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SITE.WORK DATE ID/SIG.COMMENTS OwllEf, BUiLDEX DELCATAI|ON
<br />I tcEhy ofttr undcr p.runy of lEriury rh.r I m .r.mpr fmm rh. Con'Ecror' t-i...s Lrw ror 0E lolbwing ,caor (S( 7011.5
<br />BlaiBs ln Pioratrb. Codc) Any Cily or Cou , lhth Gtuirs r tEmn h conrDd, .ll€. inpDrc. &mlhh or r.F, M,
<br />nu-iE, Fi,l0 irs n!l[ft...,$ EflEr tlE {Dltd' ro. sh Fmjt lo lih r rBEd nd.cnr rhc lE or dr ir lr.nrd ,'ur$tn
<br />&, rh. pbvilidni or tlI Cunneky r Licc.*d t2w lchrnrcr 9. Commtu-ir8 sirh Strrion 7(xl0 ol Divtn,n I otrlE Busims md
<br />Prlfcasnn. C.d.) d lhd lE or slr B.ktrt, E.lremnl rlE b(ir for rh. rlkg.d.r.n{rbn An,v.lrrbnofsdi'.701I5hrui
<br />rmltrnr for r Fmi obl.rls rL .prltrnr ro . civil p. lryof 'rmErh!. fiv. nundEn do[es (lJm)
<br />-1.
<br />a orF o,th. rroFny, c my ctrploF.t wnh w.8s a dEn sl..lqEneirn, silr & dr wrt.,n E(ffE6 mr
<br />irtdi.d or of.Ed ror rb (Sd.7044, Bu.iE$ d Prof.s*,ns Cod.: Th. Conrtuol3 Li€n€ trw do.s mr +ply ro i owr. ot
<br />rtE lmp.ny el$ hoild! u ir+rDB tEan ,n vb d6 uh k* hilMl, or tsEll or rhftu8h hir dr lEr own.ryrk,yftr,
<br />Fovid.n 0d uh i,t{rcEEd.e d ir.!d dofidd fr st l( hffi, ft hrait !t,mrd ir!*ihsmFr
<br />of.oitErDG th. osnd Duilttr siu lBw t i hrd.n ofrovi,s lhd h. or rlt diil d lni! or i,rIFE dE FotEr, fu tlE I'uq,r of
<br />-1.
<br />$nsrcrof rh.F,thy, am.rclnrihlymntrmtin8 *irh liccnsd conrEb^ b roNru.l rhc pu.d lsd.7014. Brtinc$
<br />aEt Er,tusiro Cdr.: Th. Contmrols L!.n* L.e dcs nn pl, lo e osRr or poFny sho buildr or in roErth.r6n.lnd *ho d'ddr ld 0.h FlFds {rh. co,rdoll9 licnrd lrn6ur ro rlr c.nrBlor'! Lirne L*)
<br />I rh d rcmr{ und.r SNrirn
<br />O.l. O*&.
<br />WORI(rrs'L^-(l[tPF\lslTI(rN
<br />Dfcr.A&ula
<br />I h.rchy ulfirm undd I'.Mxyoflf,luryoft ofth. tullowi4 d.clrhriuns:
<br />-I
<br />h.E in *iu B,nuin. C.dirsr.6r Corcr'r 16 S.laln@ rd hrtm oqxtrdnn. $ FDvid.d for b, Ssrior]Tm ol tlE
<br />bbo. C&h. fo. rhc p.rfotn@r of rh. *ork for qhah tn ,.mi is nsu.n
<br />J h.E.nd *rll Mnr.r worr6 co,r{l.nqrDn 'Nunr.. s Eluircd by Sdi,n lrm of rlr bh.. C!rh, for EFfmNor
<br />rhc worl aor which this pcmn i\ nocd. M, qorkGa cohp.nBlion irsur.m. cMi.r rn polty numbcr G:
<br />Pef-:) 1,.. *\ a-]"*IL\
<br />' lGr)Ll,rtEcY .;1 t!tr&
<br />-l
<br />ccniry thlr in ih. FrformN of lhc *orl fm *hich lht p.rmil is Lsswd, I shrll ml cnphy anr lErsn in rn, lMErn B lo h.or $bid to tlr wr6 orFMbn Ls. oIc.lifdu .,'d .8G thi It I 3lhlld beoc $birl lo dEe*6r otrpcnsltrn l,mvtiotri of Sdio.17@ ol rlE bhd Co&. I dElt. tubrith 6rtly eilh rlD- pbviri@.
