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SITE.WORK DATE ID/SIG.COMMENTS o!,F.B0ldd D.(hntio.
<br />I lH.br'.mrm undd p.rhy ofFrlry Er I.hd.nDl lom r conincoB LeML,wao. Efollow'.srr$n(c7ort.5acEd
<br />.d Prcf6.h. Cod.)r An, Cny o. Counry which ..qun6 a p.mn to o6truc1, txd. ihpr.v.. d.botBh o. crlr M, trrud@. prior lo iB
<br />i!!urc., llh (qut6 rh. lpplient lor lurh ponir ro 6lc t lismd ll.lm.nr rh.rb.or . ir tic.d.<t psut to lh. prcvilioo of rh.
<br />Cont.doir Lrc.6.d tr* {clrpr6 e, comh.E'n3 *nh Sdb.7000 otD'v'r.. ] oarh. Bur6r..d Proa6ibB Cod.) o, rh.! tEd
<br />k L qdpt rlErcnom trd tlEbdir for t,E.U.s.d crd bn .Any violrbn or s.db. 7011 5 b, &y .rpli.rd for. Fmh rubjd E
<br />.pplrui io. civil p.diy ofd mrc
<br />'h.,
<br />6!. hundr.rt dolhn (!J00)
<br />l. a orE oarh. pmpdy. or my .nploy6 * (h y!96 u rh.n sk (orrp.Mion. I ill do rh. wo.r .nd rh. ntudE. n ml intdd.d
<br />oi off6.d for nk ( 56 roaa. BE,6t..d P.ol6rDnr Co& TIE Conhdr-t l-@c u* d6 Dr .ppt) ro.. o*E of rlE prop.q
<br />*lb b{ildt or mpr.r6 rtr6( r wio d6 t$h *od hlrelr o. h6.,a or th'oush hr or hd owtr .Epby6, pro icd rh.r ruch
<br />inpmvcm.nB m nor inr.nd.d or ofi.rcrl aor s!1.. lf. how.v.r, rhc buildinr or impbv.m.nr itr 3old eilhin oe r* ofcohpl.thn. th.
<br />O"ra-Buildd*ill h.w rh. bud.. ofprori.C th.t t. or ih. mt build or inprov. for th. purF* otrk)
<br />- LBo*F01(h.lroFny.u.r.,uiv.ly@nr6iI3snh..ErI.o.rtuoBb66rrucrrh.For<t(Sr.70,L.BuitB.,.t
<br />Poldion Cod. Th. Codhcloar Lr..* t w do6 d lpply ro .i ow ol propdy *ho b!'tdr or rEproc lh.rFn . .rd who6,trB lor ru.h rroj*lr snh. Conxtdo(r lE6t d pcrunr ro rh. c.dhdor'r L'c..r. trw )
<br />I u.rmPr udd Sd{n _,B & P C. forlh. rcen
<br />!1]a5[a!cauu;tiarjqlt!f(!d8an!]!
<br />I hd.byrffird unddp.Mtyof FJury oft ofttu f.lli*in3 dFLn!6G
<br />I h,\ . lnd * il, sdnl.r . Ccnificlt. of CoMn! h Sclal 6uE ror *ork.B' compcMro4 c prov
<br />'d.n ror by S6t o. l?oo of rh.
<br />llborCod.- for lh. pdforuN ofrh. f,ort lor uhi.h th. p.rn ! aru.d
<br />I h.!...d lrll m.'nrr'. ,ork.rJ comp.Nrrn 'ntu6nc..rs r.qur.d by S..r6n lT0oofrh.lrh.i Cod., forih.pafornunccofrh.
<br />rorl lor whrch rhr p.rf, r 'su.d My worl.B @mp.n n. hrur&c. c.ri.r Md p.lic, .mbd d.:
<br />Policy Nuhb6 _ _ ._ _Expir.r:
<br />(Tnn rdi,o xd dl b. @rplin.d if rlE FDi it lor Oic huidr.d &lld lll mt or Ls)
<br />I ccnily O{ in lh. Frolrlac oarh. wort for *tkh lhn Fmn t LuNd, I rhrll mr Gnplo, mt pnen in.ny mlnnd to ! ro
<br />b.r.i.3ubJ..l lo lh. w,k.R @mp.nrl'on L*,olCrhaornr,.id.srdth.t 'rl rhould b.@m. sbJ6l toth. *ort(t
<br />comFMr.n pmrBhN .lsdDn :t700 ofUE lrbo Cod..l fi.I|. fonhu nh
<br />D.,.
<br />-^or'"-, KGK
<br />WAnNINC F.'lur.lo cur.work.tr @np.MtEn@vd.B. BunLrful, md ih.ll3ubrer m.nploy.r ro oimi{l p.shi6.,i civilrE up 16 oE ho,'d!d rto6.al dolL6 (l l@.00o).h .ddn b. ro rh. d or srp.Miotr d.o.t6 B p.orikrl aor llE Sdlbn ,016 of
<br />r,E L.hor corL. ndd.,i.nmy . f€
<br />LICf, NSED CONTRACTORS DECL{R TION
<br />I tftby rrm udd Fulry of Fjury rl( I m lic.s.d urd6 FDvbb! ololFd 9 (@m@in8 *nt Scrbn 7(100) olDirnio..l of
<br />lL Bui:B.!d PrcfdbB Cod., .,n ny li.e ir ir tull to@.rn .l'.n
<br />CONSTRUCNON Lf NnlN(: ACENCV
<br />I h6.by.rfm u'r&r p. hy olFjury fi.lrh.E i! r c6rl.ri[ kdiDa.ad, for dr p6fomB. oatlr *ori for shih rnn paDn i!
<br />i!!.d (S< 1097. Cir. C )
<br />kds 3 Addrdr
<br />AIIUCANII-AEOAAAIION
<br />D.mlilioo r(mil!-A!h.ro. Nolifi .tlion F.d.r.l R.rul.tiotu (Tn! d0, P.n 6)
<br />R.q!n d l^'doaNorin(dio.
<br />I ..nrfy lh.r th. fcdnll rqul.tioir r.g.rdr8 Bh6tos rmv.l.r. ml rppliclbL lo lh8 proj.rl
<br />I ccnitr lh.r.rc.drhis.pplicrr
<br />ordEr6 rn Sr.rc l.u! rcLtins h h{
<br />lhor. m.n'io..d DroD.ny lor iGD<'tr\.
<br />ADD,clnror!r.nt$*. (
<br />ion ."d {.r. rh.r ln. .!ov. ofo@r ion ir con*r. I rsre to conply vnh nl Cny rid Coury*ruilJ*;";fidu:
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subfloor/VenVlnsul.
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />ln s u lation/E ne rgy
<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 &tl*t/rg---r-:94.^*Jd)Certificate of Occupancy ll \J \J.Z
<br />Notes, Remarks, Etc
<br />lnsp.cton Fo.ms\Sirlding-hsr6.Uo. R6dd.doc 03.31.06
<br />BUILDING. INSPECTOR RECORD
<br />Flood Zone Certif.
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