|
BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS ()wNaR lllrll,DI,:R l)Ul-C,\L\ ll()s
<br />! h.rchy rllird und.r p.n,lry ofrcrjury rhnr I n cxcq)r fm.r rhc Conrra.roF l-iccne Lrw fir rhc ft,llowinB rclv (S..70115
<br />susircss md Profcsio, CoJc): Any Cily or Counly u[i.h r.quncs a frnnir lo (,srrucl. alln. mPolc. dq]xrlisl' or rcNn x y
<br />{rucrurc. n ,,ro irs is\xrft.. rlso rlquios rhc {plkmr for su.h Fnnir tu flc c sisncd {ircnrni rhrr horshc is licc.s.rl irursu!
<br />h rhc pDrnions ol rhc Conrroctr's l.i.cn*d L,w (Chdpr.r g. c. nncrci|s rirh S.dion 7qx) of Division :1 ol rh. Ausnrcs 0nd
<br />Pi.ri\sidsaud.)orrharhcorshchcxcm rncrcfronrndlhc b!si\ r'or lhc rllcscd cxemtrn,n AtryviobrbnolScdion',1):ll5hynny
<br />opplicr for a pcnnil subjccrr rhc lprlicanrro0civilFnalryotnornotrh,ntlvchufldrcddollar($500)
<br />l. is osmr of rhc pmlIny, or my .mployes *ith r.a.s !s r hct $lc otrD.nsarion- sill do rtr wolk ffd Ih. (utN is nol
<br />iJ ctrdcd or o llcrcd ior slc (Sa.7Ol4. Buincs ond Pmfcsiotrs C{{lc: Thc Grnt,.r.is Li.ctrE riw dms nol opply ro an owrcr or
<br />rhc pmpcdy wlE t{ild\ or in!,mvcs rh.dn. rJld who dms shh *oi* hinrcllor hcBclfo! rhmu8h ht or hcr own.itplorccs,
<br />,rovidcd rhal $rh iq,mvcmnc m nor id..t d or oftcrcd f sh. ll ho*ls, rhc buiklins or inqtrnwn.nr h sold !'irhi" nc r
<br />oiconpLlirr rlr owncr Buildcr *iI h.rc lh. burdcr ol provirS ltur h. or sie dil Doi huild.r i'npsrt rh. tmpcny for thc pulFt.f
<br />-1.
<br />asowNrorrh. pnrEny. rnrcrclusivclyconrr&crinB wirh licc.sci conrrr.bB b rcnrru.r rh. pn&cr (se 7l)1,1- Bunncs
<br />rnd PNl6\ii Codc: Thc C..krcror'\ Li..nsc Law d.cs nor aprlyt, M oqncr oiproFny who build\ or inprolcs rh.rcun.
<br />.Dd who .o mds lor such,)mtcch wirhaConaacro(s)liccnscd pu^ulnrr. ih. Contncrors Lic.ns trw)
<br />,^" - 1/,P:YZ+r uru.!a[!Qr
<br />Ihdr.hy Il,rnu d Fnrlry of pLntrry om .l rhc i.'lk,wing dNlaDrbns
<br />-l
<br />hilc arxl sill minrain ! Ccdificsrc .f Con*.r roS.lalnsndfor work.N'compcnsolion. as lrovided lbrbySetion:lT0Oolthc
<br />bt or Codc. ior rhe pclfolnuncc of lnc slk for which lhc rEmi n nrucd
<br />I hrvc,nd sill nrinrrin sorkc^ conrr(hnrim nurnrc. a\ rqurcd bySc.ri,r:l7rx)ol rh.litxtrCorlc. forrlt Frliirnrn.c oi
<br />rlr *ork frtr ehichrhi!tcirnir i\ i\{rd. Myworkcrr coml]ctrsrnoD irsurincc c0rier a policynu'nh.r rc:
<br />PolicyNu'nb.r lirlircs
<br />-l.cnify llrd ir rhc pcrfonruNc ollhc sork lor ehich rhn pernrir i\ is\ucd. I drll nor.mPloy nny pcron io,ny @ncr
<br />v, rs k, hcronr suhJ.cr b rhd wolkcn c.mp.Nrr ion hws of Qlihari0. .trd !3B rhlr it I should tlrom lubJc.r ro rhc
<br />w.rkch..tr'pcnsarn,n[ovisio,solScdiotr:]TLDofrhctjhrCode.lshall.fonhwirhc..dy*irhrhosphvisions
<br />WARNING: ljrihrc b e.u6 *rrk.6 orn Ndion mv.n8c is unlawful. atrd shlll subicr d cnllloy.r b rin nal Pctrihts md
<br />;:"r\"ift$ifirTt# ruK" m8','
<br />I t *ffi* |
<br />,,r,prQ,..vlw.
<br />ndcr I)crrlryofpcrjury rhxr I n li.rnvd u nlcr !n)vi\irni olChrtr.r 9 (unnntncinS \rirh Sccri,rt 7(D0) ol
<br />sa0d PrcL\si"nsCod.. aflt ryli.ctr\c is i'r tull6rc. rid rlli{r
<br />CONSTRIX]TION I FNDIN(; A(iENCY
<br />I hcrchy atlirnr uidc. Fnrlr), or pcrtuiy rhar rh.rc t i.o.(d.tion lcndina lacncy au rhc ri.rromn.. orrhc sork lnr shth rhis Pcrnrir ii
<br />tsuc! (Scc. l0{rr. Civ. C.)
<br />APPI !(]ANT DFCLARATION
<br />I lmh! afiinn uidcr liorhy.l p.r.jurt onc olrhc follosine d..lrr0rnrn\:
<br />Dcnlnilion Pcrnrir\ Albcnos Norifiern,n Fcddrnl RcsUhrnnrs (Tirlcilo. Pda)
<br />Rc{tlircd tItrfi of N.rifi urion
<br />l.cniryrhd rhc |cdcn|rcsula|ions rcaadins r(r{o\rcnrcval rc n.rrpfhrblc io rhtfr+cr
<br />-lccnifyrh3rlhiurcrdrhiratdicarn,nrnlrrr.rhdrrhcabvcirf.rn
<br />i{Discotrccr lr8ret'.l,mtlt*irhallCilyandC.utrry
<br />horiz! r.rcscdalivcs otrhh C
<br />4;;1{d-.
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Sublloor/Vent/l nsulation I
<br />Roof Sheathing dtltoltXtu fr,traraJ1 b)
<br />Shear Wall ,_ t I ul\-
<br />Framino
<br />lnsulation/Enerqy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lr/asonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />I
<br />1lll,r? I Wx\\^et t47V)
<br />Certilicate of Occupancy T w
<br />Notes, Remarks, Etc
<br />opl U,Y {co\l- o hr-H
<br />Flood Zone Certif .
<br />FINAL
<br />x-t-
<br />U(lra
<br />I
|