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SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDER DEITARATION
<br />I h6cby lmnn undq pq6lly ot Fju,y rnd I m .xmpl Eom lh. contrcloB Liccns. I tv fot lh. followbg r@n { s* 70r l.t
<br />lrBinqe a,rl ,tot*on ( od.)r A.y Cily or Coutrly which r.quic ! pann kr consru.I. thd, mpmvc. ddrolilh ot qE. sv
<br />srtu.ru.. rir tr irs isumq llso r.qut6 th. tpPlicsr aor such Fn lo nL t .,8n.d sddMl thll lt or 1E i! licd!.d plelr
<br />lo rh. FDlnioB of fi. Conlrlcror ! Lic.nsd rrw (Chaprd 9, Com€ncina unh sdio. ?o00 of Divilion I of rhc auind hd
<br />Pmfsions Cod.) or rhal h. o, !h. is.rmpr lhscftom dd lh. bssis ror rh. all+.d .rop(ion Any v'ohtmnofs.dio.70ll5 bv uv
<br />!!?lic&r for ! Fn 3ub)(c rh. .ppli@l lo o c'ul t Blly o f not morc lhu livc hun&41 dollds (lJoO).
<br />-1.
<br />6 0*16 of lhc poFly. or my dplorE *'nn w+6 6 thcn DE conp<B,ri.( qil & tli wI ni tlE rrudE b ml
<br />iirdrj.d or oII6.d lor s]. (Sc 7044. BBi]id od PmfsioN Code TlE Cot Ed* ! Lko& llw d€ ml .PPly lo e ohd ot
<br />rh. FFt, *hd toil6 d i,rF!6 lFEaq nd *'tb tkq mh wtl hirulao, Ld*lao. ilE uSt hn or lE osn dplovc
<br />provid<d rhlt ruch inFolc'dr c ml iddn d u orI*d 6r e].. l[ hosqs, dE hlldBS or ingoffi ir -ld *ilhin orc ]d
<br />oastnpldb( 0E O*B ad& wil lIw tlE hntar olFolru dirl lE or CE dll ml hild d i.{.otr tlE FDFtv ftn tlE Frr.r. ol
<br />L s o$E of th. Fo?sry. m .r.ldiv.l, coMins wifi li.o!.d .oddoR ro olerud llE FoJ..t (sc 7o{4 8$u6
<br />drd Probir Cod. Tn. (onrn roa3 Lic.@ tis dc mr +?ly lo u ovnq of FoFry *lE hildr or inpra!6 rh6an.
<br />ud who mdrl(lt fd s*h FoFl! wnh ! Cod!.lo,1i) lkdE d F,s6t to
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<br />Comrcl , Lice Lr*)
<br />I m.rdd udd Sal
<br />!985lSf.sOMrEdlArIA!
<br />DECIJAAIIAT
<br />I h6.t!y rmm un<16 pdrny of Fj!,y om 01tn. lolb* ins <k L,.lioB:
<br />-l
<br />hr\r rn will mi,ndn . C.ni6.d. of C.Ml to S.ll-lBr 6r wtdr onp. ri@6 FlYi,cd aor byS*l.n l7O0ofllE
<br />trld Code aq rh. Ffotuc of rh. wr for rtltt tlE Fnn ir isd.
<br />\lh.w.,n",tl d@ *sro @rlFEdDE Ultl,tu..6 GtuiEd b, SGlk! 1700 ofrh. Lrbor Codc tu $.FfoM.of
<br />lh. *dI fc *nih thir FDil i i-ed My wta .D@c.hr iElltuc @a t, poliy Mtd e:
<br />l'** e ve4E51 "JP'1trvAL ll\f,v(L C{/1,Y?4d"7
<br />p"r,.. N,.b- ?6000l) ?qt+lrl F,er-b I rq
<br />-l
<br />.oriry $.r i th. Flolrls. of th. *ort for vhth thn Fnn i! isu.d, I {dl tul dqhy ut pa$! in ov M
<br />s s ro hEom $t at ro rlE "qt6 @DpdrbD Lvs olcdifomir. nd .!E fir if I tlbuld b<oE $biFl lo lL
<br />mn6' onpqu.lion Fotirio6 oasdb.1700 of th. L.tq Cod.. I CdL fonhwith o!4ly vin tu* Fri]bd
<br />IVARNING F.iG lo Gu. mltd' orpqBiioa srGtgc it unwtul tn ddt olirr x dryloF to ai .d Frrb -d
<br />cnil fB up to oG h!d.d rtburld &llu! (t|OO,OOO), b tddnio. b rlE.oi of oig.dioG dm.s6 ! FDailai lor llr
<br />Sa-lnn !076 of$. Lrhd Codc irl6.n..d rrdErl t6.
<br />ADoto"l,-
<br />l.t(ExsE.colraacloB
<br />DESJAAIIA!
<br />I hd.bt .lho u.dd parny of Fi'[y lhi t @ U<ad urdd FDviiba ofcll4rd 9 (6Mirs rih S<ri]. 7000) ol Divi.bt !
<br />of dE AuiB &d PDtsiod Code rd dy ltoE a i. tul 6r rd.Frl
<br />Ltot /v14 91q\fl'-
<br />o,., lt/tL/ZVt 6 c. -.,-, <ttaL?Va*r1k7. I tVC '
<br />CONSTRUCTION I TNDING ACEI\C1'
<br />I lErby drm u.'(k FDxy of Fiu.y rh, rlE. is ! cod3ndb. lddit8 tg*y tor rlE FfMc of lh. soll 6t stih lti rsni i,
<br />LBu.d (s6. 1097. clv c )
<br />I .n,1.' r Adt'B
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<br />AISUCAITLDECIJEAITO!
<br />I hody .trm u.da p6rhy ol Fjury orc ollh. fo0o$ir8 L!..lEdiont:
<br />txmolilion PdireAlb6ros Nolific ion F.d6tl Rcluh ioa (TilL 40, P!n6)
<br />-Rcquncd
<br />ktd of r,ldi6cdir
<br />I cdify rhd lh. f.&61 ElrlrtioB r.g&dins Gb6los r@ovtl e. mt .lplicablc lo rhie ,mjci.
<br />rhd I h,v. rdd rhit lppliarion &d n.t. rh, (h. abov. infomali. i! coftd. I .sre lo codply vnh .ll Cilv ed ( ounrv
<br />ordinu.6 and Si6t. Law! Elarin8 lo b!
<br />ob.vc
<br />'ndxoncd rroFny ror icFdion
<br />authort. r.F6.nlaliv6 o f fin cny Md County ro ord uFn tlE
<br />\ar+nrnr-,
<br />,,.," 1zf 1t f zotN
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subfloor/VenUl nsulation
<br />Roof Sheathina
<br />Shear Wall
<br />Framing
<br />ln s 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 />Enoineer Final Report
<br />Flood Zone Certif .
<br />FINAL It-t*t1 HAY4
<br />Certificate of Occu
<br />Notes, Remarks, Etc
<br />BUILDING. INSPECTOR RECORD
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