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SITE-WORK DATE ID/SIG.COMMENTS Own6.B!ildo l).clotion
<br />I hn.by.mrd und{ p.{lrvdfp.rury rllr l.ha.opr form rlE Conl..clo6 l,E.M l,* aor lh. folb*,4 rdon lk ?orl.J Buiro
<br />.nd Prol6rbn Cork) Ary ( ny or Coury r hich r.!u,6 r D.ron ro 6dDd. .l'8, inDmv., d.mli3h or Ep.t uv ntudR. Fir b hr
<br />B!u.n.., rl$ Eqund rh. rpplic.fl for ro.h pmit ro liL r !i8n.d lurm..l lhrl h. or rh. i! li..N.d pu6uur ro rh. pruvnioB of lhc
<br />( onucroir L'c.6.d Lr* lch,prs c, Comn.ErA *dh Sdbn T0oooaD'vEEn l orth.Eu!'n6!rnd Prora.dCod.)o, ihrl ltd
<br />rhr E crdpr thn.eoh .ii rt! b.a tor rl! .lle.d .rdFnn n) ra,lnion of SFri!. 70! I 5 b, uy .pplEd ror . Ff,d rubjcdi tlE
<br />irpli..nl lo. cilrlp.ully orrct 'no,.lhu fir. hudrcd dorl.E (t500)
<br />L G orF of rh. poFny, or my mphy6 virh tr.a6.r rh.ir eL onFBli).- *iU do ltE {orl.nd rlE rrucr@ ! mr Gl6n rl
<br />o, oIT.,d for el. ( Se 704r, Bu.'ndr .nd PrclB36.! Cod. 1'h. Cont.do, i t-8.8. lr* d6 n.r tpply ro .n owr oa !h. I'Dp.ny
<br />*ho buildt or ihDrov6 thd6r ri who do6 ruh rorl hilMllor rEElao.lhmwn hi! or h.. own.nphy6. provirl.d lh.r ru(h
<br />mFowh.nls r. ml inr.ri.n orolTdld for rk Ilt w-d. tlE hildiry or inp.oltrld n sld vnhin oR yd of ompldior rb.
<br />Ownd'Bundav'll hlrcrhc hrd.n ofp.ovin3rhd h. onlE ml build o, dpror. torrncpurpo$orel.)
<br />L a oeB ofrh. pdp.n), rm.r.lurir.l! conrrdiha girh hc.@d.o.rctor ro co6rrud rh. Fojftr ( S( 7044. adr6'.nd
<br />PrcfdrFn (od. lh. Coit.dor\ l.r.nr.lrw dod nor rpply ro.n o*e, ofrropFry who bdnd! o mpro\6 rhsmn. lnd who
<br />contrrct aorluch pror6r * hr Contrcio,(, I'cor.d Dunu.nr toth.('ont.dor ! Lr.n!. tl*,
<br />I .d.r.mpr unda S(lron
<br />}TORKf, RS (OMPINSATION Df (:I.ARA ION
<br />I rE .by .mm unrto t'.u ll} o, F.Jurv oE o t
<br />',E
<br />fo lhunt d(lr.l rrE
<br />Ill.v.!dlilltuinuinrCcnilic.r..f(oM ro S.lf.tNu.. ior Frl.rr' .omp.Mtrn, d provid.d lor byS.c'En l7m ofth.
<br />lrhor (-o&. for rtE Ffol x. of
<br />'lE
<br />$o.r for *hkh rlE Fn, ir iB*d
<br />I h.v. md w' ll mrrr.h *ork.rr' @mp.ui ro. '.JUi.M, .r r.qutr.d hy S*ron I7m of th. uhor ( od., ror lhc p.rfor n..oflh.
<br />*o,l lo, wh.h rhBFmn B Bu.i Mv*o,k6 6mF.nrb. rsmr...trir !d p.lry rumls e
<br />Polrv N0rnhs l:rFr.r
<br />(Ihss.(ri,)nn.slndrF.comnl.rc,flh.l.nn is in (h. hundr.d d.lh'r Itl(rrl or l.r\)
<br />I..n'ry rhd in th. p.rf.m.r. olrhc *o.t aor {hrh rhis p.mir ir rsu.d. l.hrll mr mploy.n} p.r$n rn lny m!nn6.o a ro
<br />tt.n.rubreri(' rh. rorkas c.np.nston h*rof('.hlornr. rnd.srerh !ll rhould b..o.r.3ubjel h rh.rorkar
<br />,ff"*''" ^'*""*"" "* "'"1,1."fi=3E5i' "' [ffi4
<br />\l ARIri lN(; F.'lur. ro srr. eo'ldr' comp.rtDn co\.r.9. ,s unl.*ful. rnd lMll 3ubr(i rn .nrplovd ro oim'..| p.Eh 6 md .n il
<br />nn6 uFloon.hundrd rhourtud doll.R ( l lrx).mo).in id.Cirion lo rh. co( oaconr..rlrio.. d.tusc! i! pro\ id.d roirn Sdion 10?6 or
<br />rh. bho, cod. 'nid6r rd rnom!'r f6
<br />U(IN$D,SINIBACIASiPE(I4SAIIoB
<br />I imby rmm ud( F.uty of Frry lhr I u lk B.n uns Flvirn. of Ctr.'r6 9 (om6cirB I nh S.<ri.n 7000) ol lrrnion ! or
<br />rlr Bdtus .nd Prol6rio6 Cod.. md m, lic.G. it rn tull Lr.c rrd .fiGt
<br />{A4de
<br />I hdlbr.lrm und.r FoIy otFj!.y rhd ttft i...orEltu<1io. bdi!3 ..Gy aor th. Frfol E ol E *ort tor wnih thi Fmi it
<br />irtu.n (Sc 1097. Civ. C.).
<br />Aftllcal,rtul;(I aalllll
<br />!).ml,rhn l.mds.Asb.ios Notii(lrnn l.d..il R.luhrionr(tirk.l0, Pln 6)
<br />R.qurcd l.I.rdrNonlic ion
<br />I.dify rhrr rh. Ld{!lr4ul.rion! Eg.rdm3.sb6r rmo\.|r. n, tppli(rbl.ro rht proFr
<br />I cdriry rh.r I h.r. cd rh!.rplt.lirn.!d l.r. rni rl* .rt inaomrion n.od.(t l .ac ro conflr *nh rll cir, Dd Couiry
<br />odiDmd ..d sr.r. L.sr El i!, !o boildina sNln(l6n,.id h@bt.uth.ri,. Epr*.!rri!d olrhn Cn, r.d (nu yio6rduFf,rh.
<br />ah\c nr.nrii..d fl lcny
<br />(
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subfloor/VenUlnsul
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<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 />Engineer Final Report
<br />Flood Zone Certif
<br />FINAL p/d(/,ts *tt-41
<br />Certificate of Occupancy U
<br />Notes, Remarks, Elc
<br />M \WP5t\P.rml'lnspscton Forn}3\Eoildin!-lnsp.cton R.cord do. 03 31 06
<br />BUILDING- INSPECTOR RECORD
<br />*'Nfr
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