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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsu lation
<br />Rool Sheathing
<br />Shear Wall
<br />b.v-fi1v
<br />[1wall
<br />Nr(414(&!)tnr. Larn 7 -244Y I'
<br />| -1"[V k,l1fiaU
<br />Irrlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />De Final R ortU
<br />En ineer Final Re orl
<br />Flood Zone Certil.
<br />/n
<br />FINAL ro-ll-lK
<br />Certilicate of Occu pancy v
<br />Notes, Remarks Etc.r I l,^/0 Po 47 o
<br />owNt:RRI .tr,tR t,tit,( lRl I I )i,,1
<br />I h.aby Diltm undq rnrlly of p.rjury rh,r I an .xc'npr r,,m rhc CnnrJcroF' Li(cnsc Ltrs htr rhc.lullvqrne rcJsn lsc.70.rl 5
<br />Busin.* r Pror'e$ion Codcr Any Cily or Coutrly *hnh rcqu rc\ i l[rmir h, (nn{ru\r. alrr. r'i!,"c. dcm,[,h or El[n jny
<br />(rucrurc. Drir,lo irs i\suan.., aho,.qunc\rhc orplicnnr lor su.h p.nnir kJ litc, sig cd n,rc rc rhar hior shc i\ !:cnscd Duisulnt
<br />r) lhc F,vi\i,,i\ nrrhc Conrrucnx s Licen*d L1w lchrptcr 9, Conflctuins sirh scc'ion'70{x) oa Divhion I of rhc Businci, and
<br />Pmi.ssiotr\ Gnl. ) or rhnr hc.r\he ncrcmpt rhcrction:ondrhcbasn r.r rhcatt !.dcx.iflnri nylidlrnrnotSadionTo.tlStiy!try
<br />rpplicrtrr for . 0crnrir subjc.rs th. +plicanr r. aci!ilpcnahyofnor rorcrhrn 6!c hutrdrL{d.ttr^(g5tx))
<br />l. \ostrc.ofrhcpopcny.ortrrrcmplorcc(*irhqre.sdsrhcir$L.rnnpcnuri,'n.Nilldorhcsorklrxjihe(B1ur.Nmr
<br />idctolcd or.frcrud Lr irl.lSdc.7lx4, Bu\in.s rnd l\oicsi.nsC.dc 1hc (htrrNnr'r l-rcis. Uw doc! or arply n, ai .stur ol
<br />rh. nn,n ny who l,uikh or i'npn,ks rhcrmn. Jshodocssuch(orkhim\cl{orhcisclforrhmulhhnorhc!o*ncnrnlorccs.
<br />f'n)vidcd rhrr su.h if,r[ov.nrfi n rn i erLd .r.rttor] f(, slc tl ra's{r.r. rhc hu
<br />'Iling
<br />or in{mEnr issktlirhir.ncyqr
<br />ol co'lr{rhri'n. thc Owtrcr Buik i sillhavc rh. bud.i ofItroling rhll hc or \hc dn d huild or inuolr $c J)r,Fry for rhc rniF{.i
<br />I. r\ owtrcr .l rhc |t)Nny. a r.r.lu\ncltcotrrrcrlng {irh li..n\cdconnrcrorroconshrd rlE pmFcr lScc 7(!,l.lluric\\
<br />kl Prolt$inrC.{h lhcConrruciofsl.i..oscLa*docsn.rapnlyt,nnown.rofF)t'ryshohuild\orin,proksrhcrcon.
<br />rilt sho conrrrF lor such tn olc.r rvirlr d Cofuncr{n( n licflrscd !u runr h rhc (tdrlctd r l-i.cnsc Lr\- )
<br />I ncrmpr undcr Sccrio
<br />l) l€ O$'n€r
<br />\Y( IRKFRS' C{ )NI PI.'NSATION
<br />D[!L I{ltQN
<br />I hc'chJirllirnrnndu pctrilryol,).UUry.m.l rhcftll()sid! dr.lrrnirnN
<br />_lhavcfl will nri rin , C.n ilicnr. of ct)n{ ! b Sclt' I n$rc nn *or[.^ conD(n$iion. as pmvidcd Ibr hy Sd-rio. ]700 of I hc
<br />lrnor Codc. for rhc pcrronnanc. of rh. work f(n which ihc pcrarit is ssu.d.
<br />Ihdv.nndwill'nri'ninsorkcr\comrclsari.ninsmmc.*rqurcdhyS..rnnr.l?lx)ofrhrI:h.rCodc.furrhnrrlonn.coi
<br />rhc Bork n, which rhi\ r--nnir i\ isn'.rl My wolkcr .onrtcnsrr.tr insur .c.rntr Md Fni.y iumb.rrc:
<br />.ivil fitrcs rp ro onc hundrcd lhousand d.llns (SI drE8ci rs prrridcd lnr rhc
<br />Sc.rn r:11176olrhc I rhtr Cqlc. i cr.(!trd
<br />*", o34q."eg
<br />DECI,ISAII!]N
<br />undcr rovisiotr oiCh0ptcrs(conxrc .nr8 wnh scction 7Ln0) of Divisio.1Ih.rbr rin n dd Itrn lrlo,pcrjuryrhrrI
<br />a(og1E
<br />o"" O5-Z Q -?-off O\a*aNlGsn r>d-:-l
<br />I h.th, ru.nunder lcnnlryof pclurylh,'
<br />isucd (Scc l097.Civ C).
<br />r ldrlir! r!.nc-\ lnr rhc Jf,rlan,nn.c otrh. ro' k lar \hi.I rhn F rrir i\
<br />AIIIICANLDE.CI.AATIION
<br />I lrrc$y oatn uDd$ N0rxy ort)$jury.Dc ol rh. r{nk,wins dtrhrurionsl
<br />DcnDlihon Pcr.rirs A\h.{os Norificdion Fcdrral Rcrtrhrions(lnh 40. Parl6)
<br />Rrqurul l-cido, Nori6.riii
<br />-l.crrilyrhlr
<br />rhc fcdcnl r.Br rvrlirc nortprlkLblc r) rhispml.cl
<br />inlnnnri,r n.onccr.l rgrN h.onply wirh rllCilyrnd Coutrry
<br />byaurhorizc rcr.rnl,ivcs oi rhis Ciry rtrd Couflyrocorcr utr rhc
<br />J@qiztut
<br />Forms/Steel/Holdowns
<br />Framinq
<br />lnsulation/Enerqy
<br />Brown Coat
<br />w.\ut)
<br />-lcenilylhrrnrrhclErtunn,iccofihc\orkforNhichlhispcn.iri\isucd.I{hill.orcnrrhyrtry|riN
<br />inrnyni mr
<br />r) d\ ro lt.o'm srh)ccr lo rhc aorlcr conrEnsariotr ldws ofcalinmii. nftl lgrc rhd if, \h,trld hccom sul,jcci h rh..
<br />work.s c.nrFtr\rri(m pr,lisiotrs oiSccri{nr.!?0O oilhc Lnbr Grlc.l \hill. tudhwirh.omply snh rho\c pmri\ion\
<br />WARNINC: tuilurc n, Ecurc workes'conrrns,rn,n.or$nsc i\ hhwfiil, ud shrl] suhjccr m cnnlo]rr ro ninrilnl pcnrlrics rnd
<br />of rh. Bu\i'r.ssand Prolcssions codc. ald myliccn\c h in ltllLr.. ltl cfl.d
<br />l.ctr,l.a. \ rl. r
<br />o3aLS4srb
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