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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG."-_ COMMENTS i)$ NIIR Bt Il-Dtrl DI.r,( RA I t()N
<br />I hmchy,nirN undcr p.mlly oa ncrjury rlur I m ci.mpr from rhL Cofta.ttrJ Liccnsc L!* lur ltc fink'wing r.N rS(?011.5
<br />Ausinc$ ond Pmicl,i.n Cdc): Any Ciry or c.unry shi.h i.quncs i lEmil ro .on{tucr. rlrci. nntmv.. {lcrmlin or rcpat lny
<br />(rlchrc. nrior lo ils h\u!mc. ako r.quimsrh. applicd n, such p.flnilro lllcr sisncd ddc trnl thar tEor snc is liccn\ed Nr\u"nr.-
<br />r, rh. p$vi\i(,8 or rlf Conkr.kn r Liccnscd Lrw (Ch4rcr 9. (nnrtn.inS \ith Seclion TlXx) ol Divi\ion I oi rhc Busirrc$ Ind
<br />Pnntssiofls C(!lc) .r rhll hc o, .hc kcrcn\fl lhcrcrroNintl rhc hrsh l.rrhc rllcscdcicmprion Any viohrionofSccrion 70:rl5 hytriy
<br />rpplicn tu r p.rmir snhjccrsrhe 0lplicanl ro scivilp.n.lryotnor B)rcrhan fivc hundrcd dollo( (S5N)
<br />-l-
<br />as osncr orrh. pdFny..r nrtcmtby.c\ $ilh wrsc\ !s lhct $l. roniltcn$r$.. qilldo Ih. sol.nd rrt iturur n h{
<br />nncMcd or offrrcd Lr slc l S(.7r!4. Businc$ lnd Pi,lt\si,n,s Cdc Thc Co n.loisLiccn{lr'*doc\notrpllyrotrno*Nrof
<br />rhc Dmrrdy who ttr'ilds or ilr[mE\ ih.fr'h. arrl who d,ts seh w r* h imscll or hcr*lt or rhmuCh his or lE o*n .DPlorm\'
<br />,' ovn[,] rhri soch i'npn,vcnr$ tm nor ir cRlcn or oll.rd ior vh li ho+rwr. rhc huiunl8 or in]rn'vcnrnr h $ld *irhin oft ]f,tr
<br />oicolry'Lrion. rhc O*m, Brikld *illl[R rhc buili offiorirt rhir h. or \hc did En huill.r nrytuvc rlE lmpcny for rtu PUrII){.f
<br />I. as osNr .f rhc l]nJpc.iy- rm cx.lusivcly conlrrr ill! *irh li..n\cd ..nkri.r ro con(rucr rhc lro t.r (Sc. 7lll1- llu\i'ts
<br />lRl th,llssionCndc'lhcContn.kr-st-i..nscl-rsdocsnolq'!lyroanowncr.rtn,rny*hohuildsoriml'ovctrhcrcor
<br />i d *lb (,nta.h for such pmlcclr*ith!Conrncb(s) liccn\cd Pui\unnr hrhcCotrra.ntr\ I i.ci* t-rs r'
<br />lr'n.r.m.r undcr S..rion B &PC (rrhrrean'n
<br />Dale ()*n.r
<br />wllRxrRs' c0l\tPENsa'rloN
<br />Dricl .Eaugl!
<br />I hu.by rffi n !ndcr |[.rlly of pcllury om of ih n'lk,wi'rt ilc.turr ion(:
<br />-lhultnlwill'tui'nnhaCcnific.lcolConscnrloScill'i\urclu*urkcr'(rrlEns(ian.aspmlidedforhrScdionlT00.frhcItrh-rCoJc. itr rhc pcrrarnrn.c of rhc qolt f.,Nhichthc pcrnrir is isu.d.
<br />mainrain wortcrJ..nDcns0nun nr\urnmc. rs rcquird by SNr ion .l7l]() o lr ljln. Gdq r.r rhc P-.1'onumc ol
<br />conpcnsarn nr\unn.cclricr inl poli.) nu'ntxrarr
<br />11t?
<br />l.cnrli rhnr iI ihc pcrli)rnuncc ofihc work ntr BIi.h lh'! lcnnir i\ i\\uqt- I shrll iot cilPk,y rny pcrs)n itr rny 'ntri .r
<br />v, rs t' hc.otrr s!l,J.rr ro rhc so cccon!!.nsllionhrsolCrlif(rnirri iStr\rhar il l sbuld lf,iart \uhjcd rorhc
<br />sorkc^..nrtris irnrpnrvNhtrsolSccrion.lT0Oofrhctf,hrCodc.lsh{ll.lodirwirIconpltwirhrho{Dmvhions
<br />\'|'ARNIN(;. l'rilurc r,) {cu'c *orkcA .onll,r \rridr co\(rB. i\ unhwlnl r
<br />.rIltrr\ t,r.och,'n,i'11 \i',J'.r li ll.,'\ '(''!iLiiii. tr' -,U L{,',''|,c.
<br />i-,". orr,rl,r'" 1,r,.'.,,1" 'id.{rn'lr !'i\'.1.(1, 't I
<br />,,^,",4r+/71.,,,,,,,"^, Lh'/rl-/ t "*-*.,-+SHtr*
<br />r rD .mnl,,\.r r).nn,i'rxlltinlri$ tr(l
<br />6n. daruscs ,s povidcn Inr rhc
<br />I hcrcbyrlinn,lndcr p.iahy.l F.tluryrhrt I ar Ti.c wt ulklcr trolin.trofChrrlcr9l.onnmmin! sirhS.cri TIXXD orI)ni\ir l
<br />rr rl[ llhirr\\ nd ltolcsiotr! (rrnr) rtrcn\. i\ i,r h, thrQ rrtcllrLr
<br />%o '-r'f::'-
<br />U/iL
<br />, ?tYtrb
<br />,,U bit-'
<br />( l( lNs-l Ru(l l-l()N Ll-NDING a(lFN(lY
<br />Ihcrcby {Utnurlcr ncnrlryofl)crlnryrhd ihcr. h rc.ndrucrion lcndi',g lcntforr1rpcri,rn,rmcolrhcworklor*hichihnt^-nniris
<br />1!\ul rsc.. l(x)7. (-rv C r
<br />Lc dc, \ Add'rss _
<br />ATTLICANLDECLAItrIIIJA
<br />I r.Nby amnn u ftc! r.nrlly ofp!r.iur, onc ol rhc blk,win8 d.claririonr
<br />Dcnoliri{)n P..nn' rbc{.s Nori,icalion Fclcril RcguLrid* (Tirlc.10. Pano)
<br />Rcq0nrti l-crrcr of Norifi (riotr
<br />l.cdlly rlur rhc litl.rrlrqu
<br />ro c.mplt rirh all cirr_ rnd c.utrry
<br />kldhu4
<br />i/;;ii;"
<br />Set Backs
<br />.-|-,
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Sublloor/Vent/l nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Eneroy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />It/asonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Cefiif
<br />F|NAL -// 2q1q r/44 /6/
<br />Certilicate ol Occupancy
<br />Notes, Remarks, Etc.
<br />Forms/Steel/Holdowns
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