|
BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE COMMENTS . oWNER BUILDIiR DELCARATION
<br />I hcr.hy filrn uidcr lcnalry (,rnclury rhar I dn.rcmpt lmn Ihc Co rclo6 Licctr\c Us tt, rhc l.lhwirB rca$n (SLt 'l)31.5
<br />ausincss ntrd Prorcsbn Codc): Any Cily or Coutrry shich rcqut \ r rEnnil to $n{tucr, rkcr. n$tuv.. dcnnnish or rcnrn any,
<br />srucrurc. prir n) irs issu.ncc. (ko rcqutcslhc olpli.lnl IffsuchFnnirt, filca sgtr.d { cnf, rhur hcorrh. is li(cn{J N^uJnr
<br />ro rhc pmv^bns ol thc Conrmcrols l-iccnscd llw (Ch!p!c, 9- Con,mcnci',8 wirh S..ri('n 7000 ol DiviriQtr :1 of rhc Busnr\( ..d
<br />l\.lc(ions Codc)orrhJ hcorshe ncr.nlpr rhcr.fnJnand rltr bJsis nrrtunllc8cd crcmnrion Anrviohrn,nofS..rionT0ll5hy!try
<br />rDli.rnr f rl.rnrir\ubjc.rsrhc dpllicrnr lo n.ivilpcn0llyofmr n(rcrhu livc huddrcddollns1$5(D)
<br />l. is owtrcr of rhe tretcny. or my cmploya\ *iih wrsc\ trs rhcn $b .oniNn\arn,n. sill do thc wolk od $c nturE s tur
<br />idrcnd.d or oficrcd f,tr nL (S(.7(x-1, BusirE$ nnd Profc$ions C.<1.: l hc Contrckr r LiccNc tnw docs nor spdy i, atr owi$ .f
<br />rh.pmFnl wtx, hild\ invfr(B rh.or. .n{ *h) d*s skh *.lt hi'ns.la or hcrsclf or r hrough his ot hc, osn c'.Pbt.c\.
<br />pnrnbd rhlr {'.h imprornrnn rc ft)r i'n.nnd n oficr.tl tu Mh. Il rhscEr. rhc luildins or ihpmv€ft n $ wnnir .trc )(
<br />.r.onpLrirn.lhc owncr Build$ willha\t Ih. budc. ofFrovins llnl hc or shc nil Bn hdild or impmvc rh. pmpdy lhr lhe purF)$ol'
<br />l,mcrc'nd undcr SNLon .B &PC n{ hh.rqnn
<br />uan&;Bs:l!2utExlalloND!!:la&II&ll
<br />I lucby alTt r u trdcr lttrrlry .f rcrltrry rrc ol lhc li,llowilu d$lxrrr ion\:
<br />IhavcnhlqillnunrriinrCcnificarcolCotr*nrt,sclild\u'.tu'sorkc^.onDcnsdidr.r\rovid.d(trhys&rionl7(xl.frhc
<br />l.ntrtr Cal.. rmrlrNrl.irnrNcoirhcwork lnrwhic[ lhcrernri' n isucd
<br />rhcxrktur*hichrhnprnniri\n\tcrlNl!sorkdi..nI'cDstrrtr irNUrrn.. crricr r{i lx)lict trui$cr c
<br />/,,,(
<br />\,,
<br />Eltu N rh lndV(N,vo ( n
<br />N,,,,b". 1r@O l2-a AAral I 2/)
<br />I.dify rhat in rhc pclfonuE olrhc work lor *[i.h rhn r.nnir i\ nsurd. I rhill n.r enDl'ry any pcr{n ir dt 'nnnNrs .sro B_onE sunjccl ro rhc worl.r( conrci\lrii,. lrqs ol Cnlllnarir. Md {sEc rhnl ill shodld bcco'tu subi.l kr lhl
<br />sorlc ompcn\alionprcvi\i{,n\.fSccrn,n.l70(}.frhct-.brC.dc.lstnll.ionhNilhcomplysirhrl6\cPn,visios
