|
BUILDING- INSPECTOR BECORD
<br />SITE.WORK DATE rD/srG.COMMENTS OWNER BUII-DEN DELCAR TION
<br />I hreht n ftro, ondcr p.nrlly or Frjury rnar I m cxcmpl liorn llrc Conlft.nE Liceie l,,s roi rh. followin8 rcrs, 1scc.70:1 1 .5
<br />Busnrs !ftj Pr.fcsqbn Codc): Any Ciry or Counly shkh Equic\ r ncnnir b cun{tu.r. nlr$, DF ovc. dcmolnh or EnJn nny
<br />{ru.rurc. tritrlo its ksuatrcc. also rcqunesrhc arpliclnl litr su.h pcrni tu nhr silfcd larcnr rhar hcor shc is lic..s.d Pudanr
<br />n, rhc lRrvisn'.\ dfrhd Ornta.rofs Liccnscd Law (Chaprcr 9. Conrmcrcin8 wilh Sccrn,n 70(n of Diviion I olthc BusiN$ rtrd
<br />P(,lcssn,nrCodc)orrh.t h.orshc ncrenDl rhcrcfrom!.d lh.l,ush ior rhc Dll.s.d .xcnPrion. AnyviolationolSecrionT0ll5ht!ny
<br />lprlicaln forapcrmir \uhjcck rhe rtplici.iro..ivilp.mlryornolmr.rh livc hundrcd d.lh^ (S500)
<br />l. r\ osmr of thc pr.p(ny- o, my cnul,,Fc\ sirh wrgci 3\ rh.ir q,l. .oif.tr.0rion. Nill do lhc s orli a*t rlE {drrc n Nr
<br />i' .ndRl or oltircd l{, $lc (S(.7O1.1. Bu{inc$ard Proli$ions Codc lhc Gorracr.i\ I-iccDsc I awdoc\n.r rrPlyro tnouNr ol
<br />rhcf'n,ltny w,r hurlds or impmws rhcmn- lnd *ho des suh *b* hnn\.lfor hcr\clfot rhmugh his or h.r osn cDployccs,
<br />prcvidcd rh such nn!(,!cnr s d.ftn i rctrdcd dollIrcd fir \rk lf. hotrcEr. rlE tDil in8 or inDrorcartrr h $kl sirhii o u tr,tr
<br />ol co FLri(r. rh. Ow cr Bulklcr wlll hM rhc hurdcn of F,viru rhd hc or $r did mr $oi[t or inrtroh rhc pmpcny fitr rhc Nl1l,{ nf
<br />l. r\ .wmr ol rh. fm[l.ny. mr cxclu\i$1, conrracrins $ilh liccn{d conractB k, $.nrud rtr ,)hjcd (S( 7OrJ. Bt\inc\\
<br />ffil Pnra$irnC.d.,'l-heConrrro.sLiccn\.t-rwdoc\norrptlyk)rtroLvncrolOo|c rwh.buil.l\ornnnmvd\rhcr.of.
<br />rnd who cootrr.rs f.r su.h !n,jc.rl w h,C(r rrck"(s)li.cn{i Durur lorhcContrcttr \ l-i.ri* Ij*)
<br />I dmexcn.rundcrsccrion .B &PC ldlhFrro{tr
<br />]TOBf,If,I]I:OIIEEISAIION
<br />PEILdSAIION
<br />I h.rcby rifiirn utrdcr p.nrlryol I'cturyom otrhc l'ollowine dc.lamrion\
<br />Ihrvcotrdw,llrminraina(triilicrreoiCotrEnrroScll-ln\urcior*ork.h conrpcisdthn..s tovilcd for hySccrior.lT0o ofrhc
<br />L .r a)dc. ft , rhc !.rronmtrc of lhc *ork for which thc psmil h issucd
<br />_lhalcrnd sillnriorrin w.rkc( .omp.ns.lion insuHtrcc, as rcquircd bySccrion lTmorrhc LJlntr codc. for rhc pttlolnnmc ot
<br />rhc *ork a.r *hi.h rhk p.iinlr is isskrl. My worlcrJ conrrcnsdion in\uran.c.rrhr nnd F,li.y nu,nh.r rcl
<br />llnicy Nunrhcr:-
<br />I..nifyrlur inrhclrrlonn{nccollhc work lor shichrhh pc!nrit i\ ks,cd.l \hrll ior cnPl,,yrnylt.notr ir rny nDtrNr
<br />$ s h hcconrc subid ro rhe sorlsi comp.n\arnrn hw\ of Crlifi,mir, rM iercc rhnr il l \hauld hccom hi.rhrlt
<br />workr\ co'n!en\!rion F,vi\n,ns ofSrdi(,n l?0{l ofrhc l-rhtr C.dc,I (rall. lon[$ili $nlply sirh rh{)* fn,visn,n\
<br />WARNNC f{ilurc h $.uc workcr'conrpcnslrion covcruac i\ utrh{fol x' rhnll .uhlc.r rn cn[loycr ro di'ni' pcm]ric\ r d
<br />.ivrl llrcr up lo onc hutrdrcn rhoueDd do iri,nr t) rhc.o{ rl $mr-n\ulio.. d nh,rc\ r\ ituridcd lnr rh.
<br />Sr.r(fr l07a rlrlr l-.Ll\{ (i!lt.
<br />",,": f <t ll d
<br />urL\! rut
<br />I hcrh,afit undd rcmlry.rr.rjurrrhd I nnr r{n undcr pnrvnion oaCharrq 9(com'ftn.ins wirh sccthn ?Olr) ol Divhion l
<br />oI rhc Busincs ad Protc$iorN Codc. md my lic.n\c is in tull turcc alkl cllict.
<br />-3 o qsb6 u )
<br />3i c o2,=-
<br />I hcr.by amnnuM.r |En.lryofDcrjury lh.r
<br />i\\ted iscc :lrD7 Civ C )
<br />a conslrucrion lcodirs ascn.y fot ihc tdfoiinarc. of rhc *ork t,' shich rht Frnn ir
<br />AIIU!]ANfDEIIABAUA!
<br />I lrn*,y urtrn undcr pctrdllyoftErjuryonc oiihc folbeins dcclnrlnn's
<br />Dcnmlnn'n PcnniKAsb.sos Norificltion Fcdcral RcBulorion\ (l illc.llr- Prrr6)
<br />Rcqutcd L.rlcroiNolific ion
<br />nS,din8 lsbc{os rcmvrl uc rn, npnlic$lc h rhk pmjc.r
<br />nornsrarcrhor rhcahrve inlonturion ir..n(r lng.ek,cotr[lywilhlllCiryrtrilC.trnry
<br />inscoi(tucri{'n.tr tcrchyaurh.rn rclrcenl ivcsoithi\CilyandCodnryrocnrduto.rtE
<br />Sleveirr U iLL qu€..>^,""ki //tr
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathing ?1-toJ )a(>ta1 'v0
<br />Shear Wall
<br />Framino
<br />lnsulalion/Enerqy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />[/lasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certil.
<br />FINAL q-d-/g -l/lS,tJar ,7
<br />Certilicate of Occupancy
<br />Notes, Remarks, Etc
<br />o*"lf
<br />I.1J.''.^dJr...
<br />-
<br />I
<br />,,!,
<br />tt
|