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SITE-WORK ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />/,U4 n.Roof Sheathing 1 11 ln P*.IJ t .fituql
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coal
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />FINAL t{v
<br />Certificate of Occupancy t
<br />Nqtes, Remarks, Etc t'L
<br />o(. {o l
<br />1 /L
<br />(
<br />4
<br />w l+y
<br />a;(l qd
<br />a €f z7
<br />I ,
<br />,a
<br />orll
<br />tt
<br />I ,
<br />O$NET BUILDER DEII'ARATION
<br />I h6.tr .rm und6 paElly of pcjurr ltui I m Grqryr EDn rh. C6nr..lon Lic..s Lrw lor rlE followDg rd$n (S4 701 I 5
<br />lrBinB dn ProfBior Co&) An, Cny or Coury *tlth rquc i Fnn to @dM, .!., ,DFo\q {tamlnh or rP.n ay
<br />nrudsq Fbr to iB isu&c &o r.qliE rlE,qpltmt aor r.h pqmn ro 6lc ! sisn d nrml the lE or !h. it licaed F,s,rl
<br />ro rlE Flriro6 of li. ConEr6 t tk.nsn bw (ChFa 9, Coming wnh Sdbn 7000 of D rion .! of lh. A€ilB @d
<br />lmfdioN Co&) or thlr lE or ih. i! cidpt rhqdroi ed $G b.rir for th..ll.s.d .ranFion ary vioLlionofsE1ior 70ll.5 by ey
<br />9?lker for . Fni !be!r rlr qlicd ro r.ivil Flny of mr mE ifia lir. hunit d rhlld {tt@,
<br />_1. a osE olrlE ForE r-. d hr olck t€ *ih v.s6 B r&n nk .otrpddion, *iI & tlE w* !d rlE lrlurE a mr
<br />iddk!.d or olIn d lor el. (56 70.t4, Buin6 Ed ftDfdioB Cod. Tt Codriclor't LicEe lw do6.ol4pl, b dn o*E oa
<br />tlEp.!!cly wt! boiLt or rvo\E0Eblr.d *'lb dc *i Nd hielf or h.elf or mueh hit d hc o$n mph)B
<br />Folikd $d $ch idFEEB c Dr idad.d or6rid.n tor $l I( h.*n6. rlE hlildirB d irDEn\-En a! ild wihii 6G rd
<br />ofonpldio( tlE o'rE Bdl& wiu h.r th. Un&, olFows thr lE q lrE did mt tnild or inv.ot. fi. FrFy nr di F4oj oI
<br />_1, a o*E of rhc FoFry, d 6ctuiv.ly coMine q nh lk.E d codralm ro otdnrl lli Fj.(l (lic 7o{. B'Ms
<br />&d thltshn Codc Tn. ( omflcror. l-ic..rc Llv doB tror .pply ro e own6 o aFop.ny *ho builds or inprord thd@n,
<br />ind *ho coflrrr! tun lcn FoFr $th r Glrdonr) li.rel FrBuir lo llE codt.dd'3 Lr.e l5 )
<br />_l e.roF lds Sdir_. B. & P C. f.rlhir 'a)n
<br />D.r.: OIYE:
<br />.!tq86!8!.grMlEdtA11o!r[cutallo!
<br />I hd.tl''rm uda FrlrolF,rt oE olllE lolloring &drnbE
<br />-l
<br />n^r od will ni,llj.. CdiaEd. of CoMr ro s.lf.lM fm wld @mp.ndio'i, 6 Fovir.d for b, s*lion !?m of llE
<br />lrlor ('o&, for thc Ffoll1@. of th. "brt fM *hi.h rlE Fmn i! i*!.d.
<br />-l
<br />h.v. and tr'ill Mirr.i! *dtdr'oiFE rDn ietu.. s rcqut d b,S.dion t700oirt L.rDrCo&. tor th.Fl(,r]4.ol
<br />rh. worl for which lh! pqhrr ! Nld Vyworrdr NmF!.IEtr,cuJ@. .md.rd polE, dunbc o..,*- -Sq+€ (wn't.An].wdne t;nd
<br />q oc ourt-]r\.\
<br />-I.dit$
<br />inrh. Ff.'M.of th. worl fd sti<h $i Fnn n i.tu.d.I nuu ml @phy s, pastr h.ny m&F
<br />s s ro b.com 3uudl lo tll. w*6 .ohpqr.dion Lws of Crlifodir. !d rec lhr ill druld baom objdl lo [E
<br />\vtd' onFMbtr Fovirioc of S..rion l7O0 of rh. Ltq Codq I rlrll. tdhwnh 6od, Bih lho- FDri]ao6.
<br />WARNTNC lailu. ro c@ sortd onpasrion cov6rs. ii unh*ful sd shltl rubial & 6ploF to ctnitlt F!ti. &d
<br />(ivil fin6 uD ro or hurilr.d rho6rld d6llN (llm,oml in .&tbn ro lh. ftc of 6rFE iioi. d.n s6 B FotiLd tu th.
<br />sdrion 3076 olrh.l,!or cod., inldd !d.horfty r f6
<br />1z1ro/ r g ssl alc (
<br />DICIASAIIO!
<br />I ha.t, rlfro u.da Fulty oa Fjory lh{ , m tcd!!.d undd Foririon ot Ch,plr 9 (o@ftnE $iln Sdbn ,000) of Diritior I
<br />of rh. BBiB ad Pofaio6 Co&, nld mt ltaE a 6 aull aore dn.lIcd
<br />g o 3soo l
<br />^,.,- )L _o{,lftudan
<br />cQxu[ucllaNr[lDtac Dl(I
<br />I h.rt, .trm !,xls Flty of FJur.- lhr $6. i3 . odltudD, lddiry +trt for rh. Ffollffi. of tlE srt ft'r *nah thi! Fmi 6
<br />i!o.d (s6 1047, Civ. C.)
<br />AlEt t(]AdfDlcttSallll!
<br />I ha*y lfrh u.d.t Frhy of FJUry otu of lhc touoqi4 <LcLdlho:
<br />D@.lirFo P@i!-A!b.r6 NorifEdbr F.dd.l RctoLrioN Gnk 40. Par6)
<br />R.qutcd Ldlq of Norifi.dion
<br />-lJFrrS 'hd
<br />ttr r.dsd rquLt'od Esdduu 4b6rot '@!.1r. n.r rpplk.bl. ro rhN pmFr
<br />-L4cdrlyrhdIh6v.Gdrhn!pplic.!nnrn 4. rhd thc.hvc inaomrion i!.0161 I .!rc ro @mply wilh.ll Chy !trd Cooly
<br />oidiI,E xd Sd. lls GhilB ro hildiD8 @'irucri'E .d halb, .lnhoriE EFrsr.i6 ollhn cny !n Court' to orc l4o. rlE
<br />rbov. morionGj preIEny f.r iBF.rion tur!o3<
<br />^pprd',or^Ba,sh
<br />,* D. }.,l- 4-
<br />Pmr,Eur.rpri.u: X JqSS,(A 51 r-e\
<br />.>loftL
<br />,I'E ,aI
<br />BUILDING. INSPECTOR RECORD
<br />DATE
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