<br />WARNIN(;] Fnilur. ro $.urc rorkcB c.mpcnsulion covcrlgc is unla*iul. rtul $rll sublccr an cnDloycr ro qi'ni'd p.Mhid\ nid
<br />c'vil fincs trp nr orc hufrkcd th.usrnd dollm (tl(xr.(Xx)). in rddirion b rhc.o{ of.onrcns.rion. tlr.uAtr ss f)vidcd fff rhc
<br />DECIA8AI]ON
<br />I herchy lmm unde, Fnaliyoapcrjlry rhar 1,fl li.cn{rl undcr provision ofCh.plct 9 (com@noing wirh s(tnn 7(ID) ol Divishn:}
<br />oi rhc ausircsmd Pr)fc$ionsCodc. sd ny liccn* is in lull ntr.. mdcflc.r
<br />,,," B Ii"tr\'Nunrr{' qz\\ol5
<br />vludio clqBuild.crsln4-
<br />IANIiIf,IJCIIIINIENDINI;J(iENII
<br />I hcrch,nifirnrundcr!cn!lt,olp.rjurrrhar rhrc i\rcunitu.rion h nrBlBcncy lor rhc pcrfonrBnc. ofihc worr iotshichrhtFnir ix
<br />n\ucd lsft 1097. ci! c.).
<br />tenh, . \, tr..
<br />ATTUCA TDEILAAAIUN
<br />I hcd, mhundcr Fnaly oilcrjury one olllr tulb*in! n^r,.ii",q
<br />Drnxnnn,n Pc.nih Arbc{os Noiification tscdcr0l Rc8uhlionclln[ 40, [d6)
<br />-Rcqui..,l
<br />l.it$ ot Norill.arirn
<br />I.cnilyrh rhclcdcrulrcEularior\rcg!trlirg r\if,no\rcnntrrlrc nor rfthiblc h rhir p',r..I
<br />-l
<br />ccn ily rhJr I h3lc rcr.l rhis atdi.did dRl sulc rhrr rhc rtnr inlonur ion is romcr I rerN b romPly ! nh ill Cir y rtrJ Cou.r,
<br />ordinanccs md Srarc La*s rlarins ro buildir! .onstruction. ulx] hc!.h, rurhtri/c rnrcttrraovcs olrhG Cny ond Coulry ti cnrcr rFn rli
<br />v*."",fi .Qrut'tr clG Buklt(t"rc
<br />,,,,", \4ll4t3
<br />Set Backs
<br />Forms/Steel/Holdowns I
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor l')l61dtt /
<br />Subf Ioor/VenVlnsulation
<br />Rool Sheathino
<br />Shear Wall
<br />Framing -r-(('4-lA-(@
<br />lnsulation/Enerqy
<br />Drywall g-t- /8 Q+frj )@/
<br />Ext./lnt. Lath
<br />Brown Coat
<br />l\r1aso n ry
<br />Pool Fence
<br />T-Bar 7-/0-/8,lJt taA,7r)
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />FINAL
<br />Certilicate ol Occu nc
<br />Noles Remarks Etc-q'a,
<br />IDiSIG.
<br />I. isowncroirhcI'(,!cny. Mr crclusnely .onrr clirs sirh I iccn\cd co itr.tr\ b .on i fl.t th. rn)jc.l(S( 70{, Bt!i'r.s\
<br />xnd ltDfcsinr Codc: l hc Cont*kr's Lic.n\r Lrw d.t\ tror dprly tu nnowrcr olnmprny whi, buiUt.r nnfrorcs rh.rcon.
<br />r d sho .onknds {d su.h t)oFds wnh r On rdckrlr liccnscd rursua t,rhcC.rrh.ktr'\Li.cnsclnw)
<br />)4.q- t6 .
<br />Flood Zone Certif .
|