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BUILDING. INSPECTOB RECORD
<br />SITE-WORK DATE IDiSIG.OWNER BTJtt,DET DEI-C RATION
<br />I hcrchy .lltD undcr l.nrlry of pcrjor, ihd I n cx.'nnr lin rh. Cotrt.cbF'l-iccn\e li* ior rlr follosin! i.rbn lS..70ll5
<br />Busi',r\\ trtrd Pturcs\n,n codc) Any (.lry or Counry qhich rc'luircs r Ennir b con{tucr, rhcr. inrii(trc. dcnnlish or rclat ioy
<br />nrudurc. prinro iis nsurncc. aho r.qutcs lhc,mlicmr fttr such pcrnir t, lilc t \i8,f,d (itenEnt thal h.or shc i!,iccnscd l{hoanr
<br />b rhc pmvi\ion\ .trtf, Conkr.r, s Lic.nscd Lrw (Ch{rd 9. ComtrEncirs sirh S..rioi Tlxn or Division I ot rhc Bu\irrc( trnd
<br />Pn,rcs\nrn1 Cod.J or thN hcor shc iscxc rtr lhcruLom!d rhc hasi\ I{trrhcxllcB.dcxcnuion AnyviohlionolStcrionT0:ll5h}rny
<br />rrpli.rnr lor 0 pcnnir suhjcch rhc rppli.rtrr ro r.'vilpciilrJ".rmr nmrcrhm livc hundcd dollm (5500r
<br />l.isowtrcroilncflopcnr.ormy.mpk,yccswirhNrgcsasrhcnn,bconrFnsarnnr.willdolhc$o dldtimnNistrlr
<br />inrcfrlcd oroftcrcd fdslc(SN 701-4. Bu\ircs\ i Prolt{\iotrrC.(l. fhc O'ntactr'\ l-icci* L.s dirr nor oplly r. 3n o$ncr of
<br />th. F)pcny who $uil,ll or ir{rckr lnck . tLrd *lrr ddr {trh sorl h n\cll.rh.rsltorrhmuEhhi\orhcrowncnDloycc\.
<br />pi.ri,lctt rl[r su.h iprolrmnrsmDorirlctu<lorolitlcdl'.rslc.li.howcrcr,rhcbtriuingorimrarvcnrnthsoll*irhi",,nrJttr
<br />ofcoDukrotr. thc Osrcr Lruiklcr will hlE rh! hrdcn ot Eovn,g ftd tt or \hc dil mt build.r nq'mE lhc lrrPdy Li rlf, PUrIns or
<br />Ln\.scrofrhctntEdy.rmcxclusivclyconrBdins*irhliccnscdcoDkrcttr\t,.on\rucrrlffroic.rlscc.7lg.t,Bu\i'tr*
<br />rtu thrli\sir Codc: l hc Conrrrktr \ l.icctr{ La* duc\ orrprlyk,Jn.$ncroln(,pcny n) huiid\ or nnpr.vcs rhcrcoi.
<br />rtul qh. ro rtudslorsu.htnojccls $ilh rCoDkxclrS\rli..rrcd N*urDrhrhcC trtr0clor's l,iccnsc lnw)
<br />I 0ncxc rt, u,rdcr Sc.lnn-B & PC lnr rhs rcr\
<br />Dslr O*ner'
<br />woRI( rts' aijNt PrNsA rI()N
<br />DICI,A.BA.IIAN
<br />I ltrchyr0nmundcrNtralryoll.riur!.ncofrhcr(nbqi,rxd.clnrrn \
<br />lhrvc $l willnutrr:lin r Ccnili.rrcolaon*nr t' Scllli\urc ritr workcrJ co.llcnsalion- rs pmvidcd nn hy Sc.rion .170(r ol rlt
<br />I-lhor C{xlc. f{trrhcpcrlnnMi.c olthc wo,k l'or*hich lhc lcnnil is is\ucd
<br />rhc work li)' whl.hrh\ |rnnlr ls i\\ucd.,q'. r.,tr,r trrltN,ln) "l'.rir( L. o.:V1i^r,o,orz
<br />-l
<br />c.nily rhrr fi rhc Frronntrcc ofrhc wurk lnr $hi.h rhk ncnni G hq'cd. I shrll nor cntl{,y trny p.lsnr in rny DMNI
<br />(i \hbLco tr nrhl..r rotk\w.rkcr(conrpcn\rrion law\ .l Crlilnnin, and rgtcrhd iil sh.trld hccamc suhjtr rorlr
<br />*orko f conlli truriotr lmvhio.s ol Sccrion 1700 of rhc l-rhtr Gxlc. I \htrll, tunhqirh conllly r irh rho{ I,ovisnli{
<br />WARNINC lrilDr. ri scurc *orkcr conrDcns0ri.n covcrrgc is trnh*lul. nnd nrll sublccr an cDl'torr b si'ni'ul PLnnhi$ m
<br />.ivil lincs ut t,.nc hutrdr.d rlnrsi dolnf ($l(]l).o{X)). in rldirion k'rlt.on ol c.nDcnsltiof. drtugcs r\ |rovdL\l lor lhc
<br />Sccri{,, :l076 o, ihc l]htrC(xtc. ir crc! rnd! onEt s L.c
<br />Z\{c r^J,*, O?-:lZ:?-O8 6e.- A
<br />UCII IELCONIAACIAB
<br />DECIII.BAIION
<br />IhcehyrflirrxMcrltrrllyoipcrjuryrhurIdliccscdund$provi{n,nolCh! cr 9 (.un'Eming sirh Scctio. 7000) of Division :l
<br />of rh. Bu\im\\and PbfcssinnsCode. lnd nrylicc.se h in tull tor.c rr clt.r
<br />AR
<br />o'L- \Z:!-o -).,,,,'.,,,.,,,. Octmncls Calf <falrA, "J
<br />q.
<br />CAN$TBUEIIOII,IXDINCJCENII
<br />I hrrhy Jfiktrruidcr ftralryol Nrturyrhll lhcrc i\ ! con\lrucri.,n fnding qcicy ir rh. pdlonrun c.i rhc s.r[ t qhi.h thn tcnnir h
<br />n{,.(lrS.. lo97 (n C}
<br />dtrucaNfD[clAtsauo!
<br />I tmt'y rfiin. under pcnrhyorpdjxry onc olrhc foll.unrE dccltroliotrs,
<br />D.nn[dr PcnDitsAsbe$os Norificllid F.dcalRcguhrn N Oirl.,l0. Prfl6)
<br />-Rcqutcd
<br />Lcll.r ol Noriftdi,n
<br />rrlrrc n.r xt,[!.rhI k,lh \ |[,i..r
<br />rl'.rlr\. 'ltr ]rr(,r \..'r.Lr lrlmn)(nnt)lv\rhxl ( ryirl(,trtr{\
<br />t rort(tr'rr rcprcscnririvc\ otrhls Ciry rnd Gru i ro cnrct ulxln rh.
<br />Crac- ZeeC"G4h^\
<br />,,,,," oZ^rl-fa1fu
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Su bf loor/VenVln s u latio n
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />It4 aso n ry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />l6-r-((\,wJr )
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />COMMENTS
<br />Flood Zone Certif .
<br />FINAL
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