|
BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNER BUILDI'R I}EI-CARATION
<br />I hclchy alinflr u cr F_nally or pcrju.y rlul I am c\.nu liom rhc O'ntrcl"^ Li.cns L.w lir ihc rill,'u'ins rc.ar (S..7011.5
<br />Bu\nrs\ anJ P'ollsion Orlc) Ary Ciry or cl'lnry whrh r.qurcs a pcrn n, uon(rucr. allo. mpnvc. ,lcnolkh "r tunrir rtry
<br />sirxcrur.. trnork' [1 '*uituc, .ls. r.quii * tlt althcrnr lnr {kI Fiin[ k, liL , nSn J nar.ftnr rhd h. or sh. s lic.nd Ni\urtri
<br />t, rh. pn)vir(,ns ol rhc Conkrctr\ l-ircnscJ t-trv (Chaflcr 9. Conmcn rne wirh Seri,)n 7llx) nl Divnion ]l oi rhe th\incss m'l
<br />Pdasso,rs Culc) dr ihrr hc .r shc is crcnu thcr.hoh trJ rh. hr\ir nrrhc rlLecd.rmrudi ny vflrttrrnotSc.lon 70]15 byrny
<br />dppli.ad lnru p.nnn {rhjek nr rmli.ld n, !civilpcn ryol nor nntrcrh{fl livc hMrcndollds (5500)
<br />_1.,s owncr nr rh. Ftupcd y. or my cnrtbyr\ w h waecs as rhcn q't .ontcn{ on. w tJo (f, s,rl ard rh.{tulmr nor
<br />inl.n i or ollrcd tu sl. (Se.7O14. Busftrs atul Pn a$'oN CGi.: t h. Ohrhcroi s Lr.nsc trq docs ndr +fly ro ." .qncr ol
<br />rh. r6p.ny eno huiui or in{Birr rlrr)n. iJrl wb Jtf,s r&h md. himr.ltor hcrcllor rhrclgh hs or h., owoemployccr.
<br />P('viJcJ rhar $,ch inllroKmnh m Rr inr.n'lJ oltaBl tur slk li h v$q. rhc 6uildi.3 or impnN.m n s.L! wirhin m rrrordrr{,krtr th. Owncr Builcr *illhilc lh. hunlcn.f F)vint rh,t h. or shc drl u)t hur or in$,vc rhc pn'Fny r(tr lh. l'U{r}s nl
<br />_l. dr o*ncr ol rhc Pl'pc y.amciclo\ivcly.onrrcr1Ir3wirhli.ctrscn..Drr..nrn,con(n,crrhcrojccr(Scu ?o44. Ruincs
<br />rl Errasiotr Co& th.Ci)nt,rtorsL(.trs.I-rw docs norlltlyk, rnowncrollll,lc ywho huilJ\ o htrovcr rlffcon.
<br />rtr who ronrrach nr {'.h [r.jccr! wnh r (i)nrr..lo ls) lic.trscrl Nru l,,ilr.(tnl!..ntrsIrcn{L.*)
<br />I.mcrcDt'r utrJ.r S.cr
<br />-,4
<br />& l.C n)rrhtrrc,vn,
<br />]YOBtrE8S:e9IITENS IIO!
<br />lIgtAEaugB
<br />I h.rcl'yn tnuid.rl.nrlryolpdjuryoN.rrh.nrlk)wi,r8,t.clrrri)n\:
<br />I hrvc turl wlllnrmran a Ccn iar.rl c .f Con\cnr k, Scll:ln\uE ntr work.r' o\i.i\rtDtr, r( Ijn,vkl.d lnr hy Sccnon l7U).1rh.
