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BUILDING. INSPECTOR RECORD
<br />DATE tD/stG.C(.r'JIMEN'fS OWNEX BtJII,DOR DET,CARATION
<br />I hcrcl,y !ffln undcr p€nalry ol p.rjury rh r I m.xcmrr r6n rlt cdnkro( Liccns tiw lbr thc i,llosing rc.\on (So.ro]l.t
<br />tlusincs Md Polcsion Code): Aiy Ciy or cou.ry whi.h toqun$ r Fnnjl to consrucl. alrcr. improlc. d.nrli\h ot rFn ant
<br />nd.or. trin b ns issuin... oko r.quiEs rhcappli.onr Lr slch Fnnil lo filea sisncd iarc'Enr rhar hco.shc is liccn\cd ,)unuunr
<br />ro rhc pmvnions oi thc Conrmcnn\ Li.cned Irw (Chrrr.r 9. ConrmcNin8 wirh Scctiotr ,OO0 of Division :l ofrhc Busi.css Md
<br />Pn,f.rsionsCodc).rrhar h. orlh. iscxcmfl lncdinn0ndlnc hoxis l'o! lhc allc3cd crcmprion Anyln)larionofSarion?0ll5hy0ny
<br />JmlFld rhr ! Fc'mir 'uh|Nh rhr rrlltrrnrx' d,nilr.trrlryolnormr-rh,n 1tr. hJndrcn d.llr! '15(O,
<br />/!l-._""*,,'r,r" pr.ny. o, n'ycmnlor.c( tr h tr.8cs rs rhct s,h coflrpcn\arbn. will d() rh. $or* a}l .tr nnx1urc is nor
<br />inrcnddl n otlcrcd ror slc (Se.?(ll,{- Burircss und [t.tcsrn'n\ Cdc: 'lnc Grta.r.rs Li..nt tjw dcs nol atply ro an owncr of
<br />rtu pDlcny *txl hikls or i'qmrs rhcNn.ond wh d,B sEh q,* hinrclr or hc6cll or rhmurh hir or h.r uwn cmployccr.
<br />[oridcd rhal sucn impmwnh m tur i, .dH or ollcrd for slc. !l ho*.tr. rhc huikliry or ilrqmvcarnr is v,ll wirhin .nc )Mr
<br />.f.onpLrion. rh. owncr Buildcr will tur th( hrdcn or pn'virs lMr h. or snc did mr build or nn ort or l,oFny lor rh€ purlnc nl
<br />I. N oqfti ur rhc phpcnr, am cxclusivcly c.ntcr inr wirh liccD\cd conkact'n t, $ ntud rhc pojcd lss 7l}r,r. Bunmss
<br />n Pn,llssi,nCodc:'l hc Conrtrttr ! Ln.tr\c Lnw docs nor nt!ly b rtr u*ncr or n.oEny who huilds or nnpiotcs rhcrc.n.
<br />.nd wlb..nric*hrsuchpn,jccrs*irhBcoor,rdo(nlic.n$dpuEUnnrhrhccunt(ttr\Li.cnsctjw).
