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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE tD/stG.COMMENTS Ohn-Buildd Ddla.lion
<br />I hcby rtrim uadd pa.lty of pdju., rhdt I h .rdF tm rhc CorrEdd' Licm3. L!* td rh. lollowii8 r.son (r.c.701 1.5 Buri.e!
<br />md P.otsri@ Codc): Ary City d Couity which iquiE . p.dir ro c@!tr!.r, llt !. inprov., d.molish o. r.p.ir My rrucrur., pnor ro iuitibe, .lo r.quiE tfi. .pplimr f* rucr! p.tuit to fi1. . ra8n.d rltlfidr lh{ h. d rh. ir li6r.d poBuu( ro rh. Fovtiou of th.
<br />Cdftlor'r Llcdd l3 (Otei( 9, Cd,1,M.ins *irh s.aion ?ooo of Divirid 1 of {E Bsin$ 6d }rof.si6, cod.) o, lh h.s
<br />rh. i! .r.rrt thcfrm rd 6. b.n f6 rh. .ll.&d ddFim .Any viol.rio. of s.crio. ?0! I 5 b, e, ippricMt for n pcmn rubj..6 $.
<br />lppli6r ro r clvil podry ol.o( ffi lhe {iv. hh&.d doll.a (t500)
<br />_1,! Md of th. p6Fny, q !r, d!ploy.., iirh *!86 s th.ir bl. 6hp6n @, *ill&d.wortlnd lh. rlllctu.c h norinrdd.d
<br />or o0cr.d fr t.l. ( se.704,t, BBin ir hd Frefaid! CodG: Tn. Conlrrdd! Licd'. lrw d6 .or .pply ro m own.r oa fi. pror.ny
<br />*ho buitdr or ihprorr th.l6, sd rho d€ run *ork himcla d td.lf 6 rhrouSh hi! 6r hn om mptor*r, p.ovid.d rhar iu.himpioemir E nor intddcd or olfftd for !d.. It, how.v6, rh. blildiig or ,hprov.lErt n rold wnhi. on. yc8 o( conpkrion, $.
<br />O*nd.Buildi wiu hlvo lh. b!rd6 of provi.8 tht h. q rh. hor buil.t d iEprcrc fd th. p!Ao$ 6f Il.)
<br />_1,!*idof dt prcFny, e .rctuiv.ly .o.tr..dr8 wirh lie .d @Eerd ro cdnrud th. p.oj.d ( 54. r0ri, Suinsr Md
<br />Pbf4rim Cod.r Th. Confii.rd'! Li.d. L.* doc! .or lpply to 6 *id of prorlrry *ho blildr d inprov4 $a6n , ed who
<br />cmr!.I' lor luch proj.$ *nh r conhdo(, liei$d pudusr ro d. cdrsrof! Ltai. L.* )
<br />_l m.rcdpr lidds.ciion .8. & P.C. (q rhit rcsoi
<br />WOIIXERS COMIENSANON NEcl {RATION
<br />I hceby rftim undn p...lry oa pai!ry 6c of lh. folloqing d.cl6tio.r:
<br />_I h!y. ed *ill drirrrin rC.nilicii. of C6tdrto S.lf-l urc for work.R' cohpalirion, s povid.dfdbyS.crionl?ooofrh.
<br />L.bor C!dc, l- lh. pcrfmc. of rh. wqt fdehich thc pmn n tuu.d
<br />_l hrv. .trd willh.tir.in rdlc6' .otr!pd!.ti@ i.srm.G, a cAuiEd by Sdion 37oo oflh. L.bo, Cod., tor rhc p.rtmlnc. oflh.*dt fd whi.h rhir pmat it i!u.d. My rd*6' cdr.n'ni6 iuurucc cuid sd potic, .udb.r rE:
<br />PoliryNumbc ExpiB
<br />Ohn Grl6 ncd no. b. conpldcd ir rh. Fmn u ld O.. huid.d dollet tt I
<br />y'c.nify d h rhc FtmMs of $. *d* fq qhich lnn pmir n ,ru.d. I
<br />bacM. rubjcct 1o rh. wo q, ' .mp6rrid l.*! of Clliaooi!, Md r8rcc
<br />WARNING: F.iluc b ,RE *dtd' ffipdlr$oi @vo8.I,o .mploy.r io dimin.l p.ialri.r ind civil
<br />find up ro oic hoidrcd rhoursd dolld (t 100,000),in idditio. to !h. con of d6.86 a provia.d for rh. S.dioh ,076 of
<br />rhc Llbor Codc, inrnd ed.noncy! a.6.
<br />LICf NSED'ONTRTCTORS I)ECLANATIOT
<br />I hdby .mm und6 pdhy of pdjlry lh.r I d ltakd u.dd povirio of ch3pr6 e (
<br />th. Buind Dd Proaari6! Co<L, ud hy licd!. L ln full |ft. &d.6ccl
<br />I hRby rmm lidd p6iry of !.rlDry $d rhft ir r c6ntucli6 l.ndirs .s6.y for rh.
<br />nlucd (S*. 3097. civ. C.).
<br />olthc wdl fo yhi.h $n p.hn n
<br /> IPLIC^^ITtS DECLAIIAIiON
<br />Dcmolilid PmiE-Albdc Noriliqlid r.d.nl R.gul.rioN (Tid. aq Pen 6)
<br />_ R.guicd tarr ofNo{fic ion
<br />_r c,P,ll!'
<br />'h.
<br />f.dd.r rcsuhrm '.8dm8
<br />r/f.Gnjry 'hI I h!!. dd lhir .tglioiid rd
<br />odi.ec6 &d Sl'l. Llwt EIdinB roboildi.S
<br />tov. moddcd EDpdt, for in4.crid o -d?
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />SubfloorA/enVlnsulation
<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 Requirements
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certificate EXt'll (EU
<br />r cc, u I .'UIJ
<br />SAMC 843, 2 ,0, 556. 867
<br />Certiflgate of Occupancy
<br />Notes, Remarks, Etc
<br />FINAL
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