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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE IDiSIG.COMMENTS O}VNDX NUII,DER DEI,CARA'I]('N
<br />I h.rcby rliirnr u cr ncnilry ol pc'irry rhd I n.$!, lioln rhc (inracror' I iccn* t-rN tr rhc li)ll,tvirrg rca{tr (St(?0:ll5
<br />Bu\ir.s md Pnnc\\i.n Cndcl: ny (-iry or Counry qhich rcqutc! x pcmir ro..nnrucr. rlrcr. iNPn*.. dc mlNh or r.n{i'8try
<br />{ndu'c, rrirro irs issur..c. !ls. rcrtutcs rhc rpllicrnr larstrch Fn I h liL. \iEtrctl {i.ntnr Ih h. or shc h lic.n\.d nur\urnr
<br />ro lhc provi\i,in\ of rhc Conrhcttr's Liccn*d LrN (ChrIrcr ,. C.nlnrncnrg *irh Sccli,nr 7(x[) of Di!knri ] of rhc hrincss rn(l
<br />aNh.rtrr Lr. |Emirsubjccrsihc atplnrnr h r.i!ilPcnrliyotflor rnorc rhnn lirc hu r.d dollnrs (S5Lt))
<br />-l.usowncrorrherror.ny.,trnrrcnrrk,lBswilhwuscstr\rhcnv,hcofrpctrsirron.lilldorhcsorkd
<br />rhc{nErurci\rn
<br />int.trdul or oiLrcd tnr silc (Ss.?(!,,l. Busirc\\ rnd Pm [cs\i(,n\ Codc thc Co rndtr s l-i..nsc l-rN docs tr.lltnllytonnowncrof
<br />rhc fmrcdy who huilds or inl|lnrc\ rherdnr. {rkl *h) des $ch sr)* ni a'lforlrcr\cll.rlhnughhhorhcro(icmDl.ycc".
<br />F)vi.lcd rlEr su.h iDpmrcmfBrE nic'klrdnotf.rcnhrqlcl[hotrcvcrrhctnrildii!Drinrt)vcnEnri\v,kl$irhi.oic)ci.
<br />olc.mfhlnn. rlr ()wncr Buiilcr Nill hrr rh. hurdcn ofpn)lii8 rhar h..r \h. dil nor htrild or irtl|)r.\t rhc pmFlry r(r rhc Nrf)\col
<br />l.r\owtrcr.lrhcfopcnr_.!Dcr.tu\ncltcontadingqnhli.rf\cdc.nrracl{rsricor{.tnf,lt(+.1lSs7(l'l{.Buntrc!!
<br />xl lh'lisshn Codc lhcCoitn ttr'( Li.cn\. Lr* doc\ nur rpplr_t) rnotri.roftoD.nysho h!il \ornn|f'vrslhcr.otr.
<br />atrd slD codrid\ f({ such nn,Fc( trirhn coitrckrrl\) l'.ctr\cil Dusnr brtu ci,ntacroa! Licctr\c L]s)
<br />I n rrx.tr, trnacr S.ci ,
<br />Dnle osner:
<br />IVORKI, RFCOIII'FNSATX)N
<br />I}ECLAMITON
<br />Ihcrchyrililnu cr pcnrxyorpcDuryoN ol rhc Llki$ira dcchrrli,n,\
<br />I h(vc irrd willnmi,nrin r Ccnili.ar. ofcotrtni h Scli:ln\urc lor qorkcrr conlEns{ion. ts pn)ridcd f hysccrionl7(lrofrht
<br />Libr Coic. fr lhc pcrloriMmc ol rhc *.rk nr whi.I rl[ ndm[ is ir\ucd
<br />I hivc rM \illnlrinl.in {orkcri.o r|f,trrnriotr irr\uhn.c. rs rc!utctl htSccrhi l7(nolrlN LrhorCi c. trrhc |{nbnnrn.col
<br />rl[ sork tur ahich rhis Nr.nir i\ tnsd My sork.ri.o D$\dri(r nr{tru.ccxrtr rnd Poli.! trtrrh.ratc
<br />P.li.yNu rb.r
<br />-
<br />I.cnirtrhrr i'rrhcNrlornnnr.coflhc*o'lrorqhtl,rl,i\nrnnir r\ i\{i.d.l drllnor ctr1dot tr} ncrur inan} mrntu'
<br />$ rlh hc.o.r nrhrccrrolhc*orks\ co rfctrq(n htrs .i Crlilrtrnir. rndagru.rh r ill rh.uld hccolE srhjcd t'rlt
<br />nokcr'.oDrt{rsdioopovi\ion\ofs&rn lTlDofrhc Lrhtr (dlc.l\tu'll. f(trrh$irh c.nrPly *lrh rho€pn,vniot\
<br />wARNINC Fxilurc h $.urc uo&cr conrEnr(ion .orcrrec i\ trnlnqrul. rn(l \htrl| suhi.r rn .'nlh)cr t) diniml Fnrlric( ^nd
<br />Sr.rion 1076ofrhc lnhrCodc, iricr $l nn,l ultnNy \ ric\
<br />D,te Appllont:
<br />I !(:FNJED C(IN'TR,ICT(IR
<br />DI.CI.ASAIIAN
<br />Ih$.hyr,linnund.rlEnallyo{p.rjuryrh l an li.ctrsJ ukl.r nn'vhior olChrprd 9(.ornnurcnrS $ilh Scciin, T0lO) ol Dirision:l
<br />ol rhc Bu\itus\xtul P6f.$ids Codc. lnd mylicen* i\ in full for.c rnl clltcl
<br />calEraul:tlll .ulDlNliac[xcr
<br />I h.rhynlfirnu d pcnalryo, ncrjory rhnrrhrc s..on{ru.tirn lcndinE agency lrtr rh( Fr(onnln.c ofrh. aork for *hich rhis P$nn n
<br />i\surd (sN :1097.civ. c )
<br />APPI I(] NT DECLAlLAl'I( IN
<br />llrNhrr*nrn trMcr Nnrlry olFrjury om ol rhc hlkrwnr! dcclffditrs
<br />Dcnmlirn,n Pcrmir\ \b.ios Noliicdri(r IicJ.Bl Rc!uhri(nr(1TIlc 4(r. P 16)
<br />Rtquncd I clrcrol Norili.rri,)tr
<br />l..,riryrhd rhcladerrlEgulari()n\ rr!rrdnrs a\hc$ns rcnrrtl !rc mrl'IPlic$lc t) rlri!tr')r.r
<br />_-lucnily rhl I hrk rcrd rhA rfn!urnrrnd srrc rhrr r
<br />ordir$rc.1rn,l srrlc Irssr.lrrii! lohniklirS.onsln'di,nr
<br />r..ir..r I i3r.. n)coilplvFirh illciryrrl(i)u t
<br />,.Jir.\cfhrivr\.lrht (il! rnd (inrry h ttrrrr ulxrnrhcw-"
<br />,lffr+h
<br />il:,.'-.I-://"*btlw
<br />***"****".7L---Jzlrww
<br />,,*-+)15)ro
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />Subf loor/VenVlnsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framino
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lVasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Cenif
<br />FINAL 6-Z-/A'J/e{fr *)
<br />Certiticate ol Occupancy
<br />Notes, Remarks, Etc.
<br />I (1dci .\r'tr
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<br />SLAB Floor
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