|
BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />\Y,01/Ur:tRoof Sheathing E!fl/8
<br />Shear Wall I t
<br />lnsulation/Ener
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certil.
<br />I
<br />FINAL b/u/tr a Ylt)
<br />Certif icate ol Occupanc y/
<br />Notes, Remarks, Etc.
<br />owNuR BulLt)ER DUt,CARA',flON
<br />I h.r.by xrfifln d cr Fnrlly,)r rcrjury ihar I m excnu lnir rhc Contrdtri t,icctr\. hs h.lhc ii'ln,$ios 'uu rscc7rll.5
<br />Itusincss ,r Pr.r.\si,nr Gxic) AiyCiryor (.unry *hich rrqutc\ p.nnir n, con{tu.r- trlr.r. nnp(,vc. c n'li\h,tr rlnrr rrv
<br />srrucrurc. prior ro ils nsurtrcc. rho rcquncsrhc applicrtrr ntr sucht nnirt) filo i {Encd n.r.tr*nr rharhcor shc s licctr\cd Nr{nnr
<br />h rhc p'ovni{rn\ oI rtE Conrrlcnn s l.iccn\cd l-rw (Choprcr 9. Conn.cncinE *ilh Sccrion Trxxr .l Division I ol rhc llu\inc$ !nd
<br />Pnrfcsso \ Codc)orrhsr lr orshc i\ errmpr ihcrcfro'n rnd rhc hrst Lrrhc rllcgcd cremprion Anyriohln'nofSccrion?l).115 hy xn,
<br />{llicJfr (r, t)cnni suhlccr( rhc amlrrnrt, rciyilncnrlryofnor nnr. rhln fik hrndrcd dolla^ (S5(xr)
<br />I. a\ owncr of rh. pn,Iiny. o n, cnlPhrrcr wirh *!8cs as rhcir n,lc con,pcn\rr ion. will do rhr sork el rhc {turh i\ tr.r
<br />inrc dl oroicrL.dinrs.k(Se7(),1-1.Ansincs.fdPr,f.si6isC.J.ThcC.ittr.ior'st.i.cnsl.dwd..\trorrpflyloMowncr.l
<br />rlr|f)ndy whr bxild\ or imlrovct rh.Nnr. rn$txrder!fthsorkhimsclforh.ncllorrhrcrghhisorhcrowncntpl.y.c\.
<br />pn,liJcd rhar su.h inriiNrmnh rrc[n i' cndcdor.fidcJ frtr qh ll loec\ct.rhc huililioA or nlll'.oEnEd h wH sirhi,', nc )cJr
<br />.iconlkriotr. rhc Owncr Buildd willhrlt rhc hurddn orptuvi'i! ihtrr hc or \h. d'd tror huild or improvc rh. pmrdy ntr lhc Nrihs.l
<br />L rsosncroirhc nopcny. rnrq.lusilely.o riclir8sirh li.ctrs.d c.dricrtr(r,rcotr(n'd rh. trorsr rScc 70,1,1. Bu\rc$
<br />r lh,r$ir Codc: Thc Codkrkr'\ I iccn\c t-x* doc\ nor xnlly nr rtr o$ncr oltropcny shi) 6uild\ or iml({r\ rhctuon.
<br />rnd $ho (dm.h lrtr su.h projccls r ith r Conr .rtrlt li(c {d llnr{r rrirhcConrmckr'!I-i.cnscl-rN).
<br />I n.\c rlr trM.r 5r.1
<br />l)ole Osner wolxtxs ulvr pr,t,rslrrot t
<br />DI:!LABiIIIa!
<br />I h.rcnyrilt un.lcrpcnilryoincrjuryorcotrhcnnhqinEd(l rdiotr\
<br />ht{r(rxlc.ntrrhcPtrt)nnri...f rhc{rtrlforrhi.hrhcl)tnnn isislucd
<br />lhavcrtrdwillnrn nir worlclr conDcns i ] i.{rrmc. r\ icquidl $y sc\rnr lT0o nl th. tilbor C.dc. lnr llN lrcr hfln,ncc or
<br />rhc work nn *hich rhn pemir is nru.n My $orker\' c.nD.tr\dnr nr{mn.c cnnicr ml Fnicy numbcr c
<br />-l.cdilyrhrr
<br />r rhc Nrfornnnccofrhc w.rk fnr Rh'.hrhA |tnni n i\ru.d.l nrll tr.r cmpl.yriy pcison inany,.inncr
<br />n, ^ n, tfcom srhr.d x, rhc w('rls( conrpcnsilion l0ws.icilinmin. rrl nsEc rh, ifl should h.co E sll,j(i h rht
<br />qo.kcr'conp.nsrrionpnrisi,,trsofSccrion.l?(xloirhclitnr(ixlc-l\llrll.fonhsirhc.mplywirhrhorprorisn,n\
<br />WAINI,\iC: I{i!u.c Io Blrc workc6' .on$.ns[ion ()vcmsc i( ntrhwful. rtrd {hall \uhJc.r !n cnDloFr ro crinrinnl FBlti\ lDd
<br />civil fitr.\ uD ro nnc hundrcd rhousrtrd doll${.r..mp.nxri,n,. drrrgc\ r\ nnnhJ li,r rhc
<br />scrrotr 1076rrrh.l ahtr corh.lnr
<br />ll!!Li-B -MrIhcr.hyr,tnDtr cr rnnlrr ortcrjury rh{ Irmlii irU wirISc.lihtr 7tD0) olOivisifl ]
<br />of rhc Bu\i'{\\ md Ihlc\\i{,i\ Codc. n'ld nry liQn{ i\ h ltlltur.c irklclfc.r
<br />!
<br />I h.rchy ulnrnr undcr Fnillyoip.rjury rlrrrhcrc i\ r.unnru.rinr lcndirS r8cfry tu lhc NrionniNc ol rh. work tnr whi.h rhi\ p.nnir i\
<br />i\{rc lsc. :10,)7, Civ ( )
<br />d.ttLlCANfDLClrISAIlQl
<br />! hctrI'y nlllnn u.dc, Ftulr! ol pcrjury onc oirh. r'ollowrnA dccl.rrnnN
<br />Dc,nolldr Pcntus Arb.{or N.rifi.ntn Frd$rl Rcgohri(,n\ (Tirlc.10. Pd6)
<br />lo33ZzRcituncd lrrrrol Notili. dr t-\
<br />-l.cnilyrh
<br />rhclcdcrilrcSul ionr rcEardnrs isb.nos rcmovrltrc ornpfli.filc to rhir!n+.r
<br />rrrlicnri,n,!nd {rrc rhrr rlrnh)\c irhrmrrion i\coae.r lJsrccr o comtl, wirh allciryrnd Cou ly
<br />rhn City and Cou.ryro cnrd ut,6rtr
<br />D.lg
<br />h.r.h! ruhrrizc rqrcscnr$ivc\ of
<br />"-v'^7t4 k)'*+q V^JC'
<br />Framinq
<br />Ivlasonry
<br />I rtrJcr , A,lJ'rs
|