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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS O\f,'TIER BUILOER DII-('A R]{TION
<br />I h6.t y lrm uidd po'dr, ot pajury rhd I d .rnFr fNn lnc Codr.do6 LiccE trw for th. followins rcMn (Sa 70l l 5
<br />Bain6r .d Proadio. ( od.): Any cn, o. Cody *hich r.quiB ! pd,nn to @nrru.t. !ltd, ihF ov.. &solilh or rgrtr ey
<br />srru.ruc FDr ro it] i]3llu., .ko r.qui6llE 4?ltd f.r t. h rsni r! 6l...ici.d lrcmt rhi lE or dE i! licaB.d lJoB{,!
<br />ro tlE F$virioB ol dr ('onrm 'r Li.or.d t r. (CtDFg 9. Coffihs * nh S.dion 7000 of Divnbn I of tlE BNing ud
<br />Pin{*D Co<|.)orlhdh.orllEiradFtlE6onEdlh.bctfo.rh.nks.dd6Fbn Any vi.ld5n otsdb.70:ll tur(.ny
<br />lp?lirdl aor r F nir !!bl€r! th. lpglicml ro . civil pmhy or nor morc lho fivc hundEd doud (1500)
<br />l. a ow6 oalh. FDFly, or oy mplorE snh f,.{6 B lh.n sk Nmr.Bdion. *i! 6llE etrI an dE e.udE k ml
<br />itrorlcl or ofiad f rL (Sc.r044. ttr,@ od PYDtsnd Cod. In (irnn rq i Lile lrw d6 mr {Dl} ro u o*E of
<br />rlE Frl!a!, $lb hil4d i!ftrBdEsxr.n s'h dEsh tro tin&l,or lssllor ll@urh hn q lE otrr d.ph)c-
<br />Folilcd lfi.l tuch imFtrvlErs e ml i,ldrd.d G olEEd ad sl. l( hotr6s.
<br />'lE
<br />hrildmg d nqlrdEi n i d sithin om )aofconpbnl! rh. O,c auiU. *in hrE rtE tudat ofFDrrry thd hc or slE dd mr hrild or Il{rcr thc prtrFy br dE Fr4nr.f
<br />_ l. 6o*E oadE FlF y. u.r.lGi!.lr.otuf in* trnh li.6B.d oirrdd ro oirrud rlr Fojdr (Sc 7(lr-l. &EuBdrl PDbinCo&: Tn. Conr.*loir Lt.e L,* &6 d iprly to Dornd ofFopdryqho hoildr inpmrdrn66n.
<br />and sno mrtri for s.h p.oJErs wnh. coffio(r) lrasj Faudn b rh.Codrrcloa! Lr.e l')
<br />I d.rmpt unls Selion
<br />!!asl8&t ttEi!i,16no!
<br />DISAAAIIA!
<br />I hd.by afl rm uod6 porally oipajury on. olrhc follo*ins ddldarioN:
<br />-I
<br />hrv. tn will minlrh r Cali6.d. of CoMnr ro Scll.l@. fd srt6 ooFeion.6 Ford.d tor b, salion !7d) ofth.
<br />ljtq Co&, fs th. Ffffi. of th. $,I for *nth th. Ftnn B iscd
<br />I hrv...d w'llnri.r.in *0116 comFnririon iBurrn.., f,s r.qur..l btserio.STCIolrh.l,b.rCod., ror rh. Flol)M.r or
<br />th. wort fo. which lhis FDn ! ie.d My rork6 compoMlion iMr .r.Mi6 dd policy numbd s.:
<br />I c.nitlh,l in th. pqlom6c. of rhc *ork lor wtichthi!p6mit ix isu.!.l sh.ll nol oDloy any pcrson in in, mdn6
<br />$ a lo b.<oe subiRl lo llE worl6'comFs.lb, h{ of ( diromi^ arl rTr thd if I rl|uld b..o@ sqqr h rh.
<br />*oltd' .r,poa.rrn Fo! nn)B of Sdbn 1?00 of rh. bbr ( ode I slEll. fdn{nh onlr'ly rrh rhor pr.vituB
<br />nARNlliG Flilw ro s(. rul6 onpddion orq.s. ! Dh{tu1 Ed ,ndl etiq! d dtrplo}q to sunin l FulB !.d
<br />.n'l fuB up ro oE hundr.d rhoN*l U,lLB (lloo.fir),bi ro th..oc oa.om[Ea!'ol\ &dsd a F.vt.d for rrr
<br />serkr (176.frhc Iihn (.Jr.,n1s6r nrtd
<br />I fieb, .mrn u.d6 Fdr, of pdtury
<br />'hd sionof(l'!ptsI(co nBcq *nh Sd!n 7({x))oaDnrnn I
<br />oI rh.lrusinddd Proldtrons Cod.- and Dy lic6r n n n'lltuc.a cll<l
<br />-L't'l 1q3L(2_
<br />D.,e "lrl,-t fb.r
<br />I hd*y .nm ulxla Flry ol Fr'!y ftr tlE! ii . odtu<rih lodios.s yfordEFfodjreofth.wrbr*tthfiiiFfria
<br />is.d ( Sa. 109?. Civ C)
<br />tznddi N.ft
<br />ATTLIIANLDICI,AAAIIOIi
<br />I ha!h, tfim unds polhy of Fjury om oa lh. followif,g .krlurioB:
<br />Dcmohtioi Pgmirs-tubdtor Norificdion ldlqal R.suhliun! (Iirlc 40. P!16)
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<br />R.qui'd L.lt6 ot Ndifrclid
<br />I cd,ar rhd th. fqidrl rcsubrnrG rEsrdiry Nhctr's rmrd s. mr .r4nr.bk ro rhit pirFl
<br />i. rhnrpnli.arit{rrklircrharllrrnh\rrronn krtr..r(rrIilreh..nrpl!s[fil(rrrnd(otrfrr
<br />i.r ddtudi<Jn. rrj h6rtr- rurtFPc rqr($rdiv6 ol rli! Ciry d(irudyroord ut{nrlE
<br />*'*"),(3 l1-v1,\B,\\sn -" st3,l.j
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUl nsulation
<br />Ro of Sheathing
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handica Req
<br />De Final Re rt
<br />Engineer Final Report
<br />Flood Zone Certif
<br />FINAL f7tr,/,J'-'*-li.t,iH r-.<{
<br />Certificate of Occu pancy
<br />Notes, Remarks Etc
<br />Il & l,( Lrrha'.r()n
<br />""' 5Elra
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<br />Shear Wall I
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