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BUILDING- INSPECTOR RECORD
<br />COMMENTSSITE-WORK DATE ID/SIG.
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulalion
<br />*44711 fu't,-, UzfRoof Sheathinq '7-24-t S
<br />Shear Wall
<br />Framinq
<br />lnsulation/Enerqy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />[/asonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif .
<br />J:A )H{ltx aFINAL
<br />Certiticate ol Occupancy \=a=-U\
<br />Notes Remarks Etc
<br />liJe<i,,\e,->,/o,
<br />^
<br />-t
<br />()rrNr,:R nt Il.t)ER trF:L(',\R,1TI()N
<br />I hcrcby.mrm undcr p.nnlry of Frjury rhdr I ar cxcmlr t'r.'n rhc G) rDch^ Li.c.se tie tor rhc folbwin8 rc"v't (scc70:ll5
<br />BusnNr rtrd Prcr6lnn, Cdc) Any Cir, or Cnxm, which tcquncs I tE ir ro consfld. .lrcr. inllnovc. &mlirh 'tr rulin rtrv
<br />strucru!..prhrrJnsh\uakc,alstcqnncsltclPpli.rnrforruchFrmirhl,lcasigacd(d.!rcnllhalhcor\hcnliccn\cdlrnnanr
<br />lorhcprcvnnnsofrh.Conlteckst-i..nscdLow(ChrPr&9.conrmcn.i'rgwnhSccrionTmoolDivirii'n-lorthcBusincsrnd
<br />Pmfcsiio.s c(dc) .r rhar trorshc hcr.'nfl lh.rcliomand rhc basis for lhc rl lc-lcd c remnr i{'n Anvriolnri'riofSsriro70115bvanv
<br />0p0licur lofu Frnrir suhjccrs rh. r!Plicanrlooci!ilpcnalryornolmorcrhrnlivchundrcdd.llns(S500)
<br />l, $ owrcrofrhc ProtEny, ot ny cnrnlo)t s silh sdsc\ ds rhct slc co'npcis,rotr. willdo rhc wotk and lh' {mrurc i\ n
<br />intcndcn or .nircd n)i ;h ( 56.?(}r.1. Busin$s md Pr.ttsioN Codc Thc Cofirtois l-i.{N. tjw d'cs nor lPplv lo un 6on'r nI
<br />rhc F)rrny vho huilds or in{n,vN th.mn. uxl who dms such \o* hid\.lror lENllor rhouen his or hcrowtr cmPnrv'c\'
<br />pn,uldca rtror *.t' inEoEnr.rr m mr inrcfilcd.r.lfcRl for sh.ll hosercr. rtr htil]iry or imProrMtnr * sld(irhinoN ]tr!
<br />;rcorlr0lclion.rhcOwi;rBuildcr*illhtr\crh.hxdctror!(,vir,8lh h.orshcdidnorbuildurnrrrorcrhcPmpcnvr'orrh'Nqrr'l
<br />l, ^owtrd.lrhcnorf,ny.,trrcxclusivelycont.dtrrE
<br />wirh liccn{d.ont otrlo.onsrfld lh. Projc'r (s'c ?0't'1' Busms
<br />;nd F\"lc..nnC.d.iheConrrrrrtrsLi.cnscLrwdoc\nrrlplyhanownforlnolcrtv*hobuildsorirnPor'\rhctcon'
<br />and ehn .ontich for soch roi(F q'iln ! GrnrE.krl sr li.cnscd rr uMt rorhcftntJcktr's Li(cnsc ttrw)
<br />_l r r.xcnrnr lnlcr Src.ntr-B & PC turr,rirrci{n,
<br />Dbr.: Ovno:
<br />WttnXets.cttltnrts't rlttt"t
<br />DE(IANAUON