<br />trtltr Ci c, ntrrh.!.nomr*ofrh.wnrk ld wnirh rlr p.mii is i\\uc,l
<br />I luvc anJ will nrrhtrh qorkcrr co.rtcnsrhon rsurakc, rs r.qurql hy Scd bn l7tx) ot rh. ttrhor Cbdc. n, rh. pcrfomr .l
<br />llE work lnr whi.h thisl.m Ls nsen. My workc* ohp.nik,nmurdk cd,cr Fnicy humlxrd.:
<br />)
<br />N,^h.,, ..' ? oo /-t'z t
<br />I.cdrly rhrr in (lr pcrfoflruNc.frhc work,br whi.h rht 0€rmir n r$uc,l.I au lor .n{,lo! lny p.Fon in any nmn.r
<br />$6totN.nE\uhjeihrltr*orlcNomFcneLonlaesolclli,omii.md+r.rhdrrlninrrlbr..'tusohjr(ro(tr.
<br />woik.F coBn nrili,,n pmvisions .f Scdio l7ftlol rhc Lrh.r Orlc,I slfll. funhq(h.Dnrply wirl llrM povrs!)nr.
<br />WARNINC: Firlurc t, ecurc work r'conpcnt.rn)n .ov.raec is rnlawhl, aftl shalt nrhF.r M.mnl',yo b dimindl pc nrr rtul
<br />rLv'L 1i'r\ nt i'.trc [trtrnr.n lh trsrtr(l (l.lln\ ('ll{x)). in ldJnn h rh...sr ol .onlf,ns{i,nr, drna!.s $ pn'v
<br />S..rk)n.l{176ol rh.l.rhtr((xlc. iJ ..c{rrlrrtl
<br />I -b-
<br />tI( L\lt,\t t)\
<br />I h.Ehy a nm undcr !.n.ky ol lxrjury (h.r I aD [$ns..t unJd pnrvnnrn ol Chq{d 9 (.o.mncing wirh S..ri,n 700}) ol Drvi\nr :l
<br />ol rhc Bnsmss.tui Pnl..*oni Cod.. mi ny liccn\. is in tuU loN anlcllcd.
<br />Ihre l
<br />4Vfal/
<br />-- /--Ao
<br />IOISIAICIIANIENI'IIC.AIiENCI
<br />I h.db, atlnm un'icr FnrlryoiFrjuryrhar rhqc F o.{n(n,cli,n lcndiq r8ch-.y i.r rhc pqti,!mh-.c ol lhc *{rk for whiu[ rhN pcrmf i(
<br />rlued(Scr.1097 Civ. C )
<br />AITL&ANLPCCIASATTQB
<br />I lrR.byxlllmtrnJ.r lEnll(t ol pcrturyoN I lhc htuwnrg ,c.ldnltur\:
<br />l).rnn nrn Pcrn ! (E{d\ Nolilicali(r rrdcrnl R.luldidns (Iirlr.l0. Prd6)
<br />-.Requanl
<br />llncr of Ndii.ri)n
<br />lEit..rilyrt,r tt,".,"*trt,isapplic{lrotrinisd(rh^rrrrihnc irn. n nn L\
<br />oRntrmccs.tr'l Srrr.l,rws Nldiry r, htrrlnrns ..n\lo'.rtrni. u h.,.lryitrrh(
<br />!t$r. mnri,rEll pn)ltr ly l'tr mnccr
<br />Appli.nnl nr l\r.trr Si8otrlu
<br />alre r).oNply wirh allCily and C'rny
<br />ivcs orrhis Ciry rtrd Coun(y r,' cnrc! rlinrrltr
<br />,/-/- ?.,-,rxr/ L - '-'
<br />Set Backs
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Sublloor/VenVlnsu lation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif .
<br />1
<br />FINAL 7hr7r;-.rU4l;Certilicate of Occ n
<br />Notes, Remarks, Etc
<br />Fo rm s/Stee l/ H o ldown s
<br />Ext./lnt. Lath
<br />I (.n,ly rhi( r[c nJdrlrc!!hibn\ rgdJ,n! r\l[do\ r.rorrl]r. n.r rpnl'.ihlc t, rhi\ t'oj.rr
<br />tt
|