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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.OWN'R BUt!,t)!JR DEI,(]ARATION
<br />I h$chy nftrn x.dcr p.Mlry of Fqury rh.r I cx.m[ fto'n rhc Conrrcr.m' Licen* l is tu lhc folhwing rca$i (Scc 70.] l 5
<br />Busincss .rrl Pio6$n,n Cc{c) An, Cily or Coudy qhich rcquircs n pc.nrit lo c.n{tud, alr$, tnlrovc. d..xri\h or mlmt rny
<br />strucrurc- pritr ro irs hsuane.oko rcquncs rlrc arnlicanr rir such rEnnir ro lilc a ri8Md sr .!ft rhrr rxor shc k li.ctr*d I'Urs.nl
<br />ro th. pmlisioN orrtf, Conra.rofs Li..n{d tjw (Chatrn 9. commn.inB sith Scdiotr 7o(xl of Divhion .l ot rhc 8!\inrs Bnd
<br />Profcsn)ns Codc) or rhar hcor shc hcxcmfl rhcrcio .nd rh.n|sh rh,rhe allcgcdcxcmprion Anrvi{,h ioiorse'bn70ll5by r!
<br />lpplicanr foroEnnit subrccls rhc llpliclnr ro a civil nenalry of.or Brc rhr lir. hutulr.d doll*\ (5500).
<br />-l-
<br />i\ owtrqof lhc Imricny. (rnrrcnrtloles *irh $rgc\asrh-i $lcmnlncnllri.n. silldo rh. wo* ird rhcqdurc i\ mr
<br />i'cndcdoroficrcdforv]c{SN?t9,4.Br!i'*$lndlh,fcsi.ns('dlclhdConrnclor'{Licctrictjwdocsnolapplyroonowncrof
<br />rhc rm|Eny who burlds or iltrlros\ rhcNtr- drd who dms smh mr* himscl{or hcisclfor rhmu8h his ot hcr oan cmnlorccs.
<br />pr,vid.d rlxtr su.h imrtuvc,mntn Dor inrcndcdorofcrcd lorsrlc.li h.ucvcr. rhchildingor i'rynrcntnr irRrHwirhir'.trc ttir
<br />or.oq)kr io!. rhc Owncr Buiklq $ill hlvc ih. hrdcn dr pm rE rlrr rrorsh. 'lil d boild or inprolr lhc pDFny for r,E lurlns of
<br />I. as owtrcr of rhc tm|).dy. rmcrclusivcly.onrmcrinE sirh liccnrd c. nn!.roF ro con {d.r rh.Injc.r(S.c 7(}1.1. Bd\i't\!
<br />aRl Phrfc$ionCodc: Tnc Conrracroa\ l-ic.ns. Lr* doc\ nor rprlyt) anotrndr orpr.p. yqho builds or nnprovc\ rhc.con-
<br />dnd eho.onrfl.Gror\u.lrprojc.Brithi(ntu(tuis)lic.n\.rlpuisurtrllolhcConlncl{\LiccnEllw)
<br />I r crc,nfl und$ sc.r t .B &PC lirihi\r.rvnl
<br />()r'ner
<br />t!l)aNi&sr!9}ltENsArl9!
<br />DEIIAAAIIA!
<br />I hc.cny.ln n utrdcr $trrllyol rru.yoN olrhc folbwirS dc.hrrri(rN:
<br />llhor Cnlc. fltrrhcpcrlolnDnccotrhc suk fu *hic[ rhc !.rnrit i\ i\\urd
<br />I hivc rnd will rninrrin workcri.nnwnsoriotr irsur.n c..s rcquiEd hySd.-rion:17(Xrofrhc lilhr Codc. f rh! pcrlonMNc.f
<br />ri I' rrtr ' \ r,l Nl1$! 'lHq^to;rt n
<br />crtricr rnd E)lirr- trtrn,hcr rrc:Mt
<br />o,,ttrw tI
<br />-l.cniiythrr
<br />irrhc n0rln,!unc. olrhc *ork tur s[i.h rhi\ prnnir tr is{rc.l.lltror ctrr,rloy rtry pcrson in !oy nratrtrcr
<br />v, ,s t) h.o'ft subi{i h rhc wor*cr\ .otrrFns.r iof, l.w( .l C,lifnmir. .nn .rhlt il I s)xrul{!hc.otrf, \uhjc.rh rlr
<br />h\rirh..n1nly *irh rh.{ !'orntrtrsworkd{ .oi\rtr\ari(n|('visions.lScdidr lT(X)of rhcl.rhn (irlc.l
<br />rk.r\ conlPci\rri(tr,.or.rr8r n !n ll {uhj.rt m cnrnbycr ro rinioal ncnrhr\ lnd
<br />rhou\rnn dol[$ lslrx) ixx)) ]n irmig.s r\ prcvided lor rh.
<br />t)l(l.\R\Ilr)\
<br />n utrd.r FnrkyoiNrjuryrhd I .m liccNal u.dq roi\t'n olChrp(cr g ($n,nfncid8 wnh sd.rion 7l)()0) .i Divni(,n .1
<br />nf rhc llrsi,,r\\ and Pn'lc\snnrs C.dc. nnd mylic.tr\c ir ir llllnn.r trtrdclt.r fr-l
<br />sr.NsrBu-Ir]Ilra!!!1ji1iD!l
<br />r\uctl lsr. 1097. civ (' )
<br />AI&lr NfDElLrrAAlIaN
<br />I1f,rcb,nninntrndcrltnrht olftrrjrrt.m ol rhr tulk,wiri! dc.h rior\
<br />l)cnn'llrii)tr P.'n,ir\ Ashcnos Norill.rri.i ltd$ l
<br />-Rcqunqt
<br />l!ncr ol Noiifi.trrn
<br />l..nili rhd rhc tadcmlrc8uhrhns r$.\ro\ trrolrlr. xi,,tdi.xhlc r) rhn lIoi(.r
<br />_l.cniri rhrr I hrv. r.r rhnnnpli.rr rtrlnnn nri i\..nc.r lrgrccn,conln, srh
<br />.'di',rtrcc\ rntlSrrrc l- $\
<br />,\ppli. l or,\!(nl Signatu
<br />I,rmilft nonr lp.itrl ll il.*,t-
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />Sublloor/Vent/l nsulation I
<br />Roof Sheathino il ult{^Y141Shear Wall I
<br />Framing
<br />lns u lation/E ne rgy
<br />Drywall
<br />Brown Coat
<br />Itilasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Ceftif
<br />FINAL VTol/9 -L(49/rq ) /urt,u 9r1& ph,rq
<br />Certilicate ol Occu anc
<br />Notes, Remarks, Etc.
<br />COMMENTS
<br />UFER Ground
<br />Ext.i lnt. Lath
<br />I
<br />l..tr,lci\ d,lr.\s
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