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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/Vent/l nsu lation
<br />Shear Wall
<br />-"?,qyry?hn(; z
<br />Framino
<br />lnsulation/Enerqy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif .
<br />FINAL i>/|Vrc b\41$
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />OWNER BU!I,DEII DDT-CARATIoN
<br />I herchy a(irn under Fuhy {,r p.rury rhir I d .xcnpr rmm rht ConlElff{ Licens. liw Lr rh. rdlo*in8 ,c.en (Scc 70ll.5
<br />Busin.ss iftl Pmlcssion Codc) Atry City or Counly *hich rcqutcs r Fiinir ro .onstflct. .lrcr. inrlrorc, dctu ish 'tr rlrn uny
<br />slruchrc. prior to its nsuarcc. alxo ,.q!irc\ rn. ,ppli.&r fu ruch |tnnir ro lllc ! sismd sr0rcmnr rnd h. or sh. L licctrsd t'uKuld
<br />to rhc Dmvni.trs ofrtr Conlr.clols l,iccnscd L{w (Chaprcr 9. Comemins wnh sc.rion 70oo of Division I ot rhc Bnsints Md
<br />Pmfc$ions Codc) or lhalh€ o! shc h cxctr9r rhercrrndMd (hc ba\i* r(r rhc aLlcg.d gcmnlion Any vi(,l"rionorScdion 70.1l.5hyany
<br />qrplicror nn a pcnnn subjc.k rhc +pli.dtrr ro r.ivilpctrrlly.ftrol.nrcrhln fivc hundr.d dollrs(35(x))
<br />-1.
<br />s\ ostrc. ol rh. ptuFd y. or n,y cmploles pirh wrB.s as lhci sole coown\$ion. willdo rh Rdk xlthc slnEtur is Nl
<br />im.fricd or.r.rcd for srlc (SE ?O14. gusincs and P\orasrions Codc Thc Conkacd s Lic.nsc L{w docs nor lpply lo di owM.r
<br />tlENpcdy $ho builds or ifimws lhcmn. and sho des srh *o hifr\.lrorh$*llorlhnrushhnorhcro*n.'nnloy.cs,
<br />pn,vidNd rhd skh in|xrlu'En* d n.r imc*ldl or oficr.{ fttr slc. ll homvLy. ,hc huilling or irprovcnr ir $ld *nhm om }tr
<br />ol.onrplcrion. ltr O*ncr BriLlcr *ill ha\r rh. hxdcn of pbving rhd h. or shc di1 mr buiu o! inDor rhc pDp.i, rui $( ou!D$ or
<br />l. rs.wturorrhc pn,t,ny. rflcxclusivclyconrclins wiln liccnsql cont .r)n k,.onnru.r rhc nrctccr (Scc. ?Ol4- Bu\inc*
<br />and PFrssion Codc: thc Coni!rcttr\ l-icensc ll* dffr nor ap,,ly tJ M owtrcr ol pmpcny who $u ildi or nnnrovcs rhcrc.tr.
<br />,nd wh. conra.rsforsu.htmlccrswith{coflnErons)liccnscd pu^rotrr r,rhcCofta.ktrt Li.ctr{ tj*)
<br />I Incxcm u 't.rsc{mn .tl &PC nrrhnmroi
<br />Dal.: Ownei
<br />woxtr,ls crrlt Pnrvilrxrx
<br />IECIAAAIIQ!
<br />I hcrcbyainnuMcr n nrltyoIpc.juryoocollhcfouowirsdsharn,n\:
<br />Ihlvcd willnrrnra aCcnirtarcoicotrsnltoSclllnsu.cfunukc*. nltnsarion- 6 J'ovilcd lor b,s..rion 1700 orrhc
<br />Ubu C.{., aor rhc pcrronMncc of lhc work l'or qhich the rcrmil h nsucd
<br />lhc \6rk lbrrhi.h rhi\ pcnnir ir k\ucd Mysork.^ c. ,r.n\ji(nr irisurrtr.ccrtricl xrl Fni.y ndtr$cr tu.]
<br />-l
<br />ccnil_vrhar inrhcrcrfomuic.ofrh. ao* for whichthis pcirnil k hsucd- I shall nor e rpk,ta.rr.6on in anymrtrm.
<br />$ ,\ o ltc.o f, sublccrro rhcqo*c( $arpcNlliotr hws oi C!lii.rni0, and nsec rhdr rr! sh'uld bcconr subjccr h rh.
<br />"orkcs.omp.ns ionpovnionsofScclion]TOOoflhclihtrCodr,l\h,ll.r.nhwith.otr{'lywilhthotnovi\trnr
<br />WARNINC trilrc t) *.trrc workoi.. rpcn{ri,rr vcruAc i\ utrlrwlul. rnd shrll \uhtl{r ,n c fk)$r kr sirnn,rlnlmlric\ i
<br />.ivil lin.\ uI b o'E hundrod rhuuetrd dol!xx)r. ir .ddirn,o h rhc.od orconDcn$nnr. dnm8cs as Prolidcd nr rh.
<br />Sc.ri{r l07l' ol rhr lnlu (i c.nnc.cqrM
<br />^".fu/ru lrt tAN/
<br />I heruhy 3tllrnrnndcr pcMlrrofIl. jory rhrl I m lrcn*d lm,!,\i, { .1 Chxpr.r L) lrofltr,r (i'ig \irh S.cri.n 7lr[)) of l)ni\nn,:]
<br />!r rh. lnL{Nr\ nD,l l"o1r\\i,fN (n,1.. xrl n')_ lirr rr \ n llr I lnr!. n (rl.!1
<br />oh 6
<br />L \7
<br />I hcrchy aln.nunncr t^-nrlr) ornLrjrrr rhrr
<br />i\suc.i lScc :l0r)7. Civ. C.)
<br />h, $nifl .ri)n lc.dir8 n8cnc, ior rhc p.rturftnr. or rhc work for *hi.h rhi\ Frnlr i\
<br />AITUIINI.IIECIANAUON
<br />Illyrl'yrfiinnu cr pcn.lly olpcrjury on. ofrh. nrbsi'tg d..hturiotrr
<br />DcnNlnion PcrmirlAshcsros Noriliclrion Fcdcal RcEultrrion\ lI'irl. 10. Pdd6)
<br />-Rcquircd
<br />Irrlc! ol Norilrdbn
<br />!3re ro..nDly wirh nll Ciryrtrd Cou.ry
<br />rives olrhh Cirymd Counry ro cnrd uF,' rh.
<br />4'4tL
<br />Roof Sheathino I t*->---
<br />Pool Fence
<br />tt
<br />I
<br />I
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