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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE tDistG.COMMENTS OWNDR I]IJIt,DER DFJLCAR AI(}N
<br />I hcrc$, rin'n u crNmlly()ln rjrv rhnr I rDcxcn!, linm rhc (onrrhB t-i.cnsc Ljw ior thc rbllowi'r-! rca$n (Sccr0ll5'
<br />IlNines {rl Proltsion G\lc): An} Cily o. County B[i.h rcquncs r pcrnir tn .on\rrucl. rllcr. im,,rotc. dcn)li\h or Epat ,ny
<br />{m.rurc- prir ro irs islrncc.!l(, rquncs ihr lpllic&r for such pcnnir ro lil. r si8n.d {nr.nrcnr rhrr h.or shc i\ |i..tr\cd puEurnr
<br />lo tlE fmvisiur\ ol r Conrhcrols Liccn{d Lrw (Ch tr.r 9, comnrncinB wirh Scclion 7(xD oi Divhn,n .l ol lhc Bu\in.s 3nd
<br />Prrt\\ion\Ontcr orrhrlh.or\hc iscxcnrfl lncrcriornnd lhc hrsi\ rai lhc ill.scd cxcnpri.n Anyvi{,h'i{n,ofs.cri 70ll.5nyar.t
<br />rtpli.rnr larr pcnrir srhjc.BrlE rrtlicr hr.irilFntrhrofnormrcihaililchuidrcdddllnrs($5U))
<br />-1.
<br />0. oqncr .i lhc proFny. or my cmnloyccs unh w.!cs $ rhcn $t comn n\alion. will do rnc wtrt and ltr (Ml!E n mr
<br />iircndcd or oficrcd for solc (58.7044. Busincsr and Pr.ic$ions Corls-l'hc Conhcroi! I icensc ljw doc\ nor apply lo anotrn.rol
<br />lhcrnfEny who huikhor ir0n,vcs rh.n,.. rnd wh. drf,s \kh qo* him\ctfor h.'\clfor rhmulh his oi hci own cnl|bycci
<br />ftuvidcd rhd such i'nlr{'rcnrf,h m frn inwrlcrl or olT.r{ Lr qlc ll h.wcrs. rhc hoildiu or inpmrcmnr h $kl uithin ,
<br />'c )cu
<br />ofcoq)krioq rhc Owncr,lliklcr will hntr rhe hrden o, prcvin8 rtur h. or shc Llid mr huikl or it\mrc rhc pmpcny ror rhc puq$c.f
<br />I. r\oqncrolrh.|]'op.ny, ancr.lu\n?lyconrrding wirh liccn\cdcn rrac!n\t,c.n{tucrrhc pn,j(r(Se 7(!1i1,3u$ncsr
<br />ra! thl$s(n Codc lhc Contn.rx's Li.ctrcc Lrw(hcs nor rmlv k, rtr.sncr ofproFnrwho huildr.r Npnivcs rhcrcon.
<br />itrd sho cdtrtr.r\lnrskhFn,Jccr\ wirh rConhct'n\)liccnsld purs'anr roihcCotuxc(' s I-ic.nv Irw)
<br />I rmcrc\rrnDdcr Sc.rir ,B &PC hrrhisica$n
<br />5 /24//9 ,,""",/- ,E]uratrE&lrautflts ruN
<br />Izlig.rla lIoN
<br />I h$.h) rlnrn, rndcr I.nrlrI olp.rJUr) om otrlr inll,,wing ddclJrJri(nN:
<br />I haec and s ill roinr!i! ! Ccn ilicdrc ol Conscrr h Sclf lnsurc lnr $or kcN conDcnslrion, !s pn,lldcd rrr hrS.crion.lT(x).rrh.
<br />lilx, Cqle. ,or lhc rrcrrbrnuncc or rhc *ori lor *hich thc ,E,nn n kucd.
