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BUILDING. INSPECTOR RECORD I
<br />SITE-WORK DATE ID/SIG.COMMENTS Owra-Build.r D.clmlid
<br />I hd.b, amm und.r pnaky of Frrry .hd I m .x.mp! fdm lll. con6etm' Lic6s. l-aw lor rh. followi.S cson Gd 70r I 5 Busin.is
<br />sd Prcfdio Codc) Any Ciry or CMiy whicn rcquird a p.mn ro con{rucr, alrcr, rmprov.. d.odl'sh or r.pair e, sru u,c, pnd tu s
<br />ieso6c.. rlio r.qutcs thc ap?licut lor luch p€mil lo lil. a sign.d llalocnl t h.orsh. is lic.nscd puBuul lolh. proviionsotfi.
<br />ConE&iols Liccnscd Law (Chapto 9, Colmacin8 wilh Setior T00O olDiv6io I ofth. B6ii6i &d Pof*ions Cod.) or Oll hoor
<br />sh. is .rnpr thftf,m ed thc bsi, fa $. all.g.d .rmprion Any violdion ol S6l'on 701 I 5 b, dy arpli@r fd ! p.mil rubt(E th.
<br />appl'.Mr r@ cn,l p.ndlry olnd morc the fiv. hundr.ddolla rtrm)
<br />w../-- l. s u* n.. ol rh. Fop.ny, * my .hploys *irh era6 a th.n rct cmp.ns.lion, *ill do th. wo{ ud thc nedu. E nor inhd.d
<br />M oaf.r.d id s.l. { S.c 70.14, Buind dd Proa6ti@ Cod. Th. CMErd't Li6s. Laq dG nd !ppl, ro e o*n.r of th. prop.dy
<br />*ho buil& or imFov6 fid@, dd *ho dc tlcl wdt hic.lf tr h.6.lf r .lEud hit a h.r own dployG, p.ovitlcd lhd such
<br />inFovn nl! e. no. inc..lcd or oftccd fd t.l. ll, lrow.va, 0E building or imFovm.nr k sold wnhi. on. y@ of cmpl.rim, thc
<br />O*nc.Buildd wiu hav. ln. bur&n of proving O.r hc d shc no{ build a improv. for thc pulI6c of sal.)
<br />l, 6 o*n r of (n. prop.ny,6 dclBivcly @u&lin, *itn lr63.d ddat6 ru cNlrd th. pNiK' { Scc ?o4a. Buin6 ud
<br />Proa6ion Cod. Th. Cou-&ror'r Uctu. L.* &E lor Apl, ro & omd oa prcFtry who buil& r inFovcs theoa . ud who
<br />,/;e/r> r
<br />_,8 &lC ad lnit
<br />y<1
<br />I hcr.by .flim udcr p.nnlty otp.rjury o. oftll. tollnin8
<br />I hsvc ud *ill mintan aCenific.t. oaconsdr lo Sclf-lnturc for *ork6 cmp.nsation,6 provid.d fqb, Sdclion J700oflh.
<br />L.bq Cod., for rh. p.rf(xrracc of rhc wdt rd rhicJt th. Fril t isual
<br />Ihav.edwiUma.ranwqtm.dmF@rimicume,crcqut.dbyS.cio170001ln.LabdCod.,rdrh!p.rromtuc.orrhe
<br />wo for*h(h rhisFmith isu.d My *ortd cmFnsario iEur&ec id&drolcy nuob.r &.
<br />Policy Nlmb.r _erpr6
<br />(Tht rerion r..d nor b. €onplclcd ir$c Fnir i! ld Onc hodr.d &llu lll0o) a ls)
<br />.yl-ltiry r.l in lnc Fr.md.. oath. wort for shi.h tht p.mi( ir isrd, I shall nol oploy &y
<br />b.cme subj.d to fic r*lcu ' chp..Grio l.* of C.lifmr!, Dd $G $d if t
<br />,r00 oflh. Lah, Codc, I thall, f6$8
<br />A)
<br />C Failur. lo rccurc *ort6 @op.Mari6 coti.a. t edshallsubj.c' .mploy.. to omrnrl pctultcs dcivil
<br />€omFsation, .!amas.r 6 prov'&d fa thc Sdt'on 10?6 oflin.s up ro onc hun&.d tho6ud dolle 1l l0o,0o0),in .dditio io th.
<br />rh. L.bor Cod., int..d 4d .llom.r! fG
<br />LICf, IISED CONTNACTORS DECLARATION
<br />I hercby rmm und.i p.ndiy ofp..Jury thai I s li@ed u.,.r prcvilin of Chaptcr 9 (comd'ci.g with S.cidn 7000)of Divis'on I of
<br />thc Busin.$ ad ProLsions Codc, &d hy licmc it i. arllaB. sd.fret
<br />CONSIRUCTION LENDING AGENCY
<br />I hcrcby !flim undd p.nalt, oapedury dal $6. it. @ntdlction ladir, ltacy fd rh. Pcrfom ccof$cwork fo.whicn this Fmitis
<br />iisucd(Scc r09',,Civ C)
<br />A?PLICAIIT'S DECL{TATION
<br />D.nolrrion PmitlAsb.src Noriliclno Fcd..d RcgukriN {Tid.,o, Prn 6)
<br />_ R.qut.d L.od of Ndific.rid
<br />_l c.niry thar lh. fcd.ral r.Buhries r.sedins ab6t6 ,!mr.l {. noi +plic6l. to tht projel
<br />__ I c.nify rh.r I harc Ead rlii arpliclr@ ed rl.l. 0!.r ln..bov.
<br />ord'na.6 ed I'r. LrBr r.larin8 b buildi.S a rcpcal.riv6 of thi! Cny ad Canty to drq uFn th.
<br />abov. n.nri6cd pnoFr, aor i$F.ri@ puDcc
<br />A,r,*'
<br />,4-"*."*,".u *
<br />Set Backs j t1'a t (\\\r-".
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />SubfloorA/enUlnsul
<br />Roof Sheathing \.2'\-a t 16\
<br />Shear Wall Nna
<br />Framing 9lt la ,/)ll b
<br />lnsulation/Energy sl'nln W
<br />Drywall ;[421,,1 ilil(]
<br />Ext./lnt. Lath 5lizht >9
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />FINAL Q\r'r \tg /lta16
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />conrracs for such poJ*n *ith aConrrb(,lictr.d p6uul to th. Contuld ! L@6. Law
<br />i3 @mr I agr* 10 conply *irh.llCiry ddCounry
<br />Forms/Steel/Holdowns
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