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.BUILDING-
<br />INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/Vent/l nsulation
<br />Rool Sheathing
<br />Shear Wall
<br />Framing ll/zY/rr,,I\K
<br />lnsulation/Enerqy io/h/ ty g\"*t
<br />Drywall trlft,(/,((jt6t
<br />Ext./lnt. Lath lut4/.-5\\kl
<br />Brown Coat
<br />lt/asonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />FINAL t2/b //s t'ri\4i
<br />Certificate of Occu pancy
<br />?1"-1>.Ez-k ..r,rF.., 6la,/./- 4C Zl
<br />OlVNCII BT'ILDER DELCARATION
<br />I h.rchy rfilrn und.r Fnalrv {)r pcrjrry rhar I m cxrnrfl imn rhc CnnrricbF l.iccns Lnw for rhc iollowin8 rcosn (Scc70:ll5
<br />Busi.cs nM Pnilc$nnr (nJc) Any Cn, or Counry which rcqun s L Fi'nir t, .oniruct. ,116. inr|novc. dcm)lish or rcl)ln any
<br />ntu.ror.. prior t, ils i\suarcc.,l$ lcqrircsrhc applicanl ior such,rnnn ro lilc 0 slSncd sI,tenrnr rhar lE.r shc is liccnrd lDru.nl
<br />ro lhc pmvtiotrs.frhc C.nlrndor's Li.ctrscd h{ (Chllr.r g. C,nnfuicilg wirh S..ri(). 71In.f Divkin.l .f rhc Bnsin.$ an
<br />Pmlcsion\ Conc)orthrr hcorshc k crcnrtr rhocLon rnd rh. hn\i\ ror rhc altuFcd .nmpr rcn Atryvnnari(n.iSccliotr 70ll.s hyrny
<br />aptlicanr tnapcmir sunjecrsrhe omli{d nr r.ivilFn.lryortui nxadlrtr rirc hutrdrcd dollnr\ (Ssur).
<br />I. d oatrd .l lhc l(,Ir y.or tydmlkiyas sirh Nrgc\r\rhcir y,lc comncnflrion. willrlo rfu so r rhcnturrn n nor
<br />idklLi.r,'ll'crcdfitr$lc(S€.7(t14.Bu\incs d Pnni\\ions Cod.: The Coftr(r'\ Lircn{ lis do.\ norrpnly t) atr otrmr of
<br />rhcnr)tr y whohuiLdsori'nnnir\ihc.Gin.nndwhodocs$khutrkhnn\cllorhcrscll.rrlr tr'Bh ht .r hcr ow0 cmtl.ycc\.
<br />porid.d lhtrr \udh i'nfm\lnrnhdEm! inrcMc,l or ollired htriak ll hos.\s. thc huildi'!! or nnrxrcnrnr i\ $ld sirhtr',n'( l!,tr
<br />ol conDLri([ thc Os .r Buildcr will hru. rhc hurd.n orrn,!iD! rhrr hc o. sh. did mr huild or i'rqi)vc rh. pRrt^-ny fr rhc ptr[r,i-.f
<br />l.!sowncrollhcropcny.0nrcxclusivclrcontr.cringwirhli.ctr{d..nlr..k)Nioco.{d.rlhcP$jLrl(S..70,1,4.8u\ircs
<br />and PmfNsirn Cod.: Thc Cotrt8.rtr r l-iccn\.1-!w docs nor rpply r. sn o$ncr ofpropcny wh,' l,uikk or ihpnv.\ ih.rcon.
<br />rnd sho conln rs lhr such Fojccls *ih i (n ruclor(s) licctr!.d pu u.nr r.lhcContrr'ol( l-iccns Lrw).
<br />Iucx.nr|, u crSccli.r-.1] &P.( irtrrhtrcr\.n
<br />Ddl. ()vner
<br />IraBar&r:.caufENsara!
<br />IICIATAIIO!
<br />I hdr.by afnm undcr |EmlryolFrruryonc oilhc lou)witrB d(lnilionr
<br />-lhlveandBillm0inr.in.CcnificolcofCon\cnlroscllINUrcrdsorkcF.onlt[trs,(ir{..s
<br />|mvAcd fu bySelion 37(x) oflhc
<br />Lahor Codc. ior rh. pcrfo.nrnccoflhc *!rk for which rhc ldnlir k i.\u.d
<br />lhnv.arl*illnuinrxin rnk.r! con,n.nsarior inqrimc. is r.(luiEn hrSccrion lTrX).fuh.l.rborCodc.li,rrtu pcrformrn..of
<br />rhc work ntr shichrhi\ prihir i\ i\\u Mtnork(s comnctr$ti,n, inwtrrrcc.rnirr i policy nun,h.r arc:
<br />l.cnily rhd r rhc |frfnnhi.cofrlr u.rk nn qhich rhi\ pcnni n i\\ucd.l sh llnurfl,flotant |trvni r0ynrnr .r
<br />w, 3rhlf,$ft uhl.d lorhcMdcr (DDcn\dlotr h$sof rhd il I sh.uld h.com \ul,jccl l0 llE
<br />wirh coDnly wilhrhos provhnrn!
<br />drll \ubF._r Dn . lpk,ycr k' 6nMrl l.nrlrs did
<br />qo'kcrs con,t.ns!rim pnvi\iotr\ oiSc.ri{,r :l7lrO.l rlr
<br />ll^RNlN(; Friluru tr! {.tr'c workc^ rfn|tn\rri,n, .o
<br />civrl finc\ uli kJ om htrndi(l thou\rtrd d.lla .o{ o, .onlllc \rriotr, dn rg$ rr t.vidcd lnr rhl
<br />s.rl! r)76,i rtR l_i l!tr ('
<br />**,Fai-a
<br />DII;LAAAII!}N
<br />undcr provtion ol Chlplcr 9 (conrm..in8 sirh S&ionIh.'chyrlln url.r |tnJlry or11.rlu
<br />or lhc Bu\inc$and PnlcsionsCodc. and myliccn\c n in tull li*cc xtcllccr
<br />o,,.,3-atao//-n*9tu,.. f, rt
<br />I ltrrchv nriirn uMci Fnrlry otp.rjur
<br />is\ucd (Sc. :l0i)7. (iv ( )
<br />dconnddi lcndi'rg rgci(y n,thc lr{rfonrncc uf rhcwoik lir \hi.h,ri\ lHmn N
<br />AlIITgANIl)l;l:LAf,trUqN
<br />I larhyalfimDMrr l)cnrlry oftf,rlury.tr. o, rhc n,lntrving,l.clfirri,,n\:
<br />Dc'nolnn,i Pc.nir\ A\hcdos Norificari.n F.{lcrrl Rcsul!rions ('lirbr0. Pln6)
<br />Rcqnn d L.rrf of Mnificxri)n
<br />16rioos rc8.rnnE .streos rcmvrl drc no( Erdk.blc k, rhn pn+cr.
<br />rhr\c i',fo'tr[ri{,nncorrcr Irt(rr,rorit]y$[hrllCtyitrdC.unrt
<br />dnd h.ftbt aurlnrizc rcprcscfaliv.l ofrhh Cny md County to cnicr uF lhc
<br />1
<br />+*@%/
<br />a-/
<br />Noles, Remarks, Etc.
<br />L:xfirc{
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