|
BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMI\iIENTS OWNER BUN,DER DNI,CARATION
<br />I h.rcby allnnr hdcr penlll, oa pcrjury lhal I 0n cxcnr0 rnnn rh. c.ntrcr)^ l-i..n!e uw ru rh. t llowin! r.ayr lscc 70ll5
<br />Busincs ,'rl Protcstnr Cqlc) Any ( irt or Counly {nich r.qu ncs r F.rit t' .on$fl.r. rlrr. i.rt ovc. dcfrnhh .r rtrt m,
<br />slrucrurc. Illi]r ro s N\&nc., rtqr rcqund\rhc arplic! lbr such pcnnirro filc I si8md (.rcnrnt lhal tEor \hc is liccn*d plruanr
<br />k, rhc pmvhions otrhc Conh.rols l-iccnscd tjw (Chrtr.r 9. Gnnr.icid8 snh Sccrion TIXX) of Divhion.l .f rh. Bn{inc$ antl
<br />Pn)f.si()nsCodc)orlhalhcorshctcxcmplrhcrcfromundlhcl)asisrorrhcallctcdcxcmprnr.Antvioldior.lS..tktr?0ll5hyrny
<br />rpplic!tr| fur 0 pcnnir {b,c.rs rhc rrpli.anr b a.i!ilpcn!lrroin.r morc rhan firc hu red dolhr (5500).
<br />L as osnd of rh. pn,rcny, .r m, cnuloyes wirh *rscs $ lhcn $b .onl[,cN ir)n, will do r,r *or* a,rl rhc {Mrurc r n r
<br />inrcndcd or oficrcd fo. elc ( Sc.7O44. Brsimss in{l Pn,itsions Codc: ,'nc C.nir0.ld s Licensc t wdocsnnrapplyto!no$rcrol
<br />rhc pnrp. y wk, hoildsor inlProks rhccnr d who dessu.haork him\clforhcficlforrhmu8hhh o. hcr own cmployc.s.
<br />F,vidcd rh such inrpn,rnrnh aE nol ir .ndcd nr ofli.R, fn sk. lr, h$trr. rhc h! ikling or irqrovc'B ns)lluirhirotu]r.d
<br />olcompldi'.. rhc Owtrd Buildc. willhaw rh. hrrdci.l pmving rMt hcorsfic dil mr huild or nl{'m'! rh. I,i)pciy to rhc puqt*,1
<br />,. a\ owncrolrlE lrorcrty. n cxclurivclyconrx.ri')Swirhli.cnsc.onrnknsr.roiitocrrhcnn+.r(Sc.701.1.Bunr\(
<br />dkl PiiJfdsbn C.dc The(-(nnEcrois l-iccnr l,awdocs..r rpt,lyror.ovnc!ofprr.nywho huildsor nnprovcs lhcrcotr.
<br />tr *ho conr..r\ for su.hprc!\i! wirh! conrn ronn licen\cd pursuonr rorhr G'ntxcroi\ l-iccnse ln$)
<br />6 Q -'za/
<br />I Lfl rhr Jlnr urd.r ]rcnrtrvor Frjurv.N
<br />I hrrc ml willnEinllir o (tniararc oi Cotre.r k, S.lllnrurc r(n $orkcr( confcn\arion. r\ pmvidcd fd hySc.rbnlT(nofrhe
<br />hhxCodc.lhrrhc pclf.nDD.c ofrh.w.ik f(n shthrhc p.n.i! k isucd
<br />I hNt rnd willhai' ,in s.rkcrs'co U.Dslrion iNurimc..\ rcquncd byS.\riir.lT0Oorrhc ljhorCodc. ftr rhc p.rlirnrNcof
<br />rhc sorl fttr vhich rhis p.mir i\ i\flcd M, qorkcrs comnctrs.tion nruri.ccc!tricr arn noli.y numhcr irc:
<br />-l
<br />ccnilyth irrhct.rInrnrmcoflhc work for Rhichrl,i\ pcrmii is isu.d.l shallnor.n,fl{'y3nyl.r$n in aiymn cr
<br />n, b rEconr \thj.d ro lhc wo.ksa conrpcnsarion hws oicalik,nia. rnd .8rcc rh{ iil siould hc..m subjLrr h lhc
<br />workcrJ .o'nltnvr6. p()vi\bns or sccr ion .l?m oi rhc I nllor Cqlc- I +oll. fonh*lrh comply w ilh rh.s DDvnn,nr
<br />\ryARNIN(;: |ailurc t, Krc sorkcl\, conD.nsalio. ovcmec is ntrlrNlul. and \hall subr$r in cmolo}tr ro ainnnil Fnllrt\ rnd
<br />.Nll fitr.s xp h oi. hlndrcJ rhousand dollar (!l(r.o(X)). ir addirion i. rhc con ot'::::::iffi;-"^^:;
<br />I hctb, afinn undcr pcmhroaFrjury lh{ l0m [.cned undcr F)visn,n otChq'icr 9(.ommn.]n8 wnh sNrion ?fiD) ol Dirhio.l
<br />of rhc ausincssand Protas sio rr C.dc. rM nry li..n\c k ir tullinrcc m rff.cr
<br />CONEIAIISUOIIEIDINC.AGENCI
<br />I h.thy atfinn undcr ricnrlly of pcrjury lnal lhcre n a colr(d.tion lcrlinS .8cncy tu thc pcrfoirErncc of lhc work for qhich lhn rErnn il
<br />k\u.d (Sec lO97.Ci!. C ).
<br />A.TTLI(A]fIIJICLA.BAIION
<br />I lrrtbvrllmun,lcrpenrlr),olt rjurvoEolrhefolk,*iDErl$hr i( !
<br />I)cnmlirn,n fcrnrirl Ashc{o\ Norilicrri$ Ij cftl Rc!uhiirxrs (T Lc.l0. Prn6)
<br />l{.qtri,.(l I rrr. rl N.r li.rr,
<br />1..'ri1r rlir h. lr,(r.'l ,.ltrln .i\ trrinl tr! r\lrn,,\ r. $rl trr ror rtth!.Ll,lr ki thr t,r,r..r
<br />ortinnmcs lnd Srrrc llws rcldiry to huildif n.\ofrhi\ CiryniJ (iiutrrt rocnrcr trB rhc
<br />rh,\. r 1(rr(l p'or^..dt ntr i'^fr(.
<br />ADDlir ntor,\,rulSisnHltr
<br />4 6
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Roof Sheathi ng
<br />Shear Wall
<br />Framing
<br />Ext./lnt. Lath
<br />Brown Coat
<br />[/asonry
<br />Pool Fence
<br />Deputy Final Report
<br />Engineer Final Report
<br />,t
<br />FINAL
<br />Certilicate of Occu nc
<br />Notes Remarks EtC
<br />Subf loor/VenVlnsulation
<br />lnsulation/Enerqy
<br />Drywall
<br />T-Bar
<br />Handicap Req.
<br />Flood Zone Certil.
<br />Lidn* Chssr-Lians. Numb.r:
<br />Drl. _ ( onlr.clor:
<br />l ,.h'', AJ,l'cs
<br />I
|