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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OTVNDN NUILT'ER DELCARATION
<br />I hcrcby rllirm uMcr |xndry ol lcrjur! that I n.xcmfl rnnn rhc Cont kd l-k.n{ LLw f.r rhc f.tl.sing rcN (5(.70.115
<br />Bu\nt\s xtul Pn,rcrsion Codc): Any Cily o. County rv[icn rcquncs 0 Nnnir to cotrstrud, llrcr. improvc. dcnF]ish,{ rcnrn 'ynr.tur.. prntr ro ii\ issuftc. xls. rcqun.s rhcapplicr hr such pcnnir r,, flcr signcd norcnEnt rh hcor shc is liccnsd puAxanr
<br />b rhc pmvnion\ ollhc Coolrrcrois Liccnscd Lrw (ChrDt.r 9. Cr.nnnci.irA sirh Scdion 70(xl of Divhiotr I oflhc Busirrcs ond
<br />Prcfcs$oN Codc)!rih r hcorshc i\ dxenpr rhcrefromudrhc barn fnrhc allcgcd ci.mtrion. Any violxrionofScctnJnTO.ll 5 by rny
<br />llpllicinr lor a pcmit subjcck rhc rpplic.trr to i.ivilpc rhyofior nxnrhd fivc hundrcd doll,r ($50O)
<br />I.,\owrcrofrhcpn,pcnr-omvcmpk,y.c\Nilhsrscsrsrhcnsobconipcnsdhn-*illdolhcw( ond lhc srrucrlrc i\ tror
<br />i drdcd or olircd fui srlc ( Scc ?01.1. Bu\ircs\ dd lt,fcsnnN Codc, Thc G, rrtr'\ I -icctr\c lrw doc\ mr atlly i. r owdcr ol
<br />rlr pnFny who builds or i.lprt)E rhcrmr a't sho docsn'chuo* hnnscll.r hcr*lf..rltroughhisor hq o$ncmd.ycc(.
<br />px)vnhd rhrr such imlrovcnrnh arc nor ir ctrdcd or.ia(n tu sb. Il how.vcr, rhc buiu$g oi nl1l)6rc rnt h $U trnhir onc ylr
<br />oicontlclioi. rhc Owncr Buikld qill l[rc rhc burdci.ttding ihr lrc.r shc di{l nor huild or nnpmvc thc ttuFiy fiy rhc !u{h{ ol
<br />I.$owncr.trhcfml)cn!.rmcxclDsivcl!.odnrcriigsnhlicrD$Jcont.tr's!,coidnr.rrhcp'.J..r(S.r?(N-1.BD\i,rcs
<br />rnd lr.lbsi'nCodc: lhcConrracrorr l.iccnsc l-a$ docs rot il) yt..nowrcrolrnrrrywho huil.lsor inrprov$ rhcrcon.
<br />rnd *h. .. ra.rs for su.h pnic.rs uirh I G,nh.r.n, liccnfd puruanr b rlrGrnrackr\ Li..ns. Lrw)
<br />litrrcxc rt, utrdr' Sr.t
<br />]YO.BXEBS-(AIIIENSA],ION
<br />DEEIIIIIUON
<br />I hc'chy llirD trn,l.r |rnrlry.l pcrinry.trc ol lic liJllosirp dc.hrarnnrs
<br />I hdvc dwill r trnimCcnili. rcofclnr*nrt'S.lIln\ur. r workcrr conrprnsari{,.. r\ pnrvidcd for br Sc.rn r l?(Dofrh.
