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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS 1}WNEN BOII-DER D']LCARATION
<br />I hcrct, rl'lnm u c!|Etr ry ol,rcrjury thd ImcxcnDr iornlhcCo racx,s l-ic.nsc lie r.rrh. rdk,wirt rciwt rsc.70ll5
<br />tlu\i',css rnd Prolt$ion Codc): Atry Cir, or Cotrnry *hich rcqutcs r Fnnir t, .onno.r. rkcr. nn!rov., dcnnlilh or rcIEn lny
<br />sdctrtrc, rritrro irs iss!.rf,c. ilh rcquncsrhc alitlicrfl fd ruch !.hnirki lllc a si8r*d rr cnE rnir hcor\he is lic.n{d pr^oam
<br />t, dto pmvi\nns of rhe Coitrcttr s Liccnsdd Ln* (ChrIrcr 9. ClnnncrihE wnh Sc.rion 70lX ol Division I ol'lhc Bu\in.\s rnd
<br />Prolissnns Codc) or 'h tE or shc is cxcnDr thcrcliom lnd rh. hisis lor rh( rlhcd excmpr ion A!,vi{ rionotsc.rinr70rl5bJ_nny
<br />!rpliclnl Inrnpcnnil suhjsls rh! imlicanl ki !cjvilpcnaIyolnor nnnc rhrn rllr h iJr.d dolltr^ i55(x))
<br />l. rs owEr or r hc l]n,tEn y, or nry cn]llorcs wirh triAcs nr rhcir slc .omp.trs.rnnr. q ill do rhe $o!k und lhc {eruk n fr
<br />i c.ded or oticrcd rd \olc (Sa 7(,14. Businc$.nd Pn,fcsions Codc:'l hc Ornrra.rois t-icensc L,s.Lcs or apply b ,tr .wtrn or
<br />rhopnrFny $ho buildi or nu(,vcs tlrmtr. md ql$ doN {.h }oR hnn\clf or hcrclior lhmughhis orhcrow cnDk)vc.r.
<br />provnhd rlut \uch i prownrnrr m mr inrcndcd oltlrcJ li,. $k ll tui$c\tr. rh. buildir8 or i'ntorctrEnr issoldwiihi",,nc )cr
<br />olc.iDlcri,r, rh.o*trcr Buikls $ill hrvc lhe burdc,r oflrovir8 rhd hc.r shc.lid ml hrikt.r in{(,t lhc pnrpeny r(r rht flrtt*ol
<br />-l.r\owncrofrhcrrotcny.umcxclusivcly.onhcliDswirhliccnscdcontrk,Ft,.onnrucrrh.!oi(r(sc.7(!4.4u\ir'csa l\ofs\i)nCodc:ThcConta.ttr-\Li.rtr\ctlwdocsnorrptlyk)rtro*ncrolpn'n nywh()tui|d\orimp()vd<rh.rc.n.
<br />.nd who conrricrs rd such prcjcdr*irhr o)nrra.tn(s) lilrtrrd prr\urnr b rhc coika.ttr s t-rctr* L2wr.
<br />l rDcnnrpl undc! Sccrn r-. B & P.C. l& rhis rcon,n
<br />lro.8tr![J:r{)llrErs ua!
<br />I)t-(r.AR^T()N
<br />I [.r.hvrlli'rnr(l.r Nr lryoltxriwrnc.lrhc fti li)*iDg (1..L'ri,n]
<br />lharcrd sillnuinuinr Ccnirf,rr. of cl,n*nr t, srlrln\urc ttr trorkm' .onrprtr\rrn n. d\ pmvidcn k hySc.li{!r37lx)olrhc
<br />kh r Cndc. hr thc Jrrl'onn0D.c oi lhc *ork r'or which lhc !.fl nil k isucd
<br />I .cdify rhrr i,r rhc p.rt)rtruncc 0flhc w.rk tu which lhis rcnnir i\ isu,l. I shrll troi.tr]Pl,,y r,ty t 1tu]nt rny n.0Nr
<br />$ r\ t, bcdnm sbFr h rtu sod.n .omp.nsari{,n hs\ oICrlifon,ir.,nd l3(c ih ilI\hnrl(l hccont \uhrcrt,rhc
<br />*oi((( .orlPcn!!r ion povisi,,is o f Sccri,n, :]70O ol rlr tih, Codc. I dhll. tunhwirh ..nrlly s ir h lior provir i{nx
<br />WALNlNc Fiihtrc ro rcurc workcr coDpensnrion corcmse t ufllwiul. and \hrll \uhrccr r r rru)cr n, ri,iul Fnilric\ rftl
<br />civil nncs ur
<br />'o
<br />otrc hundrcd rhou$trd dol )). ir lddlii{,n n' rlf, c.{ ofr(n r. \attun. danngcs rs prnviJcd li,r r1r
<br />::1{iff{lt""'"-'l
<br />ol llE lru\in.rs $d t'nfcsidNCo{lc. ttrxt tr,y liccn\r i\ i lnllrnr.c lcllltr
<br />1_o C3 :7 o'1H"r y
<br />,r,,," Qtal ta
<br />roNsr.8ltcl]QrLtrNDlNcllilIl:l
<br />I hcrc6y dltnrund.r Dcnilly oitcrjury rhrr rhcr. n ! condru.rn'n hndi'U a8ci.y tur rhc lErt)nnrrrc ol rhc tnrk hr trhi.h rhl\ F-.nnir ir
<br />A.tfLllANfDECLil3AIlON
<br />I lmby.finm undcr |Etrally.lncrjlry onc ol rhc folkrwing dcchrariotr\
<br />Drnxnniotr PcirnirsAslEsros Notificrrion ljedcral RcBuhrion{ flirlcJl}. Pan6)
<br />Rcqnircd L.[crol Noli,]. ion
<br />_1..n'l_yrhirrh.lidmlr.IUhri{Argr:inrgr\}.nosr.ntr,!alx'. or rt,f '.rht n) rlri\ fr('lc.i
<br />rtl c mnli( cd !ro|orynn
<br />,\pplionl or A,ttnl SiAtr (u flle-r[19
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />UFER Ground
<br />SLAB Floor
<br />S u bf loor/Ve nV ln s u lat ion
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq L
<br />ln su latio n/E ne rgy 4l'l,6lw1a Kll{("v<l vr)
<br />Drywall tr U I
<br />Ext./lnt. Lath
<br />Brown Coal
<br />l\ilaso n ry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif .
<br />FINAL tdtolt< 1 r.zu)
<br />Certificate ol Occupancy " t,' I ut
<br />Notes, Remarks, Etc
<br />Erection Pads
<br />rhc *nrk lnr rhi.h rhs pcnnll
<br />n,,,,.,",,,,*,- \JB\<o--lttoAlELt o-,,,,".
<br />issucd (Scc.:10S7, Civ. C.)
<br />If,nd.' s NJ rr
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