<br />lhrr. d\till $inr idtr.rk.ri.o f.n(di,ni n\ur .d. r\ r.qtrndh,Serii lTlX) .l rlr Lrtlr C.dc. li,r rM $r l.nnrmc .I
<br />rlt *ork lnrwlirhrhis pcnnir is i\$cd MysorkcN c. rpcn\rri,,n ln\urrmc.rnicr md r,licynun$$tc:
<br />-lccnilyrhdirrhcFni,irnrnccofrhcworkli,rqhi.hrhisprnnirtris{rcd.lsl[llnorc
<br />/oy trny pcr.n i. !.y manner
<br />s r. trc rrc \uh]cd ro lh.$( cr.1'mpcn\ n,n hws oi Crliiorri!. rnd i€rcc rhd irl\hould brcotu suhFr t,rh-
<br />qorkc6'conrpcnsrrionprovi\ion\olsccrt,n.Ufi)olrhcl,IuG'dc.lshlll.li)nhwirh.omplywirhrho*lrovnnn\
<br />IIARNING: railu t, *.m w.rkc^'.o rn n\.ri( .oktuSc is rnhwful. d shrll ruhlc.r ,n.nrlloycr to.ai,niml pnrhics il
<br />.ivll firc\ uf ro. c hutrdrcd rhousnnd dolhF ($100,00Oi.
<br />'n
<br />Jtl,l nn, !, rX.,^r ,'l od't^.'n!ri'{r. JrtrDlls ?\ Innil.d ,or rhc
<br />Sc\'n1 Ir, u ulrh. L.h{4,r1... ' c.r.r n,l iirnr k.J'\ h1.. ,/
<br />2/i/e rpp,i*,:>t- ffi
<br />LILA N\ED r]ON 'RA['nt IR
<br />DECIdAA.IIANIhcrebylilt undcr p.nalr)ofpcrjuryrhd I o licctrxnundcrpmvni,,nolChqrrcr9(.a,ntun.insRirhsc.ri.n7000)ofDivrsioDl
<br />of rhc Busincs md Prclcsions Codc. and my licctrsc h in tul| f.ra and cllccr
<br />CONIIAICUONIENqINII(iENrI
<br />I hcrc$y !m,rnunder pcmltyofFrjury thal lhsc is o on(ruclion hndin8 ascncy r'or rh. Ilcrfoflunce ofrhc work r.r qhi.h rhls Jf,mir is
<br />ksucd (Sc...109?. Civ C.).
<br />AIIUIANLD&CI,A.8AI]ON
<br />lhcrty.trmx.d.r p.nahy or!.riury o* ofrhc followin8 d(lenrionsl
<br />Dem.lirnnr Pcrmirr AstE os Norifi.arion Fcd$ll R.guU, bns {Tirlc .10. Pd6)
<br />-Rcqui&{
<br />Lcno of N.nircari,n
<br />-l
<br />anily lhnl thc fcd.Bl rcBulatioN rS6ding ashcstosr.mvdl e nor upplicat le to rhis p,ojc.r.
<br />Ef,t.-ity,tu'tto'"*ua,hi\aDplicarionandskr.rhdrh.otnlzrnfomrionn.ors!IrsxEkc,nywrhallCy$dCounly
<br />ordin...cs and Srolc Lows rclDrin-s ro bdildi.g con(rucrion, aMcrchr lurlnnzc,eFercniahv.',,rrhk ciry rnd cnunryro cnlc. utoD lh.
<br />oborc rmnrnmd nmncny lor r\,,cdior Nrlnscr. ,- -€:;;;;,;::;" L:)tr' -* ^j/z',/u,"^,,*.,*t nnt,-L= - L.a2zz- -C.i4!q
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Su bf loor/Vent/lnsu lation
<br />Roof Sheathi ng
<br />Shear Wall
<br />Framing
<br />lnsu latio n/E nergy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lVlasonry
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certil
<br />FINAL I K t9 uf*Ka
<br />Certif icate of Occupancy
<br />Notes, Remarks , EtC.
<br />--t
<br />Set Backs
<br />Pool Fence
<br />l.iansc Cluss:-License Nunltr:
<br />D.L: C.rtm.Ioi
<br />I
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