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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE tD/stG.COMMENTS OWNF]R DUII,DER DIiLC RATION
<br />I hcrchy illirnr under nenrlrt{n jrrrury rhar I an.xcnfl nor lhc Conk!.r.r' t-icn{ ljs for Ihc follo*iry r.!v,n (sLt70ll5
<br />Bu\inc\\ rtut Pmfc*nr Cdl.): Any Cily or Counry $hich rcqunc\ a Fnni k) ..tr{rucr- .lrcr. imp.ove. dc dsh or rcpiir any
<br />ifl.rur. Friorr. irs hiunncc. also rcquir.s rhc apdicanr ftn \uch frm to fik. liAned sllrc'mnl rhd htor shc n liencd Pulshnr
<br />ln lhe rcvi\ions oi rh. Conridcrtr's Li.cn{d Lnw (Chil,cr 9. Connn.ncin! wirh Sc.ririn 7(X)0 ol Divhioi .] of rhc Au\irrc(s ,nd
<br />Profcsnnrr Cod.).rrhdr Iror \Ic ncxcmpi lhcrcnomrnd lhcl,$i! ntr rhc rllcgcd cxcnrPrlon Anyvioldn,i.fS(ti)n70ll5hyatry
<br />{tli.rtrl aor r tEiinil suhrcct\lhc kt,pli.,nrro.civilp.dnlryot .r morclh.n fiYc hunJrcddollr\ ($5{D)
<br />-1.
<br />!\ 6wnd or rhc tolrny. rx nry c.r,rlorcs wirh $!sc\ ii rh.n vnc ..'npctr$riotr. will do rlE *ort drh.{ ruNisnot
<br />inrcd.d or ollcrcd lor slc (56 704J, B!si.c* ad hofeskt.< Codc The C.nlrucrq s L-iccn\. liw docs nor nPply ro an osn.r of
<br />rhcpmFny wh bxilds or i'npnnts lhmn- !'{ rtF dc r'.[ s1' hnnr.lforh.r.lforrhmughh(orhcro*acmlnryccs.
<br />pn)vidcd ltnt {,ch i!{Dkn.nh d fr inrcMcd orollcEl htqrh.ll hoserti rhe l iuin8 o. nrymtrrnl is skl wirhi'r nrFe
<br />oico'qncrion. th. o$ncr Buillq *ill harc lnc hlrdcn orptrNing rhd hr.r sh. did tror huild or imPn,vc rht pmFny for lh. puqnE of
<br />I. $oqncrofthcl)ropcny. amciclulivcly.onr"crnr! wnh li.cn{d conlmclqs lo .rnreru.r dr pnlcci lscc 7o'l4. ausi,'.\\
<br />and lh)frsi'n Codc ThcContrtols Liccnsc l-rw docs mrapplyh rn.urcrof[orcny$ho huiklsor i'nlrrov$ rhcrcon.
<br />trtrd *ho .onrrads lnr suh pml.cc wirh a Co n.t()rl{) li.cn{cd l!6uor rorhc C('.tr.ir-! Liccnsc Llw)
<br />I nm.x.nrpluNlcr scrrnn .ll &PC lorihi\r.3{'n
<br />Dils ()Rmr:
<br />rvoRKFils conii'i^,s^TxlN
<br />DEOTIAAIPIi
<br />I hcrchy afnm undcr pcMltyorp.rjutydrc olrhc lolkiairS d([rdidr:
<br />-lhrvcmdsilltuiniai'rrCcnifi.ircofConscnrloS.lll.{tralbr(orkc.onll]ctrs0rion.asPmvidedft,tySc.li.tr3?n0olthclllror Co{tc.lbrlhc pc.torrun.. or I hc wo.* for qhichrhc lcn nis cd
<br />workcs co tt nrrrn,n in\u'amc. s rcqu ircd ty Sar t,n :1700 dr rh. bbor Codc. for lhe pcrlor@ncc of
<br />surome .rncr ,rl tbiicy numbcr m:it+!!ftr+r' tr (' .L r<",'cJ-4
<br />I',,r,.yNr,rh"t' AJc s o aotEo3 ,,". - lF/-t9
<br />I cqliarlhilinrhc pcriornr...lrh. work rorphichrhn |Ernrir i\ issoed.I \hrllnor rnlploy3nypc60tr in trny rtrncr
<br />w r\t,t^'.onf, subhrrorhc *o*cn' conpensllion hssorcrlinnnir. nd iStc rl lil l sl'irulJ hc(rr subj.d lorhc
<br />qorkcr{ Lrmnctrs.rion pmvisions olSccrion:1700 otrhr tiht C(xlc.l $oll. i.ni$irh.rnnnl! wirh rho{ Pmvrions
<br />WAIININC Frilurc b sri. sorkcs .omtcnsalion covcrrgc is unlastu]. nnd shrll suhisl an cmpbycr io dinriml lEMllics rnd
<br />cilil finu\ ut k, oM hundrLrd rhou\and aoll!,\ r$r(r).(xx)). In rJ,l tr{ to rhc c.{ ,,r fltmr6}qr'on. ,lJruEc(-r{ F}vidcd lbr rh.
<br />Srtrtr,r I0r^,rrhfLah{r'ftlc.,rc.c.rrrlrrnrry'\rc!.
<br />^ l/,/ t /
<br />,,,,". -$-aS1 r ^*,,*",XC+.,st:h, freus-L,--
<br />LTCIISED.CI.INIEACIPB
<br />DICLAAAII9II
<br />I hcrcby0lfiirnundcr pcnalryolF.juiyrh,r I a li.ctrrd trklcr pmvi\i{r oi Chrlrcr 9 (.ofnf,mi|s $ilhScction 7(xx))olDivrion l
<br />ol rhc Busincss0nd PmlcsionsC.dc. and my liccn\c i\ in ft ll tur.c aM c,Icct.
<br />{clo l/,,r.
<br />U/Ut
<br />o
<br />6-a I h*6 CI,L'
<br />r.:QNsrArJcrrotLlllt2lNclcDNtr
<br />I hcr.by trllirnrndcr F ,lry.lt,crjury lhd lhcrc n r qnl(rudi'tr hn,line.gcnct lor ihc p.rfoi,nlocc orrhe sork nn *hi.h lhis ncn I is
<br />issrcn (Scc 309?. Civ C )
<br />AITLIIANfI]EILAAAIIO!
<br />Ihcr6yaninntrn{lcrIr. rlry.rl)crjry onc ol rhc nnknvin8 dc.hrrion\
<br />Dcnxnirion Pcrnrirs Asbc{o\ Norillcdn,n ftdcful Rcgulrliors (litTc,lO- Prn6)
<br />lnatu,cd Ixl.' ol NorilicJiinr
<br />rhrr rhc f.dcml rcAnhlions rq
<br />h*rr r8r.r r. comlly wiih all cnrd Gndy
<br />fl,rivcs olrhk Cny and C.untyio cn'cr u!.n lh.
<br />frtaaa 6-^r-(k
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />Sublloor/VenVl nsu lation
<br />Roof Sheathinq
<br />Framinq
<br />lnsulation/Enerqy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Ivlasonry
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Report
<br />FINAL 7/mlrc fl rn)
<br />Certif icate of Occupancv
<br />Notes, Remarks, Etc
<br />-->
<br />SLAB Floor
<br />Shear Wall
<br />Pool Fence
<br />Flood Zone Certif .
<br />l/ ndc' . Addir*
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