<br />L htrCudc.larrhc pc omamcorrh.ao* rorwnichrhcrcnni k n$cd
<br />:hrvcrrdsill rir rirBorkctr.o rj,{trsnrt r irsun c.-r\ rcqutrd hySc.rn l?mol rh. Lrb.iCodc.lor lhcldror.rrccof
<br />lhc r.Ik lorEhich rhislcnnir is hsucd. Mr workcr' co*r|cisd i,, i'rsuhn.c mricr turd Flicy numhcr trcl
<br />a oti CAL| l,^rtP\A
<br />t-ttr
<br />ialrcdirtrhrrinrhcl}clnrnhnccorrh.w.rki(n*hichl[]spcrnir is lsucn. I nrll trol crykiy !!y pcrs i'rx.ynrnii.r
<br />so ns to h\comc suh.,c.r lo rhc aorkci\ compctrsarion hs(.fCalil{n ir. M,ll8fc rhrt ifl should h..omc snhlc.r ro rhc
<br />ro cm corpcrsdiotrproytion(ofSccriotrITID.frhclnhtrC(.,lslull.fonhwirh..n!nywirhilmsfmvision(
<br />WARNINC lrriLlvc l. sctrrc sorkcr\ conncnqtion c.vcrugc is ulnstu!. rtrd shrll rhicl ar cnrploycr to crimiml pcnohic\ and
<br />civil finc\ u,r k) om hundrul llnu\rnl dollrs (ril(D.(xn). nr nddiri.n lo rM cosl ofcoflFnsaltun. damarcs as pmvdcn lor rhc
<br />S(rion t()16.f rh. I160r Co.lc inrcrc( o
<br />!"* r^zr- tY /L-t+..
<br />L!!]ll!!-(lru ji.!t_lol!
<br />I)t.:( l \ R,t ()\
<br />Gl
<br />I L4U &vt
<br />S'-2.t - lg c.**o." Jal-^a S 1*, ? ),14,.t/
<br />CAN BIJCI&NIEND,INC.AI).ENCI
<br />I hcruhy rlllr'h undf p.nally or pcrury rhnr rhcrc is aonntucri.n Endine agcn.y tur rhc !$ronm..c ordc sork for whi.h this ncnnn n
<br />isu.d isc. 109?, Civ C )
<br />AITUCAtrLDCCLAIAUAN
<br />r rf,rub,- rfiiflnnndcr ncnrtly o, rrriury onc or rl[ rr)lt.*irr n$lNlnirr
<br />Dcnmliridr Pcrnilr A\h.sros Norificlrior Fcd.rrl Rcrtrl!1i,$ 1[n]c 40. Pur6)
<br />R.qutcd trucr.rNorifi crrn,i
<br />I.diltrhxr rhc lcdrrnl'.!ulxr(nNrgrJr! r\lr{o\.cnnDrl xrc or rflrh.nh r k, an: t,i(i..r
<br />-lccnityrhil
<br />I havc rc rhn apllicolion und (atc that rhc rlsvc nrronMrion h.orccl.I l8retocomplywnhallCir,and G,uniy
<br />.rdinanccsnnd Slarc Lflssrchriryro huildinc consrrudion. tul I'c'chr .*h.ri7. rctrc\cnrrncs "rrhis Ciryrn'l c,,unryi..drdruynithc
<br />fi:,-^:j,.,*::"i'Z)J: {1.^--l,l^ b,"{- u-/a
<br />i"-','""",.",rn.,,, o@
<br />Set Backs
<br />Erection Pads
<br />Sublloor/Venl/l nsulation
<br />Rool Sheathin s
<br />Shear Wall
<br />Framing
<br />lnsulalion/Enerqy
<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 Certif nIUUG* laL4{6-ze-lY \ ilJtt.\x
<br />FINAL
<br />Certif icate ol Occu nc
<br />Notes, Remarks Etc
<br />t.\
<br />Forms/Steel/Holdowns
<br />UFER Ground
<br />SLAB Floor
<br />x-wil)
<br />Osner
<br />to 7Lol1
<br />I h.rchylrfirnruincr pcnalryotl]c jurrrhJr I a liccncd!tucrnmvkionofChifrcr9(cornmcncinawirhSccrt)n7m0).rDlviti.i:l
<br />ol rhc AusiNs nnd P,ofc$ions Codc,.uid my liccnsc is in tull rd.c drd cflc.r.
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