<br />I lrrcby rliirN undcr nemliyol nctjuy on. ofrhc tulloNirg dcchfurnrns
<br />-lhivcudwitlfrrinlainrCrnific.olConsenrrosclllnsurclotworkcs.orPcnslrn,nasPrcvidcdf{rbysccrionlT0oofrhcIjhin Codc, Ior ih. l.rformume ol rh. wo* lot Nhich rhc pdn r s isucd
<br />-lhavc.ndwillnNinluinwortcn
<br />compc.lation insurrnce. ss rcqurml hrS(ltr rTmo! rhc bb'r Codc. lor rhc B rlo nanrcof
<br />rhc work l.r which rhnr.rmn is ksuL\|. M,wuikcN conwtrsurion insur!rcc .aricr ,nd ,olicv nlnbcr c:
<br />. ctl
<br />r,.L,.yN,*h.. . ?!r-oolfal -.rl- lY
<br />-E'ni,".I.cnifyrl ii'rrh.|rrlormamcofrhctr.rtlbrwhichrhi\P.rrriri\n\ucd.I\hrlltrorrnr o]rnvPc^'ni anl xnntr
<br />s r\ ri hdnft {$jccr h (hc solkcN .ompctrsrr irnr lis\ ol Crlifonrir. r dPEcrhrr itldrNld hccont lublcclt'rh'
<br />$,\RNtNe: I rih'r i' n.ur $or[('\ .o rlrn\rli(n .o\r'ut r\ url](lrL!. niJ drill r.rit:Y:iil,::::rcivil incs tr ro oio hunnrcd ihoxsid dollirs (Sl([. x). tr'
<br />Scction :1076of rh.Ln&trCo d,inrco(ildlrtotmr'\tcc\
<br />,t,rr"t'1 2t I ?,,
<br />I hcrbyrllirmundcrND(liyolP.rjrry rhrrI iD li.cn{d tr dcr lvortr ion ot Chrl)rs I('o nrf,t' t! $irhSc'ri('n7(xx)ro' lrn'n'f
<br />ol rh.llLno.\srnd Pnilr!'orN C.dr. ril rylr.n* i\ in iullnn.. J rlli.r
<br />-,*"." n*,*,, ' 1- 2/ZC
<br />t,,,"' 6^Zl- /Zl ,-,,""- f &s*k4 /cc4c
<br />II)NSIBII(.:IIAN.LI:NDING.dCINCI
<br />I hcnby rfiirDUndcr Fnrtry otpcrjrry rhd rh; i\ ! dm{rudiotr bndiDs r8cfty lor rhc pdr.nmncc orrhc sork ibr qhi.h rrri! rnnir i\
<br />Lcndci\ AdJrcss.
<br />--AEELTCANI-DECL AITO!
<br />I lEatr rlfmr undcr pcnlllyofP.rjury onc olrhc rolbwir8 {lccldurn,ns
<br />txDolirio. PrmhlAstic\los N.rincrrion Icdoxl RcBulntnns (-l irlc 40. I'inO
<br />_RcquiBl t ttciof Norikdtin
<br />-l.cnifyihd
<br />rlt fcdcrllrcgxlrti.ns rclmlin3 t qos r cnnrvnl m nor tr|pliclhlc b rhir !rerccr
<br />l.cdilylhnl lh$c rcrd rhk ll,)tlicrrionl
<br />orlintrn(\ d Sl.lc liwsrldrirr! hbuildi'r
<br />rrc rh.r rhe xlx,vc rin{n r .onc.r lrgrok,.onrnl!wirhallCiryrtrJC.unrv
<br />olrli\ C irr_ rnJ ( (n!rryt, tnr.r tr|x r1r
<br />ri,v. nrtrri(nrd pr.|Enr_ lin iNt).cri(rftr ...-- ,,","r 6-Z(- /0,Alt)launr.r,\lr l Siltrrlur
<br />I'o rir(,unrlpri' ): X-5 cf+l to
<br />?c/
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<br />is\ucd rscc 1097. Civ. C I
<br />LfFdc''. \,n'c '
<br />--
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