|
SITE.WORK DATE to/stG.COtI:MENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUl nsulation
<br />Roof Sheathing o/t1/l+/ lY-$11 e-fu gK
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drylvall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif .
<br />FINAL
<br />Certificate of Occu pancy
<br />Notes, Remarks, Etc
<br />-i
<br />BUILDIN INSPECTOR RECORD
<br />O\T NI]R BUII,DI:R DEI,CAN,ATIOJ\
<br />I h.r.l, amm tr.d6 r.nalr, of Fjlrt thd I m.rmpi frem rh. conk.doE- l.i.de bw for th. follo\vinr rc&)n lsa.7orl J
<br />i,ffi: "li,TtP'I,:Ii,l"$[ir H:J,TI ;:;'ffi ril ;uJ']:*T,[T:: #:li:I*Y.#
<br />lo rrE rm\6irB of rlr (-o rnrs t l- rc.r*d l,\ (( i.pra 9. ( rmmtrms tr th S< i,n 7000 o, l),\ irhn ! of rh. auiinds ind
<br />Pnrr'rxrhns cod.) or rh.r lfor.h.6.rmfl rhd.6omrnd rh. hdr. ror rh. rlhS.J.ranrr'6. A.rlbLri.nofsdkrn1o!I 5h).n!
<br />aprli..ntlor.p.flrnrobjdsrhcanplicanlloacivilp.nahyofno'moElhdliv.h!nLl,.ddolles($5(xr)
<br />l. a o*na ofrh. F)Idr'. or ny cnrlols "irh r.s6 - rh.n !,k smFMnrn. trilldo rlE \nt {rh.snr1eirml
<br />i drhl oro,IRd for slc (S< 7o!. &!iB ud Pr.l6hB Co& IlEConrso.! l ac l.* d6sr 4lPl) t, 0*6of
<br />rlE rnrd, $ l[ hrl(h.r rs.orq 'h.6tr ri srb rk6 sh $$,t hilelf or lrelf or rhmu*h h'r G h6 o$n cm''k') c-
<br />pn vidd lhal such iDt $voanr & tul iiod.d o. olls.d for sb lL ho$6s- rlE tri{illa or r{n,v.Fn ir $kr *dh'. on !d
<br />ofcompldion. th. o$tr6 Buil&r Rill luvc lh. h!d- ol lrowB Ih, h. or !h. dt nor hild or improv. Ific rmpoly fttr lh. Ilrrrs or
<br />L a nNG of E Fpdry. m.i.lan cly.odtrha *nh licdE d onrdd h 6dd rll Frts( lse 7O!. tlallK
<br />dd Pr.hsi.n ('od. Th. Conldo.r l-ic.M t $ .[B mr rtplt r. e o*E o r propcn y r ho buikb or impmvd rhstun.
<br />a.d who co'nrc13 for such Fuel! w'rh a Conr6.1o(, lic*crl punusn totn.(brra.lois Lt6< l,*)
<br />lon.rcDrx undd Sdion
<br />D.r. (r*nr
<br />tr oRxliis' conr P[N:sA'l i()N
<br />a.&ct aEarlo!
<br />I hrrhy sllim undd rcnllly.iFjuryoncoarh. aollorms ddlrarions
<br />I hrrc rd $'U tudai. r Cdtifrd. otcotMr nr s.lutM. fo ruld NoFldinr 6 Fovrlcd ror u!\ sdrhn u00 of rlE
<br />l!tD. Cod.. t( llE Ff(,ll114. ot rlt trst fo. *htn llE pann it s.d
<br />I h{v..nd $ill nr.inriin \eorks c.nrp.Nalion insuranc.. B r.qotrd bySdn'r 17{x)olthc l,ahn (dc.lordt prr(nman..or
<br />rhc *ort for*hich lhls rmil i. isud
<br />CAYN2$Y'
<br />ion iNuruc.cffi dd polkr- numho e.
<br />,.,,". sIa I llLea-
<br />I cortry Oa io rh. p6tomr.. orrh.*orl lor *hth rhis p.rmn n !iu.d I lhrllft'r dtlo) lny tE$n in my n.nE
<br />$ a b tE om st .<r h th. r.n6 comFdion Ls oacrllom( ,i reR rhd ir I rh d heoffi.ubid 'otlr$olt6 ftmFMrn F.ririo6 of sdiof, l?m olr lr Lb6. (ixrc. l rlull, fonhs nt oqrlr q irh 'h.* F!\ iiio6
<br />WARNINC: F.ilur. lo sE wod6 mmFsdion co(dsc k unhstul. ed lhrll rubj.( & dploF lo cini l FBhis md
<br />.ivil fin6 up ro on. hund..d rho!$nd doll6 itl0o.00o). in oddnbn ro rhc cN ofconp.tuilio.. dmaga d pkrvd.d for rh.
<br />Sditx !076 ofrh.lihY inrrsr dd drnq-i fs
<br />iT rDEOJEAIIO!
<br />I h6.hy omm und6 Fnlllyofpdjuryltul I on licm*d unds pro\isFn ofchaprs 9 icomndchl
<br />of rh. BciIB dd Pmf*hE (-od., di mt lt.M ir in full f.i( rvl.fiEr
<br />,,..,,..,,,,,, qGG \e\- b
<br />',..-sl a\\ \} (.,,.,.r
<br />(allla!(fla!.u;dllricac[ (r
<br />I lEEby lrm un&r Frlty ot pGrury
<br />'h.r
<br />th@ a t cotrrrudion lodins .stry fo, rh. Fftuc. of rh. so.I 6r shkfi rhb Fnrn i!
<br />isuldtse.1097.( i! c ).
<br />allllla.NLll(l.ASarlox
<br />I hdd1v iIm undd Fnrlt, of Fjur, .R oarh. foll.$ ins ddldd i)n3
<br />t>slnFn P@'r$,\3tBr6 Norin.dion F.&{l R.guhrrtu (Iil.l0. Pd6,
<br />RetrRd lnrd .l Nor6.ar i)i
<br />l.dit thor rh.Idld.l r.8ul|li(!ns ExodinB dFn,s rmo\rls. nor amlic lcr,r!hirrmj(l
<br />V, I ( 6r
<br />'
<br />r\ ,hi I hr c , cal ,h* 4r!k'ridhiiG rnd s',I. I :\i Eld'ry r' tu
<br />atxtr. 'nor'on.d prcpcn) for itrst (nr
<br />nn&dd .rhr rh<rts\. rnlntur'n anrdl l.*ra n $!rd. " rh aTl( (\ inll(.unrr
<br />'-. tirl rr"Ed hr.t ! .urkrn2. rqr.ddN6 o
<br />^Or,n"n,
<br />u, ,t*-, ,,'an", r r" X
<br />Prni,(nrn.,pd rK H o\:<- vq>(\Crnr
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />Lic.e Nu tq
<br />-
<br />K- p)
|