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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steeli Holdowns
<br />UFER Ground
<br />SLAB Floor a
<br />Subf loor/VenVlnsulation r -l r ,l^l
<br />Roof Sheathing tlmlaa t Y.Y't W 4\{)
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />It/asonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Depuly Final Report
<br />Engineer Final Report
<br />Flood Zone Cenif .
<br />/ FAleaTc.I -67
<br />FINAL IY
<br />Certilicate ol Occu an
<br />Notes, Remarks, Etc.
<br />-1.
<br />as osncr of rhc IIlrrEny. or h, cq,l{,yccs wirh waecs ff lhct s)lc comFnsarb!, t l ,io rl* worlr ad rlr {eh i mr
<br />inr.nlal or olf..d for elc (Se.7044, Bxsimls dJ Prrtl'on\ Gx]c Th. Co.trtr s l-{cns. bw der nor atply b m osrer o,
<br />rhcpn,Fny who huius or inDR,ws thcFu, d wh,docssuuhwl himscllorhcrclio!lhnn'ehhisorhcrowncmployoes,
<br />pruvidcd lllal suuh imnmrcmnhemt hrcJrrtrl or.llarcJ lorsak.ll hlwcrcr. rlE hodding or impnrEmn! is$Uwnhnorc yra
<br />oa $npLrDn. rh. Owmr Buiuc! wdt havc rl* hurdcn of l,olin! rhd tr or sh. dxt tur btr,X or dl,uE rtE ,rsFry for rlr lurfd* ol
<br />_1. as owtrcro, rh. F)ncnr. {mcxclusivcly uontra.tng wirh lien*d onrrn b6 lo con(rucr rh. lnoj.\r (Sc 7044. Busoc$
<br />atul PiDfssin Grlcr Tlr Conkrckr'r Lic.ns.lf,w dms nor aplly k, eowncr olpoFdy who huilds.r inrptuv.. (hcrcon,
<br />and wk, uonrrcls lt, .h ln)jcch wirh ! o)nlm()(s) li..nscd pusu.trr rD thc Conrraunr s Lncnsc ljw)
<br />I mc\cnpl un,lcr Selion .a &PC r.rrhs!c!$n.
<br />Dat.: Ovn.r
<br />l4aatrEf,s:-courrNlArpn
<br />nEq.ABAUrA
<br />I hcruby rtltm undd p.ndryofpcrjuryom ot lh. tnlbw'ng 'lcchBronr:
<br />I h.\r n, wrll nrar an , Ccn 'liarc of Con*.r b Sclf-lnsu( tu workc^' oml'.tr$tnn. !s pNvidcd lbr hy SNrion 1700 01 rl*
<br />If,htr C'di., for rhc fcnditund of rhc w.* tur whri rh. lcmrn N rru.d
<br />$:hlvr rnn*illmarnlr *orkcs .omp.nsrlon rnsurln.c. r\ rc{u1rcd hy S$l ion l7(D oi rhc l,rhor Co'lc, tur rhc Fdntucc ot
<br />Ei,Iu' " fl::i
<br />omFnsarn'n insuan'cdricr {rr''r"num"cr
<br />q? / ute23 />
<br />I.c ily lhrl in rhc NnnrnrEc tlhew.rkldwhkhrlnllcrnrlisis\rcd.Ishilln.lcnrdoyinypc^oninlnynumcr
<br />v) a\ k' ltom su6j(r b rhc vo,kcn compcn$rion hws ol Ca[lnmu. ad r!rcc rhd 'fl \lDuU l*oft solr.cr ro tlr
<br />wo'[.'\ (on,F]\rrotr p'!!vrtrin\ rl S.(rkr lrlO ol rlr l rlitr Lii1.. l \hxll I conaly wI h rhJe I)ftJVNons.at!AIrNl\(;r l.rLlu. r, Rnr. $orkr\
<br />+,Le.crtiiu r. 'i'"J",,n*rt
<br />.1vrL li',.\ u! i) oN r,trD,ir..i rh tr\lBl
<br />Z
<br />IECIABAIIO{
<br />I h.Eby altirn unJcr lcndlyolpcrjurylhal I im liensd und.r F)vNiotr ol Chlltcr9lcommnciry *ilh Selion 7000) olDivnir:l
<br />of th. Bunkss and Pnfc$ions Codc, ,ril my liccN. * in tull li)Rc rrl1 ctfccr.
<br />c-9 3t.4
<br />!rlN:l!!1f]ot{rtut-\i-tu!!rl
<br />I hcaby ilItrm u.de. Fndly of F.jury $al lh.r G a uonslrucri). Lnd,ne arcnoy for thc pcnomNc ol lh. *orl t)r *tth rtis Fmjt it
<br />issucd (scc. 1097. c'v. C.).
<br />n 4ltrlHblc ri rhA f )l(-l
<br />4.*,rr,nu, , *"" *uu ,n,, lrpric.rion 5r{ narc rhlr I {sre k'omoly *ill lllCiiy lnd Counry
<br />onlrtritrccs r Sr.rc l-uwr rcL1tiu n, huilnine.oD(Nc prcsnuivcs olrhh Cily an,l v
<br />itx)v. nEnL rcd pop.dylnr intf,.lnrtlurriscr.
<br />ADnliGnror ArrnlSisnnhrre =<a
<br />;ii?JillJMWm,
<br />I
<br />Erection Pads
<br />I
<br />OWNER BUII-DER DEI-CARATION
<br />I lrrchy allirnr unlcr pctr ly,)l pcru,y lhal I m c\cnDI ln)fl' lhc C.nkrr'6 Li.cnr Law n]r rhc ,tlloeins rc8,n (Stu1rll.5
<br />Bunncs nnl Pturcsrh Cdl.), Aht C y or Counry *hiuh dqrm\ r Frm t) onnru.r. ,lr(, mpiov., d.n,lish or Epitr ,nt
<br />stn'clurc, t&b ns i$udnce, rlso rcqumr thc rptli.Ml rorsuch Frnnt lo rilc. sittrcd nalcnrtrl dmr hcor sh. h ljccnscd punu.nr
<br />tr rh. F,vkil)n\ oI rh. Coorractx\ LirnicJ t!{ (Chaprcr 9, Comtun in! *irh SNrnn TIXD of Div^nn I oflhc Busincsr dd
<br />Pnrcssi..s CoJc) or rh h.o.shc scrcmfl rh.rction rnd rh.h6n fDr ihc lqcd cr.nflion. Any vnn.tiDn ol S(lon r03l 5 by any
<br />llplicni nroIr n,ir su$jcch ih. trtlli.anr h,.ivilpcnrlryolnorflxrcrtun livc hunJrcd 'iollxn (t500)
<br />t ndcii Arur$:
<br />AIIUCANLIIECLAAAIION
<br />I brcny diinn undcr ,rnalty ol Jrrjury orc of tlE tbllowo! delnrat bbr:
<br />oc,frrlnion P.rnns^lb.{los Norifr ion F.icrd Rc8uhrn,.s lTnl.40. P.n6)
<br />R.quncJ Lctcrol M)liliali)n
<br />_l.c'i,fyrlDr rhd,.Jc'rli.Bxhrtr)n\r.!dn ardf,{or
<br />----+---
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