<br />I rfrcxcnr|, nndcr Sccr
<br />Yu","5 2243 j*k{1,(t
<br />IJ TUXAITAN
<br />I h.r.l,v ilitr or ufdrr Nnnh, ol pcrjrry on. ofrhc l,) loqn,!,l..lInrtrN
<br />Ihrird willtrrint.in rCcnific,rcotConscnl ro Sclf ln\urc nrr s6rkc6 $n osdri(,., Ni pmvidcdLrbySccltnrll7(rrofrhc
<br />libor Gdc. ror rhc ncrrorm.mc ol thc No for $hi.h rhe pcnnil k issucn
<br />I h.vcand will mri.rain wor*cri conFnsarion in\urDncc. ss rcqunrd bySc.rn)n 1700olrhc tit{r Codc, lor ihc ll.rL trn..of
<br />llf *ork l(,r *hi.h rhis |cirnil is nsu.! Mysorlc .annp.n\a|b. in\lratr.. .nnicr atrd lhlicy nunrbcr arc:
<br />r,, r(l
<br />'gk .hl_vrhir nrhcNnnnnin.c.llh.\orktu.trhi.hrhn|irtr,ir i\n{r(l.l\hrl rrcnrJnoi- itry n ^ofi'irN rrr (r
<br />$ rsb h.com.ruhjc.r n,rhc workcN con!{,rs i(D liw\ ol CiliLarii. rrl xgrcc rhrr if l \h.uld bc..nr $hjLtr b rhc
<br />*orkcF co'npcnstrrnrnrri,visioniofSc.roi l7(Xr., rhc Lrtttr C( ..I rl(ll. hdh*irh.\nnnlysirhrho{ Prornion\
<br />WAI{NIN(; Irlilurc r. $cur. *.rkri.onrlt snri($ covctusc i! utrhwtul. ind \hnll su6J.{r m rrploycr h) fi'niNl Etrrllicr I
<br />.tril lltrd\ ut, ro on. hu rcd rhou\rnd .trllxi\ r!lrx)(xxrr. tr i,r xi rh. .od ot conpcnsarion, danrScs !s pnrilcd lor rhcr
<br />Sc.ri,jn 1076 ol rl,c l.rhtr (id.. i'Ic,.! rtrd r drr!'\
<br />X,".,5-77: tX ^
<br />coNnrncina u h Sc.ri.i Tlxx)) otl)n r!tr$:l
<br />ol' rhc Busincsnnd ltn,Lsi.nq c.dc.,nd my liccrsc n ir full lora nnd .1id
<br />CoNSTRUCTI(}N LFI\DNE CIN(:\'
<br />Ihcrcbyrft'nrndcrFnalryolpjrjlryIhdrhcrci\!con\lruclbnl$dinsr!.crlorrhcPcrrban.nccoirh.$c ftn shi.hrhi tirnriri(
<br />ir{'cd lS$ :r1,9?, Cir C I
<br />{.!..fn,vnlrr or r)d.rllc ro rhis nmjccl
<br />rhcrhir. irrinnrri,r is.orcd I r!r*ro.onrllywirhallCiryud A,u y
<br />0,xt hcrchy xulhoriTc rprc\cnrdrirc\ ollhis City.nd Counryb otrl& oJ).i rhc
<br />fiorc nrnriotrci proF:dy lir ilNpc.rt,n
<br />fAD0li.rnt or Ascnt sisnature
<br />l4'*"u."--,",u",,, CA Ar4,,tzog2-
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathinq
<br />Shear Wall ,-.--\
<br />Framinq 11 ?mq8 ?,-.,e,\<J-)
<br />lns u lation/En erg y
<br />Drywall
<br />3)I./7./8.G 4"pat4 u?
<br />Brown Coat ? " k,:fT );9\-to,1
<br />It/asonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Beq.
<br />Deputy Final Report
<br />Enoineer Final Report
<br />FINAL 4lDlnii ?r)
<br />Certif icate ol Occu n rl
<br />Notes, Remarks, Etc
<br />SITE-WORK
<br />Ext./lnt. Lath
<br />Flood Zone Certil.
<br />I hrtubyrlllrnunddr.nalryoipcrjuylhol I ! liccnsl undcr p0vi\i,,n
<br />a"e&rcANll)ll! aaloN
<br />I lrl:6y sJfinn u ndf lcnrlry of !crtury onc ol Ihc roln,$ing dcclararn,ns:
<br />Dc $liri,,n Pcrmirs \h.nos Noriicrrion IjcdcrnlRcculiri{nrs (-l'illc'rO. l'ad6r
<br />-Rcquircd
<br />td!cr of Ndii.dio,i
<br />\*,,,{-22))-8
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