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BUILDING. INSPECTOR RECORD
<br />DATE ID/SIG.COMMENTS oIINUR I}TJILDUR DI]I,CARA'I'ION
<br />Busnr\\ r,kt Prt)fc\snnr Gxtr) ny Cny dr Ci,udry $hiclr rrqun.s r trnnir b c.osnr.t. ilrcr. nnlmvc. dcnFlish nr ,.rin nny
<br />nr!.trtrr, f trr, [s is\urkc. rlro rcqunc!rhc q]flmtrr for \uch ltnnr ro lilc r siSmd ( .nrnr rhrr h.or sh. is li..i\.d Prrsurtrr
<br />lo lhc nn,vi\n,n\ of lhc O)nlncrr s l,ic.n\cd h$ (Chrj,rcr 9. Cotrnnrncn,! wlrh Sc.rittrr ?(XXr ol Divisnnr I ol rhc Surirrcll rn
<br />Pn)rcs\tr)i\Coddorrhrr hcor rh. i\.rcnfr lhcrcfron, M,lrhc hAn for rhcrllo!.dcrc lntr{ AnyridrrionolS.dionT0.ll5$yany
<br />.tpli.rnt turnt'tnnn \!hic.ht}[ rpplritrrro icivillctrrky.l mr nnft rhrn h\c hnni.cd dolh^ i5500)
<br />Lr\.wDcrofihcnn)pcny.or ycll'lorrc\trirhsrsrs$Ihcn*,h.onlltrtrs[ion.silldorhctr( {nd rhc slBiure is noi
<br />idcd.{ oru,L'cd li* srl. (Sd.l(}.l-l. Btrsincs rnd Prolisrnn Codc IhcCu turoir Liccnr ljtr doe\nolrpplyt)rno*rc'ol
<br />l[crmpcdy whohuil(korimDmvcsrher&n.aMwhodocssuchm*hnnr.llorhc^clrorrhR)ushhisorhcrownc Dloyc.s.
<br />pr)vilL.d rhrr such inlrrclcnrd\ rc nor irncndul orflrlcd ntr \nk ll h)trNi ihL hriklil! ur i'nr(vr f, risq'ld\ihinonc)r
<br />-1.
<br />r\ownc!orlhel)lollcny. amcxcllsivelyconirudinr \!irh li.cnscd cofkNnns r. dnr{d.r rhr ni(ljrtt (scc 70.1-1.3u\irs
<br />dnl ftrtcs\i Codc ThcCotrtdrr's Li.cn\c Lrwdoc\ nor,nflyh aio$n$ ofl)l.Nnysh. hu]ldr.r im|rovc\ rh.rcon.
<br />a sho mnrrrs lor suc[ pnl.cr\ wilhrCodru.ron\l ltcn\cd pur\u]nlr{,rhcG,nrrr.kr's l-i.cr\. llw)
<br />I rnr cx.rrflunncr S.dbn_
<br />Dole: Orner:
<br />lvoR(IrRs contPFNsATIoN
<br />II.ECLAI]AIION
<br />I hcrchy 3lrirnrunder pclalryofFrjuryone orrhc nnlosnrs dcclurions
<br />-lhurcunsillnui
<br />rinaCcdinc,icolCon$nrl{,Sclflnsurcir*o'kcftco'npcnsarnr..sp6\idcJnnhrSc.rioo3T(xrofrhc
<br />htr Cdc. tu Ihc pcrlbnrak-.c ollhc *ut Inr unich
<br />'hc
<br />pcrnril is h\ucd
<br />lhrv.rnd willn idain sorkcr\'.o rtc \arnfl i'ntr'!tcc. rs mqrtcd hySccrr lT(X)ofhc Inh.r Coilc, li)r rhc Iltrfornuncrol
<br />rhc Nork for $hichrhi\ Fnnir i\ is{.d My workd! .onlr tr\rrnnr nr\urrtrc.dricr 0tr1policytrtrmhlra'.
<br />-l
<br />ccrrilylhor i'r lhcpclli'nnrrccofrhc work lnrwhichlhi\ ncnnir i\ i\\ocd.l sh ll olc rPloyrny Nn.tr irr rtry mrnrcr
<br />{, ns k, b..amr \uhjc.r tJrhc\rorkcrt .rrnNtr\ ri,n l.$su, Crlinnnii. rnln!rcc rhrl ill \houl.l6cconr \ubad rorh(
<br />vorlcrt contk.\urnrlr)vti.trsofSccrim]TmolrhcLrh.r(inlc.l\lEll.irh*lrhdnnllysirhrla,{pn,ri\ion\
<br />\!ARNIN(:: lJilurc h \Nrrc *.rkrh .otr,p.rs nri .ortrigc is ntrldslul. rd shnll suhjccr M cnu,!,)cr n) cn'nnrl lLmlric\ n
<br />.ivil fitr.srp k, onr huidr.d rhouqnd dolhA (51(X).m0). in dildiri.n l. rhc co( .l conrFn\rrnn,. dnargcs nr F,ridc turrk
<br />S(tnnr.1076of rhcL'h,C. ..itncrci nd inonry r i.r\
<br />cutuf, uqrurxrENrl!{il(irNrl
<br />I hcrchy slrrnonder Fmlryofp.rjury rlur rhr. i( a con$fl.rk tr lcRlnrg agcNy tor lhc rallormancc ofrhc worr n, shich rhis FYnril t
<br />ksucd (Scc.1097.Civ. C ).
<br />APTI,ICANLI2EILANAIIAU
<br />I rln+,y 0fiir n undcr pctr{lly ol pcrj!ry onc oirhc tollo*ins dc(hrlri,,ns
<br />D.trx,liri.nPcirniNArh*osNorifi.dtu l,cdcrrl R.ttrhrn,ns(Tirl.41l. lhn6)
<br />-Rcquncd
<br />L.lrc!.i Notit.diotr
<br />I rcdilrrharrhc liicrrlrc8uL n \ rp d[! rdr{olctrnrnl .1rc nor rJ,plicrhlc n, rhn pi{ijccr
<br />I ccrri!rh l lNc rcad lhn arDlic n,nmJn crhlrrhc xxc inl,nnurn,n ir.onr.r I iste ro.oryly wirh rll Cir, rnJ Coun(y
<br />ordinrncc\ ud Srolc tiws rcllrin8 ro huildins c.n{tudbn. md lrrdby rurhornc r{r.scnrditrs otthn Cil} rnd Countyh dtrrd rF,' rh.
<br />rbovc ntrtrrio.cd rn'pcny for inspcclion 0n{nrc'
<br />\t,plirxnl0r '\sctrl Si! lurr
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />Sublloor/Vent/lnsu lation
<br />Rool Sheathinq
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Brown Coat
<br />lVlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif
<br />FINAL i,lt.ilt l/ffi/lt\,rV lK't ,z
<br />Certiricate ol Occupancy alLtLt,u
<br />Notes, Remarks, Etc
<br />SITE.WORK
<br />tulP: Appli@l:
<br />t !(rEN.srD lr)NTR,((:T()R
<br />OECLAAAIPN
<br />I hcrcby ltlnm undcr pcrohyoIrE,jlry lhd I !o lienEd hdd rDvi\n,. .r Ch.rrd 9 (.omtrEnci.8 $irh Sccli'n 7fln) olDivisnrn:l
<br />of rhc Busincss md Pmic$iorr Codc. lnd nry liccnsc is nr full fore unn cficci
<br />l f
<br />',1.
<br />'.
<br />^J,1.
<br />L-
<br />-
<br />SLAB Floor
<br />Shear Wall
<br />Ext./lnt. Lath
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