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BUILDING- INSPECTOR RECORD <br />SITE-WORK DATE ID/SIG.COMMENTS OWNI:X BUTLDEtr DET'AR TION <br />I @/ .frm lnda p6!Xy orFjury lhi I m dmpt toh rh. CoI,r*16 t.ioe ln fo. rlE 6[o*i!g tB,. (s< m_rl t <br />B6'ns !d Profdbn Cod.) aly Cny or Ceiy whih EquB . Fni lo .o,uru.! .lta. i,bp.ov. ddbli+ or l4.n oy <br />nrudu..F.rbia Bl,aE. rlo r.qin6 rl.! *pr6r h.$.nFhnb 6L. rigEl nrm' thrlttriEili.cEd FEltn <br />ro rlE FvtioB of rlE C.nmor'r Li. .d L.* (clrFs 9. Conrl:@in3 $nh ser.. 70o of Diviri,D I of llE BuiEg rxl <br />ProlB.N Cod.) d rbr lE d rh. i .r.$fl rhq!fron rd th. b6a for tlE .lh.d d@Fhn Any virlnirn ofsdrDn 7011., b, &, <br />.p!li..nr lor r Fmir rbial! rh. +?lic&r r' ! cirit pd.ny of er mc lh6 6!c hundcd dollrt (t5m). <br />l. s o*n( of th. F.Frly, or my cmploFa wnh u.g6 s th.i elc ompcEdnrn. wrll & llt *o dl0E$n(1@itut <br />inradoj or o,TE.d lor slc (Sc.?04r1. ltBin* 6d Pmtdioa Co{tc Th. ( ont..roc! l-icN. llw d.6 Dol .Fply lo M om6 o I <br />rh. Fopdy *ho hilde or n'pirv6ll".@a rn *k' dE !.h K* him.lf.r h*ll or rhmuah hr or hG oM drployG, <br />p.ovidd rhd such mFoffis E d hrdrd.d u olI.ld aor elc. l[ hovd6, rrE hliulg or unForq,ar s sld wnhi. o.. Fr <br />ol conFklFtr rlE o'$n B{iEd vill h.r! llE h!(dr of!1orrs thn ,E or 3lE dn d hild or irF.Dr tlE FoFry 16r llt Flpoe of <br />t. a of,E oarhc FDFry, m.rdNirclt ..ddrg *nh licqE d co rar6 h oldru.r r,E Fora! tS6. 7Or-1. &!!B <br />.nd hrEir Cor,.: Tn Codrdoir LE@ ljw &E mllpplyro e o$'n6 ofFoFry who hrikt! or ibFo!6 rhq@tr <br />.nd wh snr.d3 fo. $.h lnirdl' rnh . (btu-ro(r) lkdE d Fllld ro E Coddtri Liuu Lru) <br />I e.roF uil( sdio. <br />Ihl. Ortrr <br />WORI(ERS' CONtPf,NSATION <br />DECIAEAIIO! <br />I h6.ry rnirn ond.r F.rliyor lqjury on. orlh. lolloEiry dEl{llio6: <br />IMv.d!willroi .in ! Cd ificot. of CoB6r ro Sdr- lBur. fm ro.ld $npdrdon, a Fvikd aor by selion 1700 of rh. <br />Irhor co&, tu rh. Ffm. ol rh. *oll for $,tkh rh. Fnh ii irslcd <br />I h.r. ud *rll nlinrai. *6116 tump.tultbi 'e@., a ..qoiEd by sd$ l7m orrh. ubor C.&. fo,lhc Ff(ru. or <br />rli *vl ftn ri{h rh5 pqf,i ! ed. \ly {dt6',* 1 Sfo/e F-nrl <br />,"r"r*,o' loJoqjg <br />omFsio. ilMe...,a in <br />,,0"- ' //'/- LO <br />I.a!fr rhd in rh. Ffomnc. of th. uorl for *hrch rhis rEmn is i*u.!j, l3h.ll drr 6phy rny F$n in uy me6 <br />$ r ro b.comc NbjEr ro rh. $od6J odpordion Lw! oacrliaomir. ud a8re rhd <br />'r <br />I rholld b..on subjcl lo llE <br />sul6'co'npcreariooprcvi5ioroofsdionlT00ofrh.lrborCodelslDll,fonhenhconplrqilhllrEpovilioN <br />WARNTNC fjailurc to su. wort6' comrENrnin .ovcr.s. is unbwful. ed !h!ll lubjel o dplorr ro 6inir,l Frtrlra. lld <br />cilil nnd up ro on. hu.drsl rhoMd dollG (tloo,lxro), in dddhion kr rh. cos ot.oip.Nnnrn, &m!a G Fwid.d f rh. <br />s<rrn 1076 ol'h.bb.rCDda i 6d Md dbq- ! ad.:4-/?:4^ <br />DpclrSarlotr <br />I hcrby jTm uidi !a.ty of Fju., rh. I d li!!.d ordq Fovili'tr ororBs e (6ffi'!s ynh sdibo 7000) or Dir toi t <br />ol llE B6itB !d ttofsd Co<L, .!d dy ltd* ir in tull bie .d .Od <br />,..*..,"*' dtl 3712 6s- <br />,.,. ' ,/ z '/2 "/ 2 6._." !"iJ <br />COISIBI]CIIONIEdDIIG.AqII.(I <br />I l6d'y .rfm undd FEIy of rFjury rhd thc. n . cotudirn laditrs udy for llE Fftuc of lb. *!rt 6r uhrh rha Fni ! <br />e.d(S( 11097, Civ C.) <br />l-r& r A&is <br />- <br />AIIU(ANfDICIJBATA! <br />I hody lfm und6 pdaXy ot pdjury on. of rh. lollos 'ns d<l,rdioB: <br />Drmolirion PmireAsbdros Norifi cdion r.d.rrl Rcsulatiod (Tirl.40, PrnO) <br />R.qun.d L.lrd of Notifralion <br />I .dify rnd th. fad6.l EguhioN E8ldin* Bb6lor roEvil e mr qplt.bL ro rhs Folal <br />Xt .-it ,t. t l'."" toa tt ilpdtdior id ia. rhd dE lboE irlondhn ir corar. t {Ic ro o,41, r'ih .rl ci, .rd cou!, <br />rdine6 !d sr.l. t.s diilB lo hrlili,B .oEr,ldbG tn horh, anl'o.i4 EF& i6 otfiir cn, !d Cor.r, b ana l4o, dr <br /><1 <br />.br. ,Krk..d FoFry for iqtrL,. <br />"nZ, 'e <br />/a- /a. / <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />Subf loor/VenVlnsulation Ir 1tr6Roof Sheathing ffiDn{)tle/{^4 <br />Shear Wall I <br />Framing <br />lnsulation/Enerqy <br />Drywall <br />Ext./lnt. Lath <br />Brown Coat <br />Masonry <br />Pool Fence <br />T-Bar <br />Handicap Req. <br />Deputy Final Report <br />Engineer Final Report <br />Flood Zone Certif . <br />I j ) <br />FINAL thslkla *v.lful ol <br />Certificate of Occupancy I <br />Notes, Remarks, Etc.