Laserfiche WebLink
BUILDING. INSPECTOR RECORD <br />(,*n(.tl!rldd ILlmrhn <br />I hd.by.mrm undd FMlrv oaFjurr ihrr I rm.i.mt, form rh. (-o.ttdoB-L@.r trx lor rh.folr,wrns ri{n lG Tnl l 5 B6ind. <br />ird P.6r6ri1n C6d.l any Cny or ( oudy *hich r.qur6 . p6mn ro 6BrM. d6. m!r.v.. d.mlth or r.llrr ey 'lructu., Fior b ir <br />ttum.. .l$ r.qun6 lhc rpplic. ror tu(h p.mir ro 6l. r !i3Ed lurmt l h.t n or sn. n lic.B.d plBurnl to th. pmvsioE of $. <br />Conr.cror'. l-'c.N.d l.ru (Chiprs 0. (omm.nc'n! *[h Ser6n TO0OofD'v']6n r ofrh.Ituirndsmd Prot n'oB Cod.) or rhrt nc or <br />!h. acr.dpr rhn noo r rh. bdn aor th.tll.3.d.r.mption Aq riohiionorsdi.. T0ll 1by i.y lppli..nt for. p.mn $bj.ct! th. <br />rr9li..nr ro . d\ I p. hrormi mr. th,, fiv. hu.dEd dolls(lam) <br />Lc ownsofrh. potEny. o. my .mrhy.6 wnh rrs6 .: rh.tr ldL .omn.n!.on. uilld. rh. sorl lnd rh.nrudu.6 norinrddcd <br />or olY.r.d for sl.( Sr 7{,4a, Bujn.rr.nd l,roa.rnon3( od. Th.(\.r.cror.l.'..n..1!wdo6 nor.pply !o rn o*nd ofrh. php.dy <br />th. burlds or mpturd rhd6.. rnd *ln dG ruh trorl him*lror lr*lfor rhroqh hir or h.. nmphy6.,roviid rhrr iu.h <br />rmpror.m6!3rr. mi 6r.nd.d or oIT<.d Lreh It h.*.rd.llx turldinB o. rnp,o\ 6.nr 6 hld rtrhin.k !..rot.onpl.rirn. rh. <br />()qF-lhrldq trillhl. rht brrd.n.lrrorinB thrr h. or rb. tur h{,ld or impro\. f tlEpurlFi.of$k) <br />l. d oe.d of th. t}mp.ny. am .r.luriv.l, .ont{drns sith lic.ed conlnck'd lo sNlru(l rh. rrcJ.(t (S( 7044. BGin6s.rd <br />PmEsion ( od. Th. ( ontridoi! l.(.nF lre d6 Nr tpply ro t. o*s ol propdy *ho horldr or rmpro!6 ih.r6n . .nd lho <br />ont nr for iu.h proj<r! u hr C.nrrdoi!,lE6rd posu.t roth.Cont.d.,i l-..nklr* ) <br />I.trr.\rnr trndc'S..rnn, <br />WORXFRS (OMPf, NS TION I'E('LARATION <br />lh6.hy irltr undd n.nihy.fn rj ) on..lrh. linhs in! d( Irr nd: <br />I h.* rd *iU Mid.in . ('difi<n. .r (-o6.d ro s.ll.lBu,. for mrkdi conrENr b.. .. r,o! d.d lor t , Sd b. I Ttxr oa rh. <br />lrbor C.d.. fo, rh. FaoImE ollh. *(t for shkh rh. Fnn ir 6ru.d <br />lh3v.indw'llm,'nr,'nwork.rs.onrI).nsalion'nr!rrnc.,.r..qu{qlbyS.cr('ntT0ooaih.lrhorCodr,forrh.p.rlornritrr.ofrh. <br />*orl fo' *hrh ths D.rnnr 6 rro.d My *ork.6'.ofrn .qt'on 'n!trm..crnid i.d noli., numb.r fi. <br />,.,.,., s:1..rtu <br />,,n"r,,^t. fa??<s-y'/o- / -f 3- <br />( IliN !.crhn i..d n.r h. compl.r.d rfrh. p.mir i. n! (xk htrndr.d dolliB lllrnl nr ks) <br />I.drfy rhrr r rh< Ffotmr. olth. rorl lor trh(h rtt F.m( ! isu.d.l th.ll mr mph, rn, pffn in.n, mlrnd $ a !. <br />h(rm. rohFr ro rh. m,la\ 'oflp.nar,on l,u! Df( rilor.r.,. <br />.omp.ns.ri{nr Dr.vin'n. orS.crion rTlx)of rhr Irtnr('.d.. I shrllt*a4f ^*r"r$) <br />WARNIN(;f!'lur.ro!dur.wort.r'.oup.ns.!oncov.[a.r!lnli*ful..ndrh.llsub]dr.n.mploy.rkdifti.rlp.nilri6rndcilil <br />{in6 urr ro on. hu.dr.d rhouund doll.R {t100.000).in ddnion 16 th..Nl orcom!..sdio.. d.m.!d B pr.vA.d r.r rh. s<rion 1076 ol <br />rh. L:ho. Con.. 'nr.r6r udrnorxv! f6 <br />LtcENSfD ( ONIII C',rof,S DtCl {X TION <br />I h.r.hy imrm und.r p.n.lry oap.riury rhir I m lic.n!.d undd nnrRion of(-h.ptd 9 (commcn.in3 *irh S..tnn 7000) ofl)i\sion 1of <br />rh. Bur'rc3r!.d Pof.snrBCod.. nnd my 1i.ffi. it m fullaorc..nd.lTftl <br />r.icr.*('r^* t] 4 C- t rt <br />rhr. 1| J 5--,/ f <br />,74Ai-q -7 <br />( o\s I Rt cIt()l l_t_\Dl\(; a(;ul( \ <br />I hfth, r mrm !.dn !.nrlr, orpojury rhl lhd n r codrrudnr kndins rs.my for rhc p.rfomn.. of rh. sort for *hich lhn pmir i. <br />irru.d{S( 1097-Civ ( ) <br />afflrcaNLs_pLc! aallllI <br />D.molirFn Plrmir. !h..nB Notifi.dion F.dm I R.Sul.rhn! ( fn k 40. Prn 6) <br />Rcqun d l.l's .l ttonrrrnr <br />l..nify rh rh.f.d6rlrcsuhrion! r.8lrdog.shskx rmoulrr. nor.pplicrhl.ro this p,ol..r <br />l..n't rh,r I h.v.dd rhn ipplior <br />ordiMft6.nd Stn. lr*. BltlinE ro t! <br />i..inditrr( rn.trn !b\. r.rorndion r tr.cr I a r.(r..oBnlv q h.ll( <br />'r!- <br />ind(irunrr- <br />rcIrenr.'i!6 ofthiCnv.ndCout! ro o16 uDo. ilE <br />rh\c nr.nrn'ftd proFn) nr <br />SITE-WORK COMMENTS <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />SubfloorA/enUlnsul <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 Req <br />Deputy Final Report <br />Engineer Final Report <br />Flood Zone Certif <br />tt /U/.i{ .tN I€:r 1fti]741(Mr*>ffiAh.,frFINALe/#b <br />Certificate of Occupancf <br />Notes, Remarks, Etc <br />M:\WP51\Permll ln3pe.lion Fo'frs\aurld n9 rnspsclon Reco.d doc 03 31 06 <br />fluaar-r ,</>1512 <br />,,.,. -f{f-zs- <br />DATE i ID/SIG. <br />I I <br />I <br />I <br />I I <br />I