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BUILDING- INSPECTOR RECORD <br />SITE.WORK DATE ID/SIG.COMMENTS I hcrchy drirn, un't.r IEnllly oi Frjury <br />OWN6R BUILDER T'EI-CARATION <br />I dn c\cmpl lirnn rhc conrr&lo^' l-iccn* tjw ntr lhc li)lkrwn! rc!$o<Sc.70ll 5 <br />tlu{n.\\ r!1 Prol.*sD CoJc): A or Cornry whch icqurcs a Frtur t' consrru.r. ,lr.r. imItnrc. d.nolih or E!!tr anv <br />rcqurs rhcaptlicaDr n s!.hFmir b lile a stncd n cnrcnt lnd h.or shc s liccnkJ t{r\uanr <br />ackn s l-iccn*n Lw (Chafrer 9 ComrcE--ii! t h Scrrion 7(Do ot Drvi\io! .l oi Ihc Busnrs '!J <br />h. or rh. is.kmfl rhcrcti.n o'l rhc $r!\ tor rhc rlle8c'l .rcnfrion Afly vidarR'nofSccrionT0.ll5 byabv <br />r osn.'ol rh. |n |rnY ortrrycn]l)loyas wirh wrscs ,r rh.r inc .omp.nrdriin, w ! do lhc qd* arrl rtE slniim i mr <br />i cnd.d or rllt!.J lbr srld (Se 7&4, Bu\inc\\ md Pnncsions (i ., l hc Cdnlra.ttr s t-rc.n{ lrw .locs nol aPp <br />rhc p$pcdy who hlilds or itrt ov.r rh.No. &.1 wla' d,Er skh H)a( hins.lf or hcnclf or rhruugn hi or hcr own cmrloyccs. <br />lDvrlen rhnr s.h imtircnEnls m fr rrorlcd ot oicrrl for qk ll lk,wcw. (h. htrl,j,ry ot in{rcwE r t{ sU uirhin on' y'r <br />;r$mphriun. r)r Owrcr Bu lct will hit rlE ttrln or ptlvms lld h.orrhc d,l ftn huill or trh{'rcvc Ir l'n'}Fnv ror rtquq$s or <br />l. $ .wNr o, rh. ln !.ny, am cx.lusivcly $,ta.rula wirh li{tr*d ontrlcb6 b connrucr rh. rojccr (So 7044 Burm$ <br />md DoL$ir C,xtc 'l hc Contac(or s Liccnsc l-a, Jds Rn a0fly h an ownct of lr)Pcn y who hullds or impov't th'rcon, <br />rnJ who ronrBck lin such pn,irk w h u o)nlncl,,(9 liccntd flBurnt r,) rht conracM s l-i(cnsc Lrw). <br />I xncrcmtr trnlcr Sccrnn, <br />uEgr^raM! <br />I lrc.chy xlTr undcr p.nrlrYol <br />Ih.vcanlwilltuinraraCcnili.rrcofConscnrltScllln\urcturwDrkcr'L-sn.iaron.!sIn'liJcdfdrbySccrion:]7fllofrhc <br />Irhor CoJc. tur rhc FrfomDncc of lhc work tni which thc pqmir t issucd. <br />t nrvc anJ will nrinlrin workcF .omFnr.r bo insur.kc. rs tcquircn $y s..r ion 1?00 of rh. ubot codc, ltr 'h' PcdnlmE--c of <br />rhc w.rk for ahrhthispelnir ir sucd. Myworkm coml.ns.lDn insunnc. .mrcr ar.l F,licy numb.r m: <br />Policy Nnnbtr:-Ex0ir€s: <br />-ldnilillul <br />rhc p.ibrmncc ol rhc rotk tor whEh lhh Pcrm 's <br />6src,l.I shallnor.n\l)l'rv anv pclYn in any nu'cr <br />$ N k) hcd'nr suhjNl t, lhe Mlrk d .otrr!.Nar ion laws or cdlinrnria, at'l rs(. (h iI slould heom NbFr t' rh' <br />wor[.r\ conf.tr$lion povisn,n! or Se..tltr .]r0O ( <br />wAnNNG: f.iltrrc b {cutc Rtrkcn o,{rns,i <br />)lrh.lrbr clllc. I shrll. Ldhwfh omdy wirh rlrs povirhn\ <br />covcri8c k unlnqrul. lnd shall suhFct atr enploy.r b uinhal lrtukts MJ <br />0O,OG,. in i.llir n lo lh. cosr ot coml'ensarbn drm,Scs !s Pn,v cd lir rhc <br />5c.1tr|n.10?6 ofrhc LrhY Culc, inr.r.n "-PoJ S ol a'C/- /f- LoLo fb <br />I h.rchy aljirn undcr r.n.llyofrrjr.y rhar I rm lren$,1u.&r p,DviirnolChapr.r I (omtrErerE wirh Sccrkln 7000) 'rDrvrnrn l <br />of lhc Bu nes a&l Pof.sionsC{}tc, dd nyl,lcnsc t in lnll tuic.,il cfl&r <br />CONSTRUCTTON LENDINC AGENCY <br />I hc66y .l1tm uBlr p.nalry or Friury rhrr rh.,. ir r consrrucl iotr lcnJin8 a8ckv irtr !h. 0.rlomne oa rh. w"k tor which rhls p'mil is <br />nsucJ(S.c J09?.Crv.C.) <br />t.1t.1 . \,,'r- <br />- <br />I.n'tc'.\ AJJrcs\: <br />!IIL!!!]It!!lB!r!!! <br />I lf,Nt,yrlllnn trlJc.o.nxiry ol ltrlttry otrc ol r[c nnbwr3 Jc(lmr$n\: <br />D.nn)l o. PcmrrsAdr{o\ N.rrlLciri,'n ltJc lRclultrior( r 1r1.40 l'{r6) <br />aaeJins rsh.sl.s rcmov{l dc nor+pliunhlc t, rhir lln)jer. <br />n rn! srarerharrh.rbvc inlilmrn,n E ro,Bt l a8rrromPl <br />in8 con(rudn,n. ud hcr.byaulln a r.rGcnlalives of rtis ciIy wirh allCiry.nd counry <br />y ,nd Counry ro cnro uF,n lhc <br />uS 1- ( f- zo za <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />Sublloor/VenVl nsulation <br />Rool Sheathing u\l,,lt *97 <br />Shear Wall lr l]r <br />Framinq Dtl]r,{)r'*fl <br />lnsu lation/ En erq y /t ll <br />Drywall <br />Ext./lnt. Lath <br />Brown Coat <br />lvlasonry <br />Pool Fence <br />T-Bar <br />Handicap Req <br />Deputy Final Report <br />Engineer Final Report <br />Flood Zone Certif . <br />FINAL alb (,<)DIW)a',,*vl <br />Certiticate of Occupancy <br />Note$, Remarks, Etc I <br />o <br />i 70 g- <br />n <br />lt <br />sutrccrslhc ippli.!nl1,, rci!ilf.ndltyotntr morc thM livc htrndrcd Jollds ([5(r0) <br />B <br />or.,l- lf - LoZO <br />c'v'l lincs u, b onc hundrcd lho!\rnd Jollrs <br />Liccnscclrssr Li.cnsc Ntnh.rr <br />--- <br />Gm" <br />= <br />lzlvll