<br />WARNINC: Frilurc to sw Mrkdj @np.6!rion 6$.Ee i unhwtuL {n rhdl rubj.ll e cm0l6y!r m aimind tEEllii ild
<br />.ivil fE. up lo om tu'n !d rh.$.lld dola (!lm.G)l ia .ddnb. ro rtE @r ol sn!.Nrbtr d.r!E! a provikd fs rlE
<br />S{tEn ,076 of th. Lrtrr Cod.. d.d ..d d6mv ! l..r
<br />o.,.. , o(trl.t,r ^**.'F _J_q<nS_1.,,r- _ _
<br />UCEM&-LI]NEAqII}B
<br />DSCIjSAIq!
<br />I lEEb, .rIrm !..,.r Fn xy or Flfy i,!, I a lic6.d u'id prDlirbn or Ch{ro 9 (offiint *nh Serb. 7qD) ot Divllion l
<br />of th. Busie$ dt Pr'acsihf,r Codc, .d my ltcnic is in tull aoc rd cfidl.
<br />r ,.-,." r'^. ' C' to
<br />uP;{u ..",*,..\ Fr-j,..
<br />cotsfquc-TroN I r\ofllc lcFr{(rY
<br />I h.mby lnrm lndd p.Mrry of Frlry rhar rhd. ii i oni|ocrbn Lndins.s.ry for rlr rErlommc Dr r hrk for whi.h rhi! Fnd n
<br />krEd (sc 109?, civ c ).
<br />AfILIIjANIIECIIAAIIO!
<br />I Mr.rmuLL. p. liy6rF,tyoE orft nnb*irs d6l&tri,ni:
<br />Dcmlilirn Pcrmik'AstE(os Nolificdion tldcEl Rcxularirns (Tirh.r0. Pin6l
<br />-RqlEd
<br />trnd ot tidfdi,
<br />:dily thd tlE f.n rd rcgubrbB EB{di.8 u{Endr EnbEl r d .ppla.bL ro rhi ttu,..i
<br />'ly rhi I hJrc r. ihir rffl'.rri,n,arcrharrlLlhrve itrnrndn,nisconccr lesrcroconrplyvirtlllCiryondCou,ry
<br />oilfirer lld Shr. tr*l EbrirB k, t itti rbtr .n lEr.6y .lrlnria EF.ednitd of thir Cn, ud Cou , ro .'{q urn. E
<br />rhtrc ftnrx)tud F)Irnl ft, m\Fcrtr'n
<br />.\u ic:nr "ris.nr sixru rtr.,
<br />l'".ui,,* "*," I p.i,,0, ;(L ir*l*-
<br />c/cq/tr1t
<br />Forms/Steel/Holdowns
<br />Erectlon Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenYl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Enerqy
<br />Drywall
<br />Brown Coat
<br />lvlasonry
<br />Pool Fence
<br />Handicap Req
<br />Deputy Final Report
<br />Enorneer Final Report
<br />Flood Zone Certif .
<br />FINAL '7lLU'.tl t)tLY*
<br />Certif icate ot Occupan cy lr
<br />Notes, Remarks, Etc.
<br />a
<br />BUILDING. INSPECTOR RECORD
<br />a
<br />Set Backs
<br />Ext./lnt. Lath
<br />T-Bar
<br />toLcLA{
<br />Fuc-v
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