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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG COMMENTS {JWNF]R BUI!,DER DEI-CARAlION
<br />I hcr.hy ilfirnr hdcr ,.Nlry 0i pcrjury rrnr I u cr.nrrr nor rhc Conractm Li..n{ La* lhr rhc n)lrrsirr! r.r$D lscc 70.11 5
<br />Bu\i'rsr r d l'r.lc\siotr G)dc), AtryC yur Cuudy which rcquir.s r n n ir b coNru.l. nllcr. iilPnJvc. dcNni\h or ruNn &y
<br />* rror. pri(trt, ir\ is$rncc. rl\. rcqunc( rhcintlic nt irtr such!.mirt) hlcJ \tnc{l n$.Rnr rhrrhcor +c i\ licttr\cd flrsutrnr
<br />rii rhc flovi\itnr\ uf rhL Contridois l,icciscd l-as (Chrflcr 9. Connncn.i'rg sirh Sc.riotr TUxr oi l)ivi\i{'n I ol rh. ln'\i'lcs rnd
<br />Pn'lt\non\ Codc) or lhal h: or \h. n crcn{r rhcrclionrind rhu hr\i\ turrhc allcScd crcnllli,r Any !tulnriotr ofSc.ii{nr 70:] l 5 hf itrv
<br />r!plicrnl lorrlrcflnir suhjecr\ rhc nff i.anlr. rcivilt.nrlryol or rorcrhin fivc hundr. dollnrs ($5(x))
<br />Ln\oqicr.lrhcronrny.ornry.d.yccsqilhwiscs(\rhcirvnc(nnFn\dri,rr.silldor1[w.rkntrdrhc{Mrurcisior
<br />fictrd(l orolltrcd lr \rlc {S( 70!. tsuircs ind Pnncs\i,n,' cl)dc: rhc Codri.nn \ t-Nisc l-rr iocs norIlPply tu an '*n( ol'
<br />ihc|rlnc v sh, lrrilds or iDprorcs rhcnnr dd who d€s {.h sor k hi'n\clr ot h.mc ll or ihfl'ugh hi or hci orn cntl(,y.c\.
<br />trovid.d rhar \uch i'npnivci
<br />^
<br />urc Bn inrrndel d oficmd ltr !'k ll ho*c\ cr. rlf, i iUinF .r i' nrtr cNN is $lil ( irh]n ' ( 1\ r
<br />-l.rsosncrorrh.proFny.0Dcx.lulively.ontacrn,swrhli.cnnd.onrrrcnrh.otr{nr.lltrPn+cr(stc701'1.Buir,c\\rn,l lh,la$im Cl.dc Ih.(onlrlcloist.iccn\cl-s.krc\nolrDnlyh!nowrcroi|nolcrry*hohildsorirnDro{slhcrcon.
<br />,nd trho c.nrr{cls f.r \trch pn)j..rt wirhr Cotrfilcr)n\r liccnscJ PUrsun hlh.(in rrttr s l-rcnsc li* )
<br />I rmcrcn,tr un,lcr s.crnnr B & r'C larrhr!r.rn)n
<br />l)0tc: OrNr:
<br />lvoIll(FRs (l( )nI t'l lNsl'l l( )N
<br />Dr!t^&l]roN
<br />I h.rchy illnn, tr nl.r p.nulry.l lu]ltryofc.frhc knb*i',3 dc.h'rri,nr!
