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BUILDING DIVISION - DPW <br /> COUNTY OF HAWAYI <br /> 101 Pauahi Street, Suite 7 <br /> . i <br /> Hilo, Hawaii 96720 <br /> �'•,, ,.� j Ph: Hila Office(808) 961-8331 Kona'Office(808) 323-4720 DECLARATION ACCEPTANCE DATE <br /> DECLARAWN OF COMPLIANCE <br /> HAS SgrTI CI 3 46-88 R£LATI NG TO AGRICULTURAL STRV CTURES <br /> PROJECT/AROPERTYINFORMA�TIO�N r <br /> PROJECT WME 1' f)li l� wt as &Q J <br /> STATE LIMO USE DESIGNATION For conflrmatia of$tato Land Use Vesigoation.contact the Department of Plan Ing at(8178)961 8288. <br /> A6i ir-�aLl Fuk&R171}R1 ti5S j o ?) <br /> Kawa­ <br /> r.J '1 + 1W�• K4, f vL`t 0hQ C l <br /> TRXfvfRP <br /> KEY 1 tii'1tO�ER�AfiFJt <br /> STRUCTURE INFORMATION <br /> USEOi:STRUGTURE �] ^ LinV n Y-'^i _4 —K a n <br /> fxEnnpTFCrN Nor,{sec$st anfQiiow ng sheets `rA. `/{ V V�S`}fTRUC.TURA1,SPAN(FUR El[EMPTJOM-.7&12 Dh1LY) ik)(tswx be less ban 25 fc) <br /> D(5TANCEFROM NEAREST STRUCTURE ��Y (It)(mm75k.} � ItOTALFLOORAREA �,q�f {xq.fr,y <br /> prnsCN5tONsOFSTRUCTl1RE length �] qf")x Wdrh (fr.) _ <br /> AGGREGATE FLOOR AREA OF ALL EXEMPTED STRUCTURES CtA6mW UNOLR HRS 46.88 <br /> Provide minimum 8.712"xt7"s to pth i apps mare a{4aq Qf s[rlrclvrC,properky lines of er suuttures,set cies to�ls�rserucsuEes ertc:suons ofstrutwte.and any Wherpardnent information. <br /> Attach extra sheets,if nctess&ry, <br /> COMMENTS(for deparrmcnt use an*, <br /> Y�[�z.� w <br /> 1!1 Q,1PCC <br /> (Obrain appr*val signaturts prior(a safum%tai of Declaration m Pabl It.,Warks) <br /> ENGINEERING DIVISION APPROVAL Flood Zone X <br /> Engineering faii isianB.H - <br /> OWNERS CERTIFICATION/DECLARATION <br /> i declare IN5 project to be exentptfron.applicable bs+ildirNg parmit/mcle requiremtnts ander tim provisions of t IRS SeWon 46-88.1 have toad jmd Full rundcr%and FIRS 46A B and certify <br /> that the preje"is in compliance. <br /> 1. I understand that this exemption only applies to certain building per:nit/code requirements.I shall obtain all*[Iter required pearits and approwds and shall cotrrpay with all <br /> applicable codes and iawa associated with this development,which may include and nor be limited to Special Nlarwgernent Area,Flood Hazard,electrical,plumbing grading; <br /> driveway.work ireCounty/Swte right of ways,fire.wastewater,and Department of Health requirement <br /> 2, f understaodxhat the issuance of a deciaradon number by the County should not be taken to mean that compiiaAce with HRS 46.68 has been conflrmeA and that it is my sole <br /> responsibility ro confirm tom 11 We,The State or County shall not be liable:lot any cfaims afis+itg from construction of buildings,structures,of appurtenances thereto exempt <br /> from the building code-and pai itting process as described in HRS 46.88. <br /> property 0 <br /> Address: V) 4 0 elf i I WA 6hOL t. '1 <br /> Phanc No: Email: Vr 1' W Ge.S S I V) I h G h'Y>t► ,am- <br /> Signature: printed Name. ` O �}. <br /> POST CONSTRU CTION A FINAL Al j0Z7,R5T_JFJCATION FORM mu be submitted upon completion of coarrauction.Failure!o sulTrllir i e farm wfltwuse this <br /> REQ_UiREMENTS- DECLARATION OF COMPLIANCE to be declived INVALID and shall VOID the building permit and/or code exemption.A single Final As-Built <br /> Notifrcatioo Form must be subrlfeted in compliance with both cf rhe following deadlines: <br /> 1. Submit form within 4 year of Declaration of Compliance acceptance date. <br /> 2. Submit form within 30 days of completion,ocoupanry,or use of structure, <br /> Hawaii County iS an Equal Opportunity Provider and Employer Rev.3/22 <br /> l ' <br /> i <br /> J <br />