|
BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subfloor^,/enul nsulation
<br />Roof Sheathing
<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 Requirements
<br />Deputy Final Report
<br />Engineer Final Report r'valGll
<br />Flood Zone Certificate
<br />FFcnl'ri:l
<br />5FINAL
<br />Gertificate of Occupancy
<br />Notes, Remarks, Etc.
<br />Ohd-Euil&r Dcclnri6
<br />I hfrby .f,im lndd p6rl9 ofpcrjury Urr I h dopt fm $. ConErdon Licarc L8 for $. followios r.!!on G.c.?01L Bu!ii.$
<br />Dd lrcfdid Codc): Ary Ciry d Comry *hi.h Equid r p.flnit lo .@!dd. n|d, iEp.ov., demolirh or Eplt sy rtrocrlr., p.io, to i$hruc, {s Equi6 rh. lPPliml f6 ruh pnn 6 fiL..iltEd n.t.ndr thr h. or rh. n I.6r.d punud ro rh. F.tirionr of rh.
<br />C6r*rr! Li6.d r- (Or?t6 9. Cffidna wnn S.cria ?000 oa Divbid J of {E Buii.s !d P'oa@i6! CodO o. rh.r h. d
<br />th. n .rhtt $diin ad d!. lair fd l5. .ll.s.d ddrprio ,Ah, violdia ol S.di@ 703 L J by My .rplicst for . p6ir rubj.cr rh.
<br />+pli6r Io r cilil p.n.lty of ioi nor. 6rn fiv. hudr.d dolle (1500).
<br />_I, a (m6 of $. F!p.ir. or f,, nploy.6 wnh w.td u rh.ir rol. comr.d.tion, wlll do rh. work .nd fi. nradur. i$or inr.nd.d
<br />6 ofd.d fc 61. ( Scc ?0,11, Buliid 6d Prcfaid Cod.: Thc C6tndor! Licd!. L& dd not .ppl, to M o{nd of rh. p6p.ny
<br />qho build! or inFoEr {:.1M, od *ho do€ r!.h wo* hitu.lf d nd.lf d rhrcu8n hi d hd own Ghploy.6, p.ovid.d rh.t .!ch
<br />inpovdaB G nol inlad.d d ofl.Ed fd td. I( ho*d6, th. blildi.B or ioprovmt ir told widi. on. y.!r of conpl.lid, lh.
<br />Ownn-Buildd*ill h.v. tt. burda ofp..vi.a thlt h.o.!h. nor buildd ihpmvc fd th. purpo!. ofdl.).
<br />_1, a @..r of lI. roF,ty, h qc,uiv.ly @.tudn3 *nh liau.d 6E ci6 ro cortrucr lhc proj.cl ( S.c, ?04a. Brin.lt &d
<br />Prcf.sid Codq Th. Conft!.toat Lichr. La d6.or.pply ro 6 Ma ofpropdry who b!ii& d ihplov.r rhdo , ed who
<br />conrlcB for iuch projc.r wth r Coit6cro(, lt.ro.d pu !.rt ro 6. Coil[cror,3 Licns. L.w )
<br />_I m.xcmpt oidosetioi .8. & P.C. lr $i! rcBd
<br />I&ORKENS COM}ENSATTON DI.CI {R-AIION
<br />I hft6y !fiim ud* p.^.lry ol Fjlry m. of ti. loll@ins dclnisrl
<br />_l h!v. s.l *ill6.in!.in r Cdifidt of Cd6r 6 S.lf-ltue ld rdt6 c6p.n!nio., s p6!id.rt io. b, s.cri6n l70o of$.
<br />Llbor Cod., for $c p.rfotuc. of rh. wdl ad wbich d. D.ml it ksu.d
<br />_l hrvc .rd willhlinl.in ?dkd' cdn?.n.iti6 iD!ura*, a Eqlir.d by S.ctio. !700 ofrh. Llbor Cod., aor lh. plrfmlnc. ofth.
<br />wod< ltr *hi.[ lhir pnt t ir!.d. My adt6' @6p.nsdon iNlmc. cEid Dd polic, numb.r .r.]
<br />fihn grfo n*d nor b. cmpld.d lt rh. Fhir ir
<br />l1l colifr$ ind.Ffmuc.of $Gq6k fe
<br />b.cm sbFcl ro $c *0116 ' ffipdr @ hq
<br />fn O.. hunitrcd dolla {1100)
<br />.ohp.nrlrion FDviti@, of Sed63?00of rh.l$qcod., I rh.ll,
<br />-2-q--o
<br />WAnNINC: Flilurc to ,.cur. *0*6 cmpa!.tid
<br />fi.n up ro on. hundr.d lh@Dd doll6 (1100,000),in
<br />rlbjet a mployd ro oiniillpdallic. lnd civil
<br />dmsB a povid.d for ih. S.dion 10?6 of
<br />rh. t$or Codc. inldBl ed inoh.y r f.6.
<br />I hd.by afim u.ddp.nllty ofp.rjury th l 6 liccn!.d hdd prcvieio. ol Chrprr 9 (wi
<br />Li..nr. Clc!:-- Lac . N.hbr4-o
<br />I t4by .llim uidn p6dry of Fj!ry $.1 rh@ i! r c6no.rid lddins .sdcy
<br />i$u.d (s{. 309?, Civ. C.).
<br />thcpdadmlnc. of rh. wolk for*hich lhis pcmn jr
<br />AP}LICN.\T'SDECLAITATIO}.,
<br />Dnolilion P.mlii-Atb6ror Norificidon F.dcnl Rcruldionr
<br />_ R.quircd tA.rofNoific ioi
<br />I cdi& d th. f.ddl drulriifi! ..q.rdinc
<br />-1"^o,n ,,n "",*^,.,,,,.,- -,lo comply *ith lllCity rnd Counry
<br />ordin.ncd ud Sr.l. L.wr rcl i.B to blildinS oathi! Cny sdCounly rocnrd upon rh.
<br />!tov. hdrrioncd pbp.iy lor ii!!.ciid
<br />^,",/, )-L+'cfr\
<br />II
<br />a
<br />ln. Eulind ad Proaanmr Coa., md h, li6!. i! in fuu forc..nd.f.c(
<br />-
<br />If------r-----F--+-
<br />I-
|