<br />Ih{!clMl*illn lnrin cc ii.rrcoiCotr\crrbstllltr\urer'irtrokc'\'..nrrn\nti(n s F,ridcJfrnbys..ri$17(I)ofrhc
<br />Lntitr Cdlc- ior rhc prfoxmn c ofrhc sork ktr Nhi.h rh. Frmir n nsucd
<br />fl hN drl s rll nhinGin $orkc^ .on|trsdid inntrrnc.. ns ruqrncd hy s.cr ior .l?(x I or I hc lrh.r ( odc. for rht rrr.rrnrrcc or
<br />rh. work tur shichthis pc.nrir is issucd My f,orkcri .onrNN,ltr i'sufuD.c crric! ,trd lx,licy nun$q re
<br />.,,,,,", -(tor,fund 0 cn'otn lOlr'on
<br />L*-rl .,nrg,,,,'.r",,,,,n.,,. ! 95 rarrr.s: . [[
<br />I ccnlly ll in rtu p.rru nrNcollhcwork lar shi.h rhs tc nir u \suc(|. lshrlltrorcnrfl.v rnvPcrn,r in anv nranrur
<br />$ r!b hccom \uhjc.r rothc $orkc6 co'nrtrDsrri{in lrssor(rlihnrir a ag,QrhrrilIshould }rdrt {h}d rollt
<br />sorkc,s.ompld\dnnrfrovisionsoiSccrid.lTU)olrhcLalrrCodc.l\h!ll.n'nhwirhconrPlywirhrho{ftuv^ion\
<br />IIARNIN(; I i lLn. ro {.urc *orl'cs .o ltn\rtr r .!rc'r8c i\ unltr{Itr]. rnll \hxll {'hi!cl xn k))_.r n,.ri'ni'nl lf,r'lri.s rtul
<br />drnrg.\ r\ Dr.li(lfll ktr rhc.ivil iNs up ro onc hrndr.d rhonsrnd dolhn (Slm.oOO), irr dd iliotr nr rlt con of.o
<br />Sc.rnr 1076ollhc l2txtr Codc. inrcrc(and lrlorNy s rcc\
<br />0t \u: I co [t ^,,,.,,, x
<br />LICENSIiD-CANIIACIOB
<br />DllcLa&tll()li
<br />IhcrctrydttnrD dcr p. rtryol pcrjury rhrr I m li.cn{d Dncr provisim .i Chrprd 9 lconnrEn. ing NirhSc.rion TlXx)rolr)ivrhn 1
<br />of rhc Busircs and PdrsiuNCodc. rRlDry li.ctrs is i'r tull r(,rc rt cllcct
<br />coNsTttUc.l_t()N I t_NDtNc aeFN(y
<br />istr.d (Scc 1109r. Civ ( )k Jcr's Ni r
<br />-
<br />APPLI( ]AN'I' T)F(:I,ARATION
<br />I lr($y rllinn u ndcr p.nalry of Frlury onc ol'thc tulk,sn,g Jccla ri,)ns
<br />Dci6hlior Pcnnik Asbcsio\ N.tificrriotr I'cdcrrl Rcguhrt,ns (Tirl.40. PM6)
<br />_R.!!ncd Lcnd oi Nori,i.nlion
<br />l.dliJy llrr rhc tncr lrcluhri,,n\ rtgrnlln! x\hc{os,ctr(rrlnrc trfl .'l,nli.xhl. L, rhr\ prqc.l
<br />\/ l..jrrr'u' I h.r" r..il rl'F,a rrtr "11 tu l.r. rl.i rlr'hrc r.L
<br />, i'.htr. Jrt \'n( 1,,\.'clJ'.s r, h'.i'ttr r !'{rrL.rtr,,Et h rhJ
<br />i\(onc.r lrgr$k).onll'ly Birh !llCir!nh Cortrry
<br />izc r.rc\.nrrri\.\ ofihx (-rryarrd cortrry ro cnrd uFrn lhc
<br />)Ix^r ff, urJ t,nrlrriy li, i'r\J'..ri(n, t0'lr.s.!
<br />,\pllicrnr or '\!rn! Sixtr l,'rt
<br />I'rr il.r mt rDritrlrr x {.h tL
<br />,,,,". ot (ur luo rl
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq
<br />lnsulation/Energy
<br />D rywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />[,4asonry
<br />Pool Fence
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />,i^zt/u/lf ,l.W1 7rl
<br />Certilicate ot Occu nc
<br />Notes, Remarks, Etc
<br />-t
<br />Subf loor/Vent/lnsulation
<br />T-Bar
<br />Flood Zone Certif.
<br />FINAL
<br />,,"...,,. . c!0 _ -c. Nu.,{, - l00R3na
<br />n,. . 0l l,.,tJl"rnrt,,,",,"",,,, x------?-
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