|
SITE-WORK DATE ID/SIG.COMMENTS OWNER BUILDEB DELCARATION
<br />I tr.b, dlrn un&r FMny of F'lry rhd I s q.npr rEn dE C6nrd6 l-idM L, ror rrE folbqiry r$n (Sc.7o.ll.'
<br />Buri*s ad Pnlcsidn Codc)r Ary Ciry or Cddy whi.h EquEs ! F.nn lo @nirtr alr6. antorc. &mli.h o. RFn y
<br />srrudw. Irrr ro ns i$ure. ds 'quiEi th. .ptlt.nr for iuch Fmft ro nh r ri8En st.l.Enl ltul lE or slE i lieEsn FtlluI
<br />ro rtE Fo$i,nr of dr Coltrrhr'r LiuEd t s (Ch.prd 9. CollftBins *nh Sdir 7m of Div'ri,. I of d. Buirs rd
<br />Prcfcsions Codc) o. rh.r h. or rlr i! crcn r rhd.tom ld rh. hart for rrE rlhlrd .r.nprion. tu, liobrir of S.<rhn '701L5 by .ny
<br />Elplicsm fo. { p.mir $bjdk 'lE q'pli.rr ro. civilFMhyofml fl,E rh{n fivc h!.nEd dolldr (1500)
<br />_1. I osd otrlE rrFny. ( my crrtryar *nn !.a.s a llE, sL onF6.lxrn. vi! &r rlt 6t.d lh. itBre i rcl
<br />id.nLd or onar.d for $L (Se.?044, AuliRs rnd Pmfcrshnr Cod.: Thc Conrtcld\ Lt r€ Lrs .!ft. mr .ptly lo i osBr of
<br />rrr F{dy *no L{ :ri o, nqFM. tlEatr an wb &E uh urrt hiBlf or lEBlf or ttuour} his hd oh cilLtis.
<br />pmviLd rh.r rEh iqmEr'ir e d irqi.d a ofi.td fq -L lt tbM. dE bJd!!8 n hrwffi i' ild wihn' d )d
<br />oforpl.tioi. tli OrF Buil&r wiu hrE tL lrnkn ol Frvi.g lh.r lE or dE dn ml tuild or intioE 0E Fotmy fo( tlt FaF. .f
<br />/4!.r. -.**,.r,* 6,p.nt. am.khsiwly o rrrhr wnh liatrrn codr..16 ro E td rt! Fois lse. 7o.4. BEiIK
<br />ad PtDf6.i, Code. Thc Conrmror'! Lic.nr. L:w &E ml splly lo !n ovnd of proFny *ho build! or idprotr ihcr.on.
<br />.rd who onul1t rq *h FoFcr3 sirh t Con.r .io(t) liin n pllMd ro tlE Coffia! tite ljw).
<br />^r, Ol rl,J ?DLt ,,"".. f
<br />I n Eh, allnD un&, FBlry of Frury om o! rh. folk'*int &tbr:rhnr
<br />_l haw nl will tuihtrin a C.n ifr,rc .f con€ni h sclf- Inrurc for *ortdr' con{xnsor ion, 6r pn'vidcd ,,n by sNr ioo .17fi1 nr rh.
<br />lihn Codr. lh rhc pcr,trlrec of rh. *u lnr*hthrh.txhrn n rsucd.
<br />-l
<br />hrv. rnd *ill roinrain $ort.F coml'cn{lion in\lrdrc. 8 rcqui,.d by s€rxrn ]7m ol ft. ljbor C.d.. for rlE tl(rtumE of
<br />rhc woir for whth rhir rErmjr is irud M, *orkcn' c.tr{Ensarion insu,r( trkr lld lDlty numbs el
<br />Pnlry NudlH - ErprR\
<br />U4f ccdiry rhrl in rhe pororBr. o, th. sork aor *hkh rhi],Ermr t ir$.d. I rhrrt mt cirDloy Ny Ftun m rny Mftt
<br />$ s !o h.om subiri !o lh. wo 6l coqEns.lion b*.ofcslirbhir. drl rse lhrl irI slDuld bc{om NbFl k'tlE
<br />mrl6 otrpcMrb. pEvtbnr of Saliln 1700 of rtE l$or C.d.. I {DIL rdhwith oirply wfi $o- I'lvitioB
<br />W RNINO: FrnrE ro iG hrtcc' 6np.n!.riin oroF i! utLwtul. .d .rdl bF.1 .n .tploF lo siniul FElit aln
<br />!n'l lirE\ ut, r' Jnr l'trft,c'l rh,r{ft1 'i ll \ '11,r'r.'in,,,, rhc .'N ,n (onrB$\ i,!,. (ltrn{gc\ x\ t(,vnli i,tr rhr
<br />S(rion 1076 nrtl. Uhr Codc, hrcc< rnd rbmy'
<br />o..,, LollvlW^ooo*,,
<br />DEcIJEAIIII!
<br />I lEEh, .fiirm un hr Fmhy ol Frrury th.l I rm liaRn undcr lrolirid. o, cllpld 9 tL$.rftRhe *i$ Sdion ,u[) ol DMsi,n l
<br />ol rhc Businc* Md Ptuf.$ion. Gdq rd my li.cns a{ in tull lorcc !d cllccl.
<br />c0llrSllqll1!.!EtrDllc-acla(.a
<br />I lEEby.fEm unLr p.Ehyot Frrury tld tlE! i! r c,nrndbn Lidins.!.ty tor rlE Fflm ol rwtlbr lhihfii! Fni i!
<br />nru.d (se .1097. civ c )
<br />AIII.ICANI.IECIJXAIIQB
<br />I ffiy lffm und.r Fnlny ol Frjur, o orrh. foll'eing drimrions
<br />D.,B,lirhn Pc.mlk-AstBro{ Norificilion l_qj..!l RquLlions Crilb 40, Pcn6)
<br />-Rcquncn
<br />Ld6or Miifdi.n
<br />-l
<br />cnify rid rhc tcd.ol EslLriotrs EBEdinB isb.*Lx Emvd e ml .{'pltabk lo thi pmFr
<br />f/\r(d'rvrhd rh.vc,currhb sDFrrJrmn !,n {urcrhd rh.lhn(
<br />:3'rH"Hl:r;;,:1Tr': :: ms$pffi *"
<br />Aprlrc,r orAr.nrsis*rurc X \) \
<br />P.mrREftipr,.,,: >( \,J ,{n(594 ( 4
<br />inforrdhn B .6r.d. I r8G ro 6hply vith r[ Cny rd C.u y
<br />6y lu$drir r.p..cnutiv.r of lhn Cily !n Counly l. cnld upon tlE
<br />*,. tqllulzozr
<br />\^l
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subrloor/Venti lnsu lation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq
<br />lnsulation/Enerqy
<br />Drywall
<br />Ext./lnl. Lath
<br />Brown Coat
<br />lVlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certil.
<br />FINAL a-tg-z /Z-ct,^Jezag 211
<br />Certiticate of Occupancy
<br />Notes, Remarks, Etc.
<br />-)
<br />BUILDING. INSPECTOR RECORD
<br />t d.ai Addr.s
<br />-
|