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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS owNER ET,ILDDR bbL.ARATioN _ -
<br />I hcrchy aijrtrr u cr pcMxy(n'pc,ury rhar I Dn.xcnpr rrofr rhc ConrracloF'l-iccn\c l.a* brrhc rillowin8 rcison (Scc70:11.5
<br />B!\ircss rnt Pnrts{ion Codc)r Atry Ciry or counry whih rcqrtc\ r ,cnnir t, con(dcr. alrcr. inrror'4 dcmoli\h nr rcnrtr Jny
<br />dtutrur.. Fior b irs tsu .c.6ho requires thc aptlicad rurru.n ltrmii h Ul. d silNd d!r.n*nt rha! lror shc i\ licctred pu!\uani
<br />n, rhc provisionr of rhc Coflrlctoi( Liccn$d tju tChaprcr 9, Co'nmcn.ins wiih sccrion ?(xD ol Dilision .l orrhc ru\incs and
<br />P(na\siorsCo,lc)orrhat hcor\hc is.xcmpl lhcrcfronand rhchrs rorrhcrllc8cdcxcnUnnr. Atryvn'lnridiorS..lirT0ll 5btriy
<br />rlpli.a turap.nnnsrbjdrsrh. aptli.anrr,rcivilpcnrhyolnolm,crhlnnvchundrcddollan($50o)
<br />l. 3\ o$ncr of lhc pmpcny. or my cmploy.cs qith *r!cs * rhctr tok .onIf, nerion, will do rh qdk rr rh. smm ii fr
<br />inrca+d or.ficrudlorslc(S(.7l}44,Bu\in.srndt\ott$i.nsCodclhcConrrlcroisl,icenscLawdocinotapplyroano*ncr.f
<br />rhc tn,pcny who tuius or nryrcvcs rhrE,n. ui who do$ such wor* hmscll or hesclf or rhrou8h his or hcr o*n cmployccs.
<br />provincd rhat su(h irl,ovcmnls m nor ir cndc{ o, dff.d] ftn sL ll hoMkr. rtf, buiui4 or irpnrrnr i\ sold rirhin onc )rd
<br />oren'Vrri{,n. lhc O*nq Aui[.r sill harc thc tDlnetr of rovn[ lhd lt or shc di] d build o. nNmv. lnc ImFny for rtu !u4$r ol
<br />I.$owrdr.Irrrroncny.n.kclusiklycotur.ring*ilhli.cnsDdconrrucknst.con({cirhcprojcLrlscc.7(}14_Bu\inc\t
<br />aBl PDrc\{onGdc'lhcConrrlclolsLicctrrcl-aqdocsnorrfplttoanowmrorprornyshohuildsori'nrovcsrhcrcon.
<br />nnd who .ontr.* for such pnrlrk wirh n a,ntmror( 9 liccn\cd lursu r rorhecontrcroirl,icen\c hw)
<br />I rDrcrc rt, tridrr Sr.rii)
<br />IABXE&IIAUIENSAIION
<br />llI.lLlXtrUaA
<br />I hcrchy alfinn u ddr lfillry of l[lurr otu ol rhc ftn[]* in8 dc.lrlllionr
<br />lhrrc Mdwillrnrinrrii a C.dificxrc of Con{nr t, Scll:lnsrc li)r scrkclr conrFn\ario..0s pmvidcd,tr byScdicn]Tmoilhc
<br />Ljtxr Codc.lbr rhc nclromrn.c olrh. s,ork rin shich rhc pcirnn is nsucd
<br />I lrnrc r d will ,rtr ri'i trork(rr .o rFi\rri,,n in\Dnm..J\ r.qutc(lhyS..rtr)n.17(x)ofrtul,rh.r(i r. f{r rh. F-rfonnmc. of
<br />n\xri,r i'xurrNc cx'ricr md lx,li.y !n,l'cr rrrhc trorl ro,l*htrh rha 'rrnnr A alusd.
<br />,^",., /hruhcLn C
<br />-l (, I
<br />o
<br />-lccdily
<br />lhrl h rhc pcrhnumc olrhc Nork for whi(h rhir fcirnir n lssuL\1. I dull tror cmploy nny NFon i,r.fl, mrtrmr
<br />s' nsb h.co r s!hJ..r n,rhcsorkcB compcn\di0n lu*solCalinrnr od l3Brha' iiIshould hcc.m suhFrrorhc
<br />w.rkcrs .. rpri\rrn)n!fl,visionsofSc.ri(n,:17(X)olrtuljtxrC(dc.lslx'll.tndiwiih.onrdy*irhrhxcpnrvi!ion\
<br />WARNINC Failrrc h *curc sorlt conrFnsrion covcrnsc i{ nnlusful. rnd shlll subicl ff cmtloF lo riflrirrl Ftuhi.\ and
<br />.nil linds uf ni rN hurlrcd llD!\rnn dolhr\ (il{)o.OX)). i d(Da8cs as tmvidcd ior rlr-""t'i,I'frt nrcrc{ ind $r,trrtry s ltcr.
<br />DE{:LISA.IIQN
<br />IhcnbyallirnuidcrnMlryofFrjxryrharlrtliccisdutr.lcrpovnnnrolChtrprcr9(connmmingwirhSccri,,n7(XX))olDiri rn.l
<br />ol rhc Brsinc\\ rnd ttofc\\6d\ Codc. Md hy li.cnse i! in fuII force aftl clle.r
<br />c46 422 z{4
<br />,,,," rF71r TZ-, .
<br />IAN,iIAIqIIANIINDIdG.dIiEICI
<br />I hcrcby nftnn uidc' fl.nllry of pcrlury rhri rh.rc il u dnNrtocrion hnding ugcncy nr rhc pcnnfltx,h-c.lrhc wort for thi.h rhls !.rnrir i\
<br />n\kd (Scc :ll)97. Civ C.).
<br />AIIU(ANLUEIIAAAIIAN
<br />I irnhydtnmundcr ncnalry.inc4ury onc olrhc lollowing d.clnhhons:
<br />DcnDlirbn P.rm \ Ash.j.s Norili.{ioi FrdfrlRc$larioN (Tirlc 40. Pnn6)
<br />Rrqtrtrcd lrrrc, olNorilidi(tri
<br />I.cnilyrhrr lhc ltdcrrl reEUhrn)ns rcCs.lin! rsIE{o{rcni,vrl{c tror r|]Jili.rhlc k' rhr\ pmtccr
<br /></i,ylhll I hrrc rcxd r[i.rDtliciri.n d snlclhrr thc]tx,vr i'nnrnhrtrn, i.onccr.I agre k,.onply wirh dll CnyrNl cl\tr y
<br />iv.s ofrhh Cnr.nd Coutrrt b cnro u|1on rlrodinrnc$ rDd srlllc Lrws rclitir18k, huild "d,y*^rlx,y. trrnfonc(lpi{,n dyntri',\pcrri,)
<br />,tt)t)li( nt or \[.n! \ix.il
<br />l'.rtr'ikr nnn'r lprinrr:'t4 r/-k-lzzlr
<br />Set Backs
<br />Formsi Steel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />Subf loor/Vent/l nsu lation
<br />Rool Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Ivlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />FINAL h/?-iltg @)
<br />Certificate ol Occu pancy - /
<br />Notes Remarks, Etc
<br />UFER Ground
<br />Flood Zone Certil.
<br />".,*,*,,*,, LrJC Soq60l jr 3 u,n,.,,
<br />lcn,l.\ AJ'lFs.
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