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SITE.WORK DATE ID/SIG.COMMENTS ()IINEX BUILDER DELCANATrcN
<br />I ..Ehy .flt r ufti.r pcnalry I Frlllry lh.r I m .rcrttll fDD rtt Cnnt&1{n l.rd{ tlr rrn rlE folowin8 E$n ( s( l0l l 5
<br />Bu\incs\ tr'rl ,tn'Lssion Cdlc):
<br />^tr,
<br />Cirt .r (-.un', whi(h rcqtrncs ! !cm[ x, d,n\roc1, rlrcr. nq' h, &E,li\h o. hF( uy
<br />nei!r.- rt r('irs nsuuu. rl$ rcqui(s th. apDltanr r(tr \uch Fmn b fh ( $8n.t st .mnl lhal ltor En|i..tr*d tluquur
<br />h rhc FIvtFnr of rlt Co ,Niir\ t,t.n*d lrw (Ch4,1.r 9, commrnS *nh Sdrion ?ux) nl Divnk,n I of rlE BlcnEs 6'j
<br />Pn,r.ssnn: Gxl,.r rhnr h. or shc ar.rcn$ ltmlmm.'n lh. h{i! for llE.lkcd.rm{ria Anytntbtnnorsdrr7o.rl5by y
<br />lpplranr tnrncr' \abFtiilx !r,ti.mr ro ..ivrl J,.Mk y or d mrc
<br />'hd
<br />6v. nudrn dol{s (S$n)
<br />.-i r\ lwEr uf rhc FoFny, or my cn{l'tr.r *nh wa8.\ d( rhct $h dn{f,trsrtnn. wll&, th. * urdrhituihi!r,
<br />rtrrsdcd ornrlircd tur Mk (Sc ?044, Bu\itu\\ and Lidcr\inr cdl.: Th. C.ftrdol\ LiG$ L.s des norlp,ily ri,anoemrol
<br />rhclmt ny *h) tnril.G or irryorcs lltm( ffd wtF dtrs h lodi himc ll .t hcMlr or rhtuugh hir (tr hcr own cmpn,r!.r,
<br />In,vdcn rhd \u.h n\mmnr e d irr.rxGl oII.Ni tu Bk l{ k*c\ri ilx ttriui.g or hlnMm.t s $ld wihr oB Jqt
<br />or.ompLrh( rlr owEr Aui&r *nl ME dr hxr:i ol fllvhs rhd lE or nr dil n t{,xo, iivmw E F{Eny ror llE nlqrE of
<br />L rso*frr.lrlr lln,p(n!, rDcr.h^'vcl!.oitrrdn,! sirh h.cnrd.oNr.rr\ tr'.on{rucr rl* |no,rr iS.r ?(}U. Bu!'rs
<br />rrl thr!\\ir(itrl. lh.O'ntr:{tn \l (.i\.L$,1,)(\ or a|rtltt' rfotrr*'.rtirotcn)_*ho hulld\ r in,[orcs rhcrfl r.
<br />rn,l wh,' ..nrrr\lnrsu.hrn,l..r\sirhs(innrkrni\)li.c \cdtttrhutrrr,rhe(-( r n.nr'\1,'..r{L'w)
<br />lr rr\.tr,, Ln([rSNri,{ It &l'( f(trrhi\.cJvr,
<br />lrdc (rrner
<br />t!08f,1:&1l;aufaitarMN
<br />D[CLAXArIl,l!
