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BUILDING. INSPECTOR RECORD <br />DATE COMMENTSSITE.WORK <br />Set Backs <br />Forms/Steel/Holdowns <br />UFER Ground <br />SLAB Floor <br />Sublloor/VenVl nsu lation <br />Roof Sheathinq <br />Shear Wall <br />Framinq <br />lnsu lation/Enerqy <br />Drywall <br />Ext./lnt. Lath <br />Brown Coat <br />It4asonry <br />Pool Fence <br />T-Bar <br />Handicap Req. <br />Deputv Final Report <br />Enqineer Final Report <br />Flood Zone Certil <br />-'t44il/">,/FINAL 'l/6ln trt^ <br />Certilicate ol Occupancy rII <br />Notes, Remarks, Etc <br />\,+ <br />orvNrlR llI ll.l)l:k l)lll-( ,\R:\ I ION <br />I hrrcby !fifln un.l6 p.nalry oi Nrjury rhd I m crcmPr lom lhc C.nt .toB Liccn{ Ljw lor thc lollosing rc's' (Sec 7011 5 <br />Uusincss dd Ptufcssion Codc): An, cny or Counly which rcqut.s t P.rnril lo carn{ru.1. allc( irProlc. dcmolhh nr r'p€n Mv <br />{ru.lurc. pior lo irs issun.c. oko tuapircs rhc apdi.Mr for su.h lcrmn k, fik n sisncd srdcftnr rhol hc o, shc k lic'nscd Putsuur <br />k, rh. ,&visions ofrlE Conra.ror's Liccnsd liw {Chnprfi 9. con$Bncin! *irh Scclioo 7000 of Divist'n 3 ofrh' Btrsincsc 8nd <br />PdtassionsCorlc)orrhr(lEorsh.nc{mIrrhcttomandrh.brsisnnrh.ollcSc{ercnPrnrn.Anvviohlnnrofsccrion?Oll5b,lnv <br />nplliconr for ! pcnnir rubjcrs lh€ opplicu.t ro n.ivil,'ctr.lllolnor turc dnn lilc hundr.d dollds (5500) <br />-l- <br />ui .vmr ol lhc propc.lr- or ny cn oyccssilhwascra\IhensbconrFisntior.{illdothewotk dlhcslrucr@hfln <br />n crkd or oficrcd ftr sb (sr_ 704,1, Busirrcss !trd Pn'r.\siotrs Codc Thc Contmhls t-i.rtrs tjw docs tror 6Pnlv ro nn owncr of <br />rlf, pDpcd, wlr) t{ilds or inpr'rcr rl*dn. ad *lm des such Mr* hinE.lfor hcrclfor rhii,ush hh or h.r owncmplovtc\' <br />,)i(ividcd rhar ru.h impmvcftnB ft mr intnd.d or ofltrcd fd $k. ll l{,ms. rhe hoilding or iqm(,Etrr i\ sld wnhin otu }td <br />ofco.ltllcrion. thc Osncr Buildd will h.vc llE bunlcn of lllrline rh.r hc.r she dil fttr bikl or i,qrxrE rhc fmFnv for rhc l,limt of <br />l. $ opncr ol lhc rnpcrry, am cxclusivcly contacrnrt *irh li.cnscd contrtu^ t' 3,neruci rtr rojct ( Scc 7Or4. 8tr'ik'\ <br />md ftDfssion CoJc Th!ConrrocroisLi.cnscLowdocrnoraPplybnnowrcrofP()FdvqhohuildsorimPn,vcslhcrco <br />rnd qh. ortm.l\for su.h Pnlcts wilnaConrm.td{) ltc.scdlucuahr rorhcConrracrois Licc.sc tiw) <br />I m cxcn,pr trndrr Scrir.r B & l'C larrhi!'crnn' <br />Drle O*n.r: <br />wonxgfs' coltPnrslrtoN <br />oEcl.an fla! <br />I hcrcby rlfirnund.r,,.nrlryorpcrjoryo.c orrhc hllowin8 d6hrarions <br />-l <br />htrvc rnd will minrlin a Ceaific c ol consctrr lo Sclflnsurc lo! sorkcn comFnsalior' is [nvid.d turbySccrio']Tmofrhc <br />ti$or Codc- ror rhc !.riormncc olrhc *o* ror shich lhc pctn r i{ ksu.d. <br />-l <br />h(wand will maitrrain so.kcrs ..mtcnsllin in\ur!i...,s tcquial h, Sflion.rTtx) orthc Lltxr Codc.lor Ih€ Fr'mnm' or <br />rhc *or* r.r *hichlhispcrmil is hflcd. Myworkss omlEnsdion in\umrce carifi ,ild ,olicv nunbct m: <br />t'olicy Ntrn$cr:-ErPnc\ <br />I <br />I rcnityrhJl in rhc t rfornrnct olihc rork nn shirhrhi\ pcrnrir i\ i riy t r\on rn rny.'rtrru <br />n, rit lEcor \ubF.r tJ rhc !or(.n dn Pctrs i,D h$( oiCrliinrnir. <br />workcr\' ..nrtrnsdn rn,rhbnsol Scrri{ 17{X)olrhc lnhn Codc. I <br />tr\R\IrC lTrtrrr \,u'ctririu'. t.{ 'P'n.r'f ii'tr'{( .ur <br />.ivil li.cs up ro om huMrcd rhou\rnJ dolln lSlU).U)o <br />s.cridr 1076 ol rh. Iibr Clodc. inlqcd lnd anonry's ltcs <br />I hcrcby rfilnrndcr pcMlryolFrjurt rh,r I an liccnqil <br />.f rhc Busircs ond PR, f.s rions Codc. arn my ltcn\c is <br />4 <br />I hcaby !fln undd Fmhy ol |[ iury rhtrr rh.m is o conslruction lc <br />ksu.d (scc. 3097- Civ C ) <br />rnrmc olrhc work lor *hich rhi\ Fiinir h <br />llu.h) rln unil.r N JLrt.l l).'iu l tf.olrh. n, kN rB <br />Dcnn,lni,)n I'cnnns A\h-{os N.rilicrri(r Ftdctul Rcg! <br />_Rcqtrt d lrrrdof Notilcdim <br />I.cnifyrhlr rhcfctlcmlrc8uhlior\Nsddi arc norrflJli.$lc t, rhi\ln,j.cr <br />l.cnilyrhrr I hrvc rcrd rhtapplicrrtr,nurli \ coRr I ure Io conlr ly wirh trll Ciry aDd Counry <br />ordimnces and srarc ljws rclal in8 t, <br />ah,vr nrtrtioncd polcny liJrinsldi <br />(/\ <br />izcrcprc{drdn$olrhirCiryrtulClutrlyb. .rulr rhc <br />ID/SIG. <br />Erection Pads <br />A|lPlicunl or AAol SiInaluE <br />=