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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE rD/slG.COMMENTS {)wNIiR BUll-Dlil{ DDl,(,\R/\TI()N
<br />I hcrch, trlilm undcr !.nhy of N'juy thil I {nr cxcnu h)'n ihc A r&rnJ t,iccnsc Irw lar rhc n)lk)wir8 rcnlD (Scc 70.115
<br />llusinc\\ md Prolc$rin Cr{lc) Atry Cily or Coutrry *hich rcqutrc\ I Nrnrir b condn'cr, nlrcr. nnPlorc. icNnnh or toNn rny
<br />r,) rh. PDri\nn,\.f rhl cotrtacrois l-i.cnsen l,r{ (Chrfl.r 9. connncNirrS *ilh Sccrn,n 7(x[) fDivtrion ]oflh'Rtr\i'n\\'1xl
<br />rrpll.ur,nrilrirninrhjc.slhclpflicatrrt,rcivilNrhvolrn Nncrhrn livc hu drcdd.llrrs(S5Ol))
<br />-l-
<br />r\ owmr or rh. pnrFny, or nry cn[loycc\ \e irh $rgcr r\ rhcn \rh co,nPc.\ulion. will do rht work $d lhc dDrN ( tror
<br />n cMcd .r ofcrcd li)r {lc (Scc TGl.l, Busi'r.ss rtrd ftofc$iinrs Conc:-lhe G,nrn.ktr-! Liccn\c ti*.locs nor srliv ro rno*ncr oi
<br />rhc |xtbry slb bniltls.r illlt&rcs rfuron- dd *tx, dcs su.h w.rk htrnsclfor lf,isclfor IhnnrAh his or hc, o*n emPk,tccs.
<br />nrovidcJ rhrr strch iipturc,Etu urc mr inrcnlcd or oltircd lbr ssL l I lhwcvcr. rlE hlilding or irq,m\cNnr h $ld s irhin onc tttr
<br />ol con+ld iofl. rhc O'mr BuikJ& will hrvc rh. hudctr ol lrovin8 rh.r hc or \hc di, mt bnild or iDProk l}t Pot'.ny for rlE IUtIn{ of
<br />I.isowtrcr.trfu,I)pc y. rtrtor.ru!vcly.otrrrid rs wilh li.cn\cd .oikr.tr t) c.tr!lrlcl rh: Pric.i (s.c 7l!1.11$rncs\
<br />a'rl hnfissinC.dc IhcC.trtrcrr'\Iiccns.l-nqdocsDorrfi,lyn,rtr.*n.'ollx,l,c t Lvh!' hDiki\.r imrn)rc\ rhcrcon
<br />rtrtl *ho ..ntrrr hr sL.h ptui.r\ rvfh r (in .].r(,ltrtr\.d fur\ulrrr, rlrc(bnrrrckr'\ l-iccn\c Lr*)
<br />-lr
<br />cxcrpr utrJr Sccrn,
<br />laaru&tl:gutENslllla!
<br />DIiCL SAllllN
<br />I hcrobttrflntrrtrnd.rt^*trrlrtof |Erjury.n.olrhcftnbsidgd(lrr ri([s:
<br />-lhlvcdklwillnDnrirrCcnificarcofCon{nrt,Sclalhutforsorkcrii,mp.trsdnr.r\Pmvidcdl'orhySe.r
<br />nl7U)ullhc
<br />LlborGnc- forlnc rEaolnbn..of rh. work for whichrhcp.rnrir n i\\ucd
<br />-l
<br />hivc id will'mNfln workcrr conrpcnrari{tr1i'trlrn ... r\ kquircd hySrcri,r.lTU).1rhc Ltbot Col.. i,n rhc pctfonnirc of
<br />rhc sork tur whi.I rhh F.rnil is is{'r,l Mt q.rkc* .o lpcn$r iqr irsn rncc crtrio u t.li., n(rbc m
<br />It,lry Nr rh$f
<br />--l.cnilirhar
<br />inrhc p.rfortun.c.l thl $olk,nr whi.hrhhFi, ir il ssucd, I rhrllnorcnlrn,yriyp(rwr ir rnv mann.r
<br />s t, h..om subF_r h ric sortr6'comFnsion l,s\ ofcilif.nlr and r3N rhar ifI stuulil hccom rlhJcd o rlr
<br />sork rJ omNnsrrion pmvnbr ot S&rnrn ]700.f th. trb. C c.Ishnll, fi,n hwirh omDly wirh rh.$ Frvniois
<br />W RNINC railu'c t, kurc worker( conpcnsaliotr cowrusc ir unldwfui. rrtl shill \tbic.r r cNllovcr lo siBi'rl pcturhics,nd
<br />civil nlcs or ro.m hundrcd lhouslnd dollor (Slll),lxlo), i'r rddilnr ro lh. corl .l.o r!.trsrtion. donugcs as ln'virldl turrhc
<br />Sccrion:lo7a'ofrhc hhtr Codc. inrcrc{ and a(omy\ fccr
<br />Dole: Appllenl:
<br />r rclnsro coNrnlr:rnn
<br />DECLISA:IIo
<br />I h.rcbya,fiflnundcr prn.llyofFrjrry rh.r I rfl lnrntd u.dcr t.ovision ofChuflm I (comrmNing kirh Sc.rirn 7000, ofDivi\ion l
<br />ot rhc Busitu\sa PmLssionsCodc. a.d ny liccn* i\ in ttllnxe Nt ctltcr
<br />-l-icctrsc
<br />Nun$.r
<br />-
<br />coNsfRllc'rloN I FNDINC lcttNcy
<br />I hcEhy llfnn uM.r,rtJry ollcrjry rhrr lhcrc i con{t.ridilttdirs!8ctcyli)rrlrpcrhnru..coIlhr*orkn)r$hichrhisPcnniris
<br />rs\rc(l(Sc. l(I)7. Civ a )
<br />l-cndci\ N nr _
<br />AI}LIIAILDIILA8AII9N
<br />I h.rby dt'n undc, Fnah! oI lciury one ofthc roll,'sn,g dc.hdions
<br />tXmlili,nr Pcrmih A\b(do\ Norificnriotr fcdcEl Rcgulurions (Tirl.4), Pan6)
<br />-Rcqut
<br />d L.ucr of Norifi.arxn'
<br />I ccrriryrhar rltr ltdcrLlrcauIri,)n\ rsrd] u n\l[{r:,cnt,!nlrr. n.rn|fl'r lcl. rhis |m,l..r
<br />I ccnililhrr I hrvc r. rhr amlicntidr rd slarcrhir lhc d.vc intunruiotr i\cotrccr Irsrtk,.omplrFirhlllCiiva counrv
<br />odinin.cs od Slrtc liw\ rchrin! b buildirS cotr\rrucri.n. nlhrrchrrurhoriz. t !r.\cohrivcs (rrhi\ Citt rtrd Counryto ctrrcr u|Fnrh
<br />rbvc nririotrcd Dmp.ny lo in\pc.r idr !trD.*s
<br />,\pDlirnnl or,\!rnr Silnnturo
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/Vent/l nsulation
<br />Bool Sheathinq
<br />Shear Wall
<br />Framinq
<br />lns u latio n/E ne rq y
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lt/asonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Reporl
<br />Enqineer Final Report
<br />Flood Zone Ceftif
<br />FINAL B -t1- tS J/rtob t?{)
<br />Certiticate of Occupancv
<br />Notes, Remarks, Etc.
<br />Cmi.r:
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