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BUILDING- INSPECTOR RECOBD
<br />SITE.WORK DATE IDiSIG.COMMENTS
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Sublloor/Vent/l nsulation
<br />Roof Sheathi ng
<br />Shear Wall
<br />Framing
<br />lnsu lation/Enerqy
<br />Drywall
<br />Exl-/lnt. Lath
<br />Brown Coal
<br />I\4aso n ry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certil.
<br />/d
<br />FINAL b-l-lr x&*ld
<br />Certifi cate of Occupancy
<br />Remarks , Etc.
<br />(,WNI]R EUILT'ER DEI,CARA'I'ION
<br />I hcrcbyrlfir urd.r n{Mlry.f prrjury Ihst I rn.r.'nfr lrom rh. c(n rrck,r' l-i.d\c bw f(tr rh. frnl)wir! i.rv'n ( Scc 7011 5
<br />EusnEsr ann Pdt$id' Codc): Any Ciry or coutrry uhtrh rrqunc\ r Frmil k, .onnnrl. ixcr. nnprur. ncmli\h r rclhi dri
<br />{tu(rc. nri,nl(' irs i\s'incc. lho rcquirc\ lhc lnrllcrnl ior $chpcnnil ro llkn \isnc(l \ldcnrni rhxrhc.r \hc is.liccn\cd punr6nr-
<br />to lhc provisiors of lnc Confu.ro.s Liccn\cil uq (chi|ncj 9. coNncn.rS sirh sccrir'n ](xn .l Divtior 3 ol lhc linsnr..l.rnd
<br />P'ufcssn,nsCodc) orrhrt hc o!\hc ncrcn,pr rhcrctnnnin.l rhc hrsn fir rh.allcgcdcrcn,prn,n tryridrrionofSccri,nT0ll5hvany
<br />apt,licanr f(tr r!.irnir sxhjL\h rhc trppli.rtrrb r.i!ilpcnrkyol nor 'norcrhri fiv. hutulrcd doll r\ (3500)
<br />I.nsotncrolrhcpmncdt,orn,y.nrphycc\siihwr!c\rsIhcnv,hconlx\rrioi.willdorhsorkxndrhc\Rlurcn,r{
<br />inlcndcil or oricrcd ior srlc (S1.7044. Btrsi,rc$ inn Pht$ioDs Codc, Thc Conlra.rois l,iccnr l.rw docs nor Jpplt b an oqncr ol
<br />rh. pmp.dy wh. boildr or in{rJvcr rh.enr. rfti *b d({\ such w( hnnscllorhcFcllorrhmughhisorhcro$nrnlllloycrl.
<br />nmlnbd rhrr such inrfl orqrnh rE noi t ctrd<l or oflt(n nr sk lll ho$c\ cr rhc huikling .r i Stuvcnrnr ir $ld s iihin otrc rtrr
<br />of.onlpldi(nr, rh.Osrcr auikld will hrvc r,t bunld of l]l*inC rlrrr hc or shr dil mrt{ild or infrovc thc nm|cdy f.r rhe pu4ns ol
<br />-1.
<br />i(o*ncrolthclIot'cn!. rm cxclus ivcly c.fi{ding wilh li.cn{i .ontrdrs rn con(rucl rhc prtlcr (Scc 7Or],3tr!m\\
<br />rnd Pnri\bnCodc-lhcConrrktr\l-icci\.I-rsdocsnorqrplrk,rnounforirotrdyshubuilds.rNtrovc{rhcrcdr.
<br />atrd *ho dn ncrs lol such nni.F wirh r Conh.M( n ltctr\cd puruinu. rhc Conrnctoi \ l-iccr\c ljw )
<br />lurcx.nr utr ., S..ridr X--/ l. )!_"
<br />ur.l]-lllutatl
<br />t hcrchy ntlnnr undcr r.nrhyol pcrNrv.N olrhc lolktrvirp dc.hmriotrs
<br />I hnvc MI will rir iiniC.nill.rrc ofcotr{ctrt) S.lf l lrc lit torkcri.o rjrnsdion. ir tr.ri(lcd lnr hySr.ri,)n.17(x)olrh.
<br />Lab.r Codc. rorrh.pcnartuicc ofrhc {uk larqhich rhc !.' trrl is n{rd
<br />._l hrvc rfd $illnui (irw.rkcnconltnsarioniNurrr.c,i\rquircdhysc.ri,rlTrx)ollhct160'(bdc,nrrhcnrnrrrdccof
<br />rhc {ork n)r rhich rhn pcnnil i\ h\ucd My*orkcs compcn$rion in{'En.c crtri.r fll rxnic, nrmhcrrft:
<br />l'(n r} Nutrrhcr
<br />-lrcniirrhrr
<br />hrh. pcrromrffcolrhc work li'r whic[ lhis lcnnir is is!!|.I shrrlnoi rnPloya.y tc^o inrtryn'anNr
<br />h i(rohoJf, suhjc.r hrh.aork.^.otrrff,tr.ari{ l q \ of Crlil.nir, aid rErc. rhd if l \hould h<oN {rbFr h rl"d
<br />workcs'coD|[Nariorpnrvisi(insofScdiotr.lTrX)ofrhcLrlrn(i)dc.ldrlllnnhNirh.onrplywirhrhoEpr)vnion\
<br />IVARNIN(;: trnrlurc n, s.ur. w.rkcn .o ilrtrqr. .orcn€d is r l wfrl, itrd shrll {rhjcd Ir.nl'k,}rr ri oiDin0l |Enrlr€s nnd
<br />.ri lnrc\ trf t) otr. hridrcd rh.
<br />S.crnnr 1076 orrhc l.nhtr CoJ.. rl
<br />lrx).r[xr) trr r dirnnj rr rh. I
<br />OICLAAAIIIIN
<br />I rm li(rncn ud.r pmvi\i{nrol('hrprrr9l.o rrncing *irh S.c!irn 7UX)rolDivisn lI h.rch) rlltD, nd.r n.nr ryol |Iriury r
<br />of rhc IlusiDc\\rtrd ftol!ssidrCoJc. aD(lDry li.cnsc i\ ir lirlltur(c irnl.llccr
<br />Lncnr (-ln\\r Li.ci( Nun$.r
<br />Darc
<br />CANSIBUCIIQNIENDINO!$INIf,
<br />! h.rcby aflir undor.nrhyorFrjfiyrhdrh.rci\nd,n\rtu.ri{rkndingr8(kyrrrrhcpcrronMh_colrhc$orklor$hichlhhpcnniris
<br />isucd (Scc 1097. Civ C )
<br />LcndclsNorc
<br />-
<br />AIILIlltNfLlEgrlS[II9!
<br />I h.rolryrrllnntrndcr If,n liyofpcrlrry oru or rhc l.llorirgdc.l rrri0n\
<br />ncnxniion I'cnnin Ashcdos N.tilicrrion lcdcftl RCBULrions ( rirlc.l0. Pd6)
<br />Rrgrncd I cncr.tNolli.rli(tr,
<br />EEUl.lionsrcB!.din8 rshcsros lcnhvll rrc nolapplic{61. ro rhi\ pmid
<br />r rmLi.nn,n d nsr. rhd rhc ahovc inhnturn,n i\ coftr.r I rgre t(i onpl, wirh lll Cily itrd County
<br />a'lhn/. r.j,,.\c0rnrtrcr ofrht (-[, and (i]unrr_ r. ctrr.r uFr rhc
<br />a,^'4,. D
<br />9-r\2a-2o6
<br />Set Backs
<br />Notes,
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