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BUILDING. INSPECTOR RECORD
<br />SITE-WOBK DATE IDiSIG.
<br />Forms/Steel/Holdowns VMErection Pads ,/a
<br />UFER Ground t- I t u?
<br />SLAB Floor
<br />Roof Sheathinq
<br />^?4ry",{Shear Wall (l>11[E lr ll
<br />,t I
<br />IA.,L.iFramingtl)YIrB T ,Y t(.raf d^^uitl ',-"I{lnsulation/Energy I \)l
<br />utapblt)Drywall I ?,
<br />Ext./lnt. Lath /t L
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />av4<,4-T-Bar r$I .)/
<br />Handicap Req uv
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />'^tqer'J,FINAL t6ltq 1i ?9./
<br />Certific ate of Occupancy yl
<br />Notes, Remarks, Etc
<br />(,WNER ITUILDER I)EI,('ARA'IIoN
<br />I hcrch, rrirm und.r Fnrlry uf pcrjury rhar I d crcnDr fronr ihc Conrmha Li...\c Lnw fur rhc nrbwirg !cr$n (Scc 7031 5
<br />Ru\nhs md Pmf.\siun (-.dd) Any Ciry or Coufry which !.quircr r tknn[ h .onsln.r. rlrcr. nn[otr. dcnrnhh or rcIan un,
<br />slrucrurc. lmrlo i* (surrcc, rho rcquiic\ thc rffli.rnr r(r\u.h lf inil t,lilc. siSrrd starcnrnl lhrr lror shc is liccn{d Phuxnr
<br />n, rhL p'ovi\nrnr ofrh. Conkrkn\ l-ic.n{d Ixs l('hr0rr 9. Coarnrncin! *nh Sc.rion 7(XXr of Oivision:1 .ilhc Busin.* !.d
<br />PmfcsronsCoc)orrhrrhco.shclscx.mJ'rrh.rcrronmdrhcl!\i(ltrlhc0llclcdcxcnrplion Anyvi.llrionofScciii,nT0ll.5hydiy
<br />trpplicrnr l'or a pcmit suhjecls lhc !npliconr ro acivilpcnnnyoinor mrcrhin rirc huidrcddolhN (55(x))
<br />l. $ osi$ or rhc phlEd!. or nry cnDlo,rcs n'i'h $n8cl r\ rh.i. vnc cotrlnctrslrirnr. will no rtu {ork uxl rh. dtuiur. i\ ioi
<br />i'ncRl.ll ororitrcdhr$lc(Ss7(lilt.Buli'rcl!xndl}lncsiqNGxlc:lh.(innrncttr\l.i.c$t.rwdocsnoramlrlornowrErof
<br />rhcpnrFrry wlfu hu ilds or nnlf.h\ rlEfrnr. .kl qho dNl \u.h ur hirn\cli.rhc^cllorrhroughhkorhcro*n.h!hy.c\.
<br />nrovidcd I hrr such i.,r,mwnrnh rrc Rn inrcndcd or.lT.ftl lnr $h ll h.r cv.r. rhc hiHin€ or imIn)vcnf,nr i\ q'kl wirhir , tr'c ) cir
<br />olmnrflclion.lhc Owncr aurldc. sillh{rc lh. hunlcn ol !tuvirS rlDl }r or shc did m'l [nik or improvc rhc p'orcny fitr rhc PtrrFJ*uf
<br />-l..sown.rol
<br />rh.Fopc,ry.0mcrcnrilcly.onrricrir8 sirh li.ctr\cn.onrrrcrocro.on{tuci rhe pnjc.r (sd 7(ll,r. Btrnncs\
<br />rirl Pnfc$ rCodc Th.Cntrta.tr'il-i.cnsc I-r{ dor\ ior qrplrh rtr.w cr ol rn,F.dyBho htrilds or imlrovcs rhcrcon.
<br />rnd sho conr is for suchl)rojccrsw(h0Conrracktrls) licctr*d nlNulnrrorhe(onr,acroi! l-iccn\c li*)
<br />7r/7
<br />I hft.hy 3f,ir undrr n(nrlrrof
<br />D[rt x{ua!
<br />I-ihr Ci)dc. fir rlcNrliinn rcollM$ork Lrshihrh. ncnnir i\ i{uci
<br />rhc *ork ,nr which rhi\ n ,nir ir n\uL{
<br />^1ts.rkrs-r.
<br />rfoi\ rtrnr iNurdn.c.mis n F,licy trtruh.r irc
<br />l.cnili rhrr h rhc p$nnnnn.c ofrhc tro!k hr wh'.h rlns 1rrtr!ir is t{rc(1. I sIrll nor cflnloy rny p.^otr n, dny nrtrkr
<br />$ tr 6 t'cconE n,hrc.l lo llrw.rkcis conulnsllion h*\ol (alili,nritr. nd lgcc rhnr if I \hould hccorft \ubj..l n) rh.
<br />norkch comnctrsrrionpnrkions.,Sccri.nlT(x)ofrhclnhorCoc.lsl ll, n,nhsirhconrplr $ihrk,t Pn,visions
<br />I(Xr.(lXr, h dilidr h lhc ..\r ofconrncn\rrin. drnHrc\ as fn'rid.d fo' rhc:::r[#(3
<br />Ihcr.bytrfirflutrdcrpcn0llyoarcrjuylhllIrnrliccntnundcrFnvhionofChaprd9(.onrkitr!wirhsc.tion?un).il)ivhiool
<br />of rhc Bu(in.$ Md Pdasior$Codc. aM rnylicctr\r is in tull lorcc.nd cfllcl
<br />CA!fl8I]qT9!I,ENUINC.AGINI:I
<br />I h.toby affir'n trnd$ p.nalryorl.rjury rhd rhurc n r.on{ructi,,n hndirg r8cft, for rlrc p.rlofluncc olrhe sork f(n which rhk Frmir i\
<br />tsucd rsec 109?. Ci! C )
<br />AITUCINLIEIIIIBAUqN
<br />I hcrc{ry llinn undcr rcnslry ofpcrj'ny nrc ol ihc ldlk,winr dcckrdrn,ns:
<br />Dcnmlirion PcrnrirsAstE(os Notificorion [cdc(l Rcsulurions (rirlc 40. Plna,r
<br />-Rcquncn
<br />l.ttcr ol Nolilic.rion
<br />l.ral i.Suhrion! rcB&din8 ishc{or rctrxx.l rrc nor ryplico6l.
<br />rhnrpplicirionlxl(arcrharrhc.novcinr'onBrion hcoro
<br />cl0riry to huildiu cotr{rucrioo. rrd hcrcnynurhorizc rcrcw
<br />.r lrgri! r).on,tl! (nh xll( ir
<br />rirn.\ olrhn ( ir! rnd ( o!trr\
<br />.>.w
<br />COMMENTS
<br />Set Backs
<br />Sublloor/VenVl nsulation
<br />Lc crs Addcs
<br />-121rc
<br />-T------
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