctlf,dllQ!
<br />I h.rby .trrm undd p.nahy of pcjnry orc o f 0E rollosins &.lrir io.!
<br />Dnmhr. Pmnr'^3!6r6 Nolrficaion l-.d6!l R.suLrioB (Tnt 40. Prn6)
<br />lcqui,ql ldls of Norifi.intr
<br />I .dt iry $d rh. f.d6il ..ruLrioB Esrdiry a!. os rmr.l r. ml qrliabl. b rhir pn'i{
<br />r..d rhi .fflrlrirn &n sbr. rh, rlE rbr. mlon,nion B @rd I .EG !o compl)
<br />r O t'.*ry o -r. ,p." rr.
<br />J'Ltrl.r
<br />rqr6.rndiv6 of ttu( ir,
<br />I'V
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Roof Sheathinq
<br />Shear Wall
<br />Framing
<br />lns u lation/Energ y
<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 />Engineer Final Report
<br />FINAL t"L /t/i? t Y4 r-:ifr \{
<br />Certificate of Occu pancy
<br />Remarks, Etc
<br />BUILDING- INSPECTOR RECORD
<br />I
<br />I
<br />I I
<br />I I
<br />I
<br />Subf loor/VenUl nsulation I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />Flood Zone Certif .
<br />)
<br />Notes,
|