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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />Rool Sheathing t-/4-/9 .,U,/;d'Dfil)
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />E ngineer Final Report
<br />Flood Zone Certif
<br />FINAL /" -ZA-lb JdcScl v(w
<br />Certificate ol Occu pancy
<br />N otes, Remarks, Elc
<br />OWNER AUILI'ER DELCARATION
<br />I h.rcby amrn und.r pe.,lry (,f p.rjuiy rh,r I m excdfl lrom rhc Conracb^ 1-l*.\r lj* ,; rh. r.lldsin! rcaRr lscc.7oll 5
<br />Businc$ a Profc$ion Conc): Any City or C.utrr, which rcquncs r Fnnit ro co (oct. rlrd. improvc, dcmlhh or rct,at rny
<br />itucrrE. r.int, ih hsumc. lko rcqrncs rhc,mlic r io, such pcrnrirro lilca si8ncd (ar.nEnr rixrh.or\hc k li.cnscd N^uinr
<br />ro rhc pmvtiotrs of llT Contoclols Licctrscd tiw (Ch.rrcr 9. c nnrminS with Salion 7fi$ of Dirkio! I oi rh. Brsinc$ lnd
<br />Iotcsions Codc) or Ihol h. o, stc hcxcmlr thcrctrom and th. bnsis lor thc dlc8cdqemprioo. Anyvidarionors..ri.nT0ll5hyiny
<br />rrplicrhr rorapcmn \obj(k rhc amlicm! bacivilpenalryotnor moE rh fire hutol.cd d.llB ( $5fi) r
<br />_l.asowncroirlEnmrrny-,n[ycnrplo)rc\uirhwiacsr\th.nshc.nrjrn{arion.willdothcw{nkunrhc{nrrrtrui\
<br />idcndc.i or o[.,cd fd slc (Sc. 70t l. Bu\itu* rnd Pn]Ic\si,ns (-{ . l hc Contr.ttr s t-i..hc l jw docs n.r lPfly ro nn .wmr of
<br />rhcpmFny q,ho hoildr o. ir{rorcs rfuron. rnl lho des su.h k)* hinNclfor hcr\clior rhrou8h his or hcr own cnuloyc.\.
<br />povidcd rhdr sucb nnJro!.nrnt d. nn irnc rl oro,ti'rd lb! srlc lt howcu thcbuildin! or irnpmveDEnr i\ {nd wirhinoi. )rr
<br />of.onlndio.th.O*icrBuiklcrwillhv.rhchurdcnofpR,vinArldlEorshcdid.orhuildorinDror.rh.pnrrcnyfirrhcpurlFyof
<br />LasowncrolthcFrcny.inc\clu\i\clr.onridirgsirhli.cn\cdcokr.ttrrt,cotrnn'.rrtrp0F-rlSec7u.il.3u!r$
<br />rtul Ih,fr$ir Co.ic 'Ihccl,irracitr \ t-iccn\c l a* d.cs n.rrppllro rn.\'n.r ofJ,n)n r" *ho buikl\or i' !n)v.\ rhrrcon.
<br />rni $h. conr \r(rn(hproiccrss[hrCi, rNr)n r li(tr{d p0^trr rrrrhcCofiK!tr\Li.cnrLru).
<br />-l
<br />JD.rcnpr uMcr sc.rio
<br />D.te:
<br />IQBXNtsI:!ATIIENSAIIQN
<br />OETLI.IAIIA!
<br />I hcrchyditnrufrld Nnrh,of Nrtury.n.olrhcli,lkrw rSdc.ldlFtr\
<br />-l
<br />h0vc and will nritrrftn d ccn iricirc of ci,nsnr b sclr.lnsur r(tr *ork cra .o.Dcn\al ion, 0s nmlidcd lor by Sc.ln'n l?00 oflhc
<br />kbor Codc, lor rh. l).rforro... of rhc wdrk for whth rhc Fmir i( i\\ucd
<br />_l hrvc ann sill nmn lin tr.rkcrs con,pcr\alion insmncc. o\ rcquircd bySccln,n l7(x)ol ihc libitr Codd, ror rhc ,.ri.rnrnc. or
<br />rh. *uk for*hichrhis pcrnrir i\ h\usl My sorker' coDr!.nsulion incurrncc codcr !M Flict n! mhcr m:
<br />P{,lirrNu rhcr I:r! rc\
<br />-l.crrir'yrhd
<br />inrhc n rionmncc or rhc*ork rd lhrh rhis,rcnnir n hnllt. lrhrllnorcmpk)y anyp.ron in rn) nr ncr
<br />y, N k, hccnnr srhj(t t, rhe RorkdJ .omfcn\ar ioi lr*s ol Crliirtrir. aid l8N rhrr if I sk,uld tidnm uhjcd k) lhc
<br />qorl.^.ohpcn\rri()npmlisnrNolS(tion:l70Oorrh.l]htrCodc.lshrll,ndh*irh.ondywirhrh.sfmvhtun\
<br />wA(NlN{i: I'trrlure ro {curc {orkc6 onrpcn$h.n covcngc is unlatrtul. rtrd \hrll\uhjccr n cmpni)6 t).ri'nirilti(trr
<br />Sll[).(xrlrr r) 'lnl](iiin ro rh. ..{ ol .o
<br />S.cril,n.llr76olrhc lihtrCod.. ir cr.s! rnl
<br />**r-/t2JlK
<br />tlliltAf,alrg!
<br />undcr lovnion olChaptcr 9 (drmnErcins sirh Sccri,,n 7fix)) orDlvisi,,n.lI hc(-byrllnDu .r rcndlryol
<br />ol rhc BusnBsnnd Pn,fcsrn\ C.dc. kl nrl li.cisc i\ ih fx ll nR! nnd clTLtr
<br />C.-3 Ct d56*u.3
<br />o ils
<br />I hcNby rlfiroundcr rEnallrolncrjury rhar I )n(nrcrion lcndirs rscn.I tu rhc lcrronnnmc orrhc sork ln whi.h rhis |Ennir is
<br />kiucd isec. 3tro7, Civ. C )
<br />A.TTLICAII.DECI,I.BAIIOIi
<br />ItEeh,n0ianundcrpcnnhyolpc.ju.yorcof rhcfollowined..l irio.s
<br />Dcfrniiion PcirnnsAshcnos Noriricdion Fcdcr0l Rcsulirirrrs (Tirlc.10. P.fi 6)
<br />-Rcquncd
<br />lxrlcr ol Nolilirlion
<br />l..n'Iyrl r rh.liJ.nlr+uliri,)ns 'c!mli'rg r\lrno! r.nmHl rr. nor rfflicrhlo t) rIn t"!.)..r
<br />d rhi\iflrli.rri rna {ircrh{filErh'vc irlonr ior is cotrc.r I r8rcc loconplysirhallcfyrnd (indy
<br />ildinA .o.(rudnnr. rnd hcrch! rullxtrizc srnr3iirc\ ofrhi\ Cny a.d Counry b cnrcr ult,n rl.(
<br />\.rc!4-q.LLC
<br />*'Ur213
<br />COMMENTS
<br />UFER Ground
<br />civil litr.r up ro onc hnndrcd ihoulrnd dolll
<br />trnd.r \ Alldtr!(
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