<br />I h.rcby 0,lnr untfur FnrllyolpcrjuryoN orrh. nrnrsnE d(ldr"ri{,hs
<br />Ihrx n*iUmdri!aCcnrft rolconBnrk,scllInrur.rnso.ks\'.!mpcn$lnr.a\povd!.I(nhysccri,n.l?lxJotrhc
<br />ljlln Cftk.lor rlt ncrlonEmc ol ih. so* li, which rh. p.rtui t n\n.il
<br />)Sl hlh . t will nuid.in *o cFr oqrn .li,n rsur.Ec. B roluiEd by Sd xt l?t)o ol llE L.kt Co&, f6r rrx Frlimnt or
<br />rh. rofl lnr whi.h lih t mil ir nslEj My wirk6s' r$qEnsti,tr iNutuc .di., !d FIty nuhho e
<br />c*,*,.'1^b t L'-r^a.Aou- \-z"r
<br />,r"r"u.,*,-ZZIL$!-I (
<br />l .cn,ry r hlr r rrE JErrormN or lh. uork ltr shEh
<br />'hF Frm i{ Fiuc.l.I \!ull nd e,rgloy !n, FB,. 'nmynuN!r !\ ro lx$nE \unFt ro rh. $orlc^ o,llsnsrion htr s of Crlilom,a. dd lFrcc rhnr f I sbuld t (,nr {t'r{l lo IIE
<br />*orrfi{.on$trqrhnFrossi,)nsors..rk)n.rT0oorrhcltrhnCelc.lshlll,lonh*ilhdrnplywiihrhE,,hvhnfi
<br />IVAININC ltrilurc h suc worlcr{ con{En{ri.n covcrslr n rnhwrul, tr'kl shullsubl..l rn cmnk)}tt ro flinriinl lf,Mhics ond
<br />rn'l rin.\ trI ri dN hun,lr.d ihrtrxrl d,llr^ (Sl(xr.(rrr). tr, ,'d(l n,n nr rlr \rony,cn{trrL drnugc\ r\ Inortrlrl ktr rlr
<br />S..ri.n 3016 or llt tjts (idq ml.Esl In anmyt rs /------2
<br />o"", /l /tt z o
<br />^cenill; Za
<br />-
<br />t-tt ttstD c()N flr\(-ro|t
<br />lllIlJ.Br|Il0li
<br />,'l rhr llulnc(xnJ l'i,rr\\i,,n\(nJ.. x'rl n,yliccn\c tr ir rulltu(c rlrlrr\t
<br />c sffrn I
<br />ti ,u*L<- tZ"S 2 u<1-
<br />coNsrRt_lc'TroN Lri{Drfit: lcEN(-Y
<br />I lEriy allrm !n1., rEelt, ol F rn.y lh|l rh.r k . otr turion Lndins .gch, r., rtE F{olrmc rf 'lr !o* for $rtt lhn Fd N
<br />i{u.d (sa .Ir7. civ c )
<br />AIITI!.IINIIICIJf,AI1I.IrI
<br />I h,u, arm' u.xi.r Fn.lly of rE jury nE or rlE nrb*nr3 .Lrlu.,r ilns
<br />txmlirirn P.rnrih.Alhclos N(rifiori,. kdall Rc8uhtn$ ( f ib.{l Pan6,
<br />Itc{!rNd tdl.rotMiinrrin'
<br />-l
<br />ccnify rhdt rhc f.dcnl rcSulanons rc8ardins lslxsr.s rcn,{aluc mr applic krorhkan,Fr
<br />rll d,ty rhd I lEv. rcad rhis 0ol'lEnrr'n rlld n.rc rhr 0E dnv. inroinElion ir .ucd I asr t, onply v h aI cny .nd Cou.ry
<br />r{tliMEs afll Sr.rc ti*sEhri,r rotriunrrc.n\ruri' {d lEctydrn r rtE*ddiws otthn Cily e'd Cdnly lo cnls qsn llE
<br />lthvc n$'x,ftd nhthy ltr a.rp.dr,n NrIn6
<br />Appri.-t ".,\"nr sirn*,.g./-=//i0 ZL)
<br />l,.rni,d Mnk rrdnr: E vel- DtaZ
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floo'
<br />Subf loor/VenVlnsulation
<br />Rool Sheathinq
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<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 />Enqineer Final Report
<br />Flood Zone Certif
<br />FINAL 19.8/tt/t LfuTA '46
<br />Certilicate of Occupancy
<br />Notes-Bpmarks, Etc :-\ _
<br />e
<br />BUILDING. INSPECTOR RECORD
<br />tt.4 7 (
<br />Zr,htr! ,azftl da-{**- . &d ,t4 'A /3L ...'P?.r'W')
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