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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNER BUII,DER DFJI,CARATIoN
<br />I hcrby atlirm lndcr llcnllr, .r !.rjury rhd I d dxcnpr rn,6 rh. Cont,.ro^' Li.cnsc Lnw tbr thc tblhwins rcaen (Sc. ?0:ll 5
<br />Busincs\ id Phtrs\n,n Co.k) Any Cily or Counry Bhi.h rlnutcs a pcrinn ro .otr(ruc|. drcr. inpovc. dcnoli\h .r mpnt iny
<br />Nru.rur.. prior b nr nsuMcc, nlso rcquncs thc ipdicanr lnr su.h F.nlil h fik a sisncd srnrcmnr rhsr h. 6r \h. i\ li.ctrsd pusuaN
<br />k) rhe pmvisions olrhc Conrracr(tr r t-i.cnscd Lrw (Chrprcr ,. Connrn.nr8 with Scdion 70tD ol Divhion 3 oflnc Bu\iic\s ind
<br />P f.*ions Codc)o'lhrr ltorsh. i.xcmpl lhcr.lrornrM rhctrsis lor rhe allcAcd crcnflion Any liolarion of Sersn T0:ll5byany
<br />illli.anrr.r,t-iinnsubjLrIslhcappliclnrloacivilpcn.lryof.olmnclhanfilehundRddollarlS5m)
<br />_1. as owmr of rhc prolEny. or my cmrloyc.s with *agcs r\ rh.n vrc .omp.Narion. wiu do lhc tro* and lhc \tnrloE is frn
<br />inr. lcll orollcrcd lar $lc (sdl()Ll4. anrftssanrl Pmfcsrionsa)dc: ThcConrrcrir's L-iccnsc kv dl,cs nor rmlr ro atr owncr of
<br />rhcpmncny *tx) huilds or tqr,vcsrhcm{r. and who des su.h m* hinNclfo! hcrcltor throtah bt or hci own cn$loycci
<br />proridcd rh3r such imrercmnb m e, im. r, d ollcR{ for eL ll lk)wcvcr, thc hriklin8 or improvcftnr is sh wirhin onc ,tt
<br />ofcurrLlFn. Lhc (Nncr auir+l sillh.rc lhc hunlcnol'previns rhot hc.r shc did Bn h{ d ur irpr.w rhc pmFn, ior th. puqns ot
<br />_1. asowncrolthcFopcny. rmcrclurivclt.onrturi',g wiih licci{d c.nr rroN io cofl{dd rhc rol.rr (Sec 701.,1, Bu\inG\
<br />d Pn)fl\si Codc Thc (1)ntncrof s Liccnsc L.w der rcr !!Dly ro un o*r.r oI pn)Pcnr" {ho bu ild\ or nryruves rhcrcon-
<br />rtrd $ho c.nrncls nn \uch ptr,J.ck wnh a G,ntacbn r) liccn{d pur\unr rorh.Contacrols Licctrsc Law)
<br />I anrcrc'npl undcr Sccti
<br />yoaxE&Lcl)ufElsd.1laN
<br />IECLANAIII}N
<br />I h.,chyrrfimu .rp.nxlly.lpcrjryomofrhcli)llosi',9 J.chrrrions:
<br />IhnvcdrdeillnEintrirrCcniarc colConscnrroSclfln$rcri,rwo.kcls.\,n9.nsarion.,1 pm!'d.
<br />r lh{k,,,rr. r. rh. r iLr rr,..r rhr qc,k r.. wr.tr.h rhc Nnn,.,+u{
<br />A#.-r-,,,nd'n,a'rn,tc,r,ompn\*on in\u'rnr.r\ n\rutrc., hyiR,'.
<br />'hc \5hr $hi. h lti. rclar '. Fsdc'l My qu'kc'!.,,mn.n.Jrtr'lir\d'Jn\. !rtr_. d thl() nun'hc'
<br />.-.?^h,lCln
<br />:d tor hy Secrion lT0Ooflhc
<br />Codc. tbr rhc li.rfotukc of
<br />1
<br />I ccfilirhal iD rhc NrliirnEncc oflhc work tor $hichrhn pclnit is hskd.l shrll nor cnviloyrtry lcsotr iD onynunNr
<br />e $ro hccom suhtccr ro rhc Mnkcn.oflp.n\ n hwiofcdifohia, and.8rcc rh{ ill should hcconr subid brtr
<br />sortss comtcnsrtion nmrkioh\ ofS.dn{ ll(x).t rh. tjh, Cdlc.I sl[ll,lonhwirh coEply $irh rh.{ Pbvi\nnN.
<br />WARNINC F,ilurc h ecurc wortcs con[cnsrlion corcns. i\ utrlswtul, rnd shnll subFr 0n cmfloycr l(' criminrl Fndrid\ rnd
<br />.ivil finc\ up t, o.c hunilrcd lhousrnd dollon (rlur.uro). in aldilnnr xr rhc..{ or.oDrp..snlon, dunugcs ns pr.vilcd for rhc
<br />::::-u\w\q'"-"
<br />I hcEby ofilmundc! ncnrllyoipcrjury rhrt I rn lic.n$d hd$ Itulhion ofChoptq 9 (conmErcina *ilhSccri,i 7000) ofDiriq.( l
<br />of Ihc Buiincs $d Pofc$ionsCodc. ond mr liccnse h in rullfolelndclr&r
<br />b t\l
<br />coNsrallquoNrElDlNc_&cflcl
<br />I hcrcby dftrm utulcr pc.ilry.ll'c jury rhlr thcre is n construction Lndirs arcE-y rttr rhc Nrl(,rnrn.c ofrhc *ork r'or $hich rhk Frnir i!
<br />nrkl lscc 1097. Civ C )
<br />AIfIICANLOECLAEAIIO!
<br />I hscby ainrm undcr pcDalry oi Frjury otu orrhc r.llowins dcclaorn,ns:
<br />Dcmolitio" Pcirnih-AstEnos NorificltionF.deral Reg!larion\lTirlc40. Pd6)
<br />Rcquncd knrr of Norifi calion
<br />rionr rgiJdins r\h.{or hnrlald. nor smlicable lo
<br />i.arion dd nlrc rhd lhc ftovc inrbrnmrion iscotucr.I agm b.omply*ilh rllCityand Counry
<br />ariv.s.frhis City. Counly ro cnts uF,n rhe
<br />-" tl4Jr tbnilding cotr!ru.rior. itrd hcrcby
<br /> DDIi(nnl rr /1gonl signar
<br />\FT
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Su bf loor/VenVlnsu lation
<br />Rool Sheathinq
<br />Shear Wall
<br />Framinq
<br />lnsu lation/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 />Enoineer Final Report
<br />Flood Zone Certif
<br />UruK/ A S.D <
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />-(>
<br />FINAL
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