|
BUILDING- INSPECTOR RECORD
<br />DATE ID/SIG.COMMENTS OTVNER tr(nI-DER DDLCAI{A'TIiJN
<br />I hcren, ain undc!pcnrlryolI.rturyrhrrIdn.kmrrfrornrhcCuDh.niLiccn{ltrslffrhttolloqirarcrson(Scc70.115
<br />Bu\i.cs\ " l Pn,rcs\i.i Cr .) Any Cily .r Coudy whi.h rcquncs 3 p.nnir k' rcn{nr.i. ,lrcr. nnDrorc. dcmohsh or rcNn rny
<br />qtu.luic. rr.ktr b ir! issu.ncc. nko rcquiEs lhelpplicanl lor su.hrcnnir ro filca \i8trcd shlciltnr lhlr hcor\hc i\ ltun\cd i,unudnl
<br />t) rhc pnivisi{n$ of rlf Contrcrofs l-i.cnscd ljw (ChrJicr 9. Comnrcnci'rg wirh Sccrnnr 7000 ol Divrion ll ol rhc Bu\iics\ and
<br />Bolt$io.s Codc) ar rhal tE or shc i\cicnrpr rhcrcfro'nmd rhc bri\ for rhc rllc8ed cicDrpri,r Any !i{,krnr.fSccrirn r0ll 5 hy nn,
<br />rpplicmr rorrpennn srhj..B rhc rpplicrnr ro rcirilpctrrlryofnor.rxcrhan fir. hundrc dolli^ (S5Ur)
<br />-l-
<br />as owncr ot rhc popcny. ( nry cnDloyccs wnh eaecs is rhct solc conrpcnsalio.. will do rh. work &xl lh. sttrlm i\ (n
<br />nrcnd.d or.flarcd i(tr elc lse.7o44. Busines ond hoiessions C.dc lhc Co tacntr\ Li.cn* tjw docs nol apll, b,n owncr ol
<br />rhc Impcdy whol ilds o, ill{rnlcs rh.ftn. :Lld *hr dcs lkh w.* himsclf or hcr*lf or rhrcugh ht or h.r owtr cmPloyccs.
<br />tliov cd rhr such nnprcvcnEnts m nol inlcdcn or olicrn tnr sic lli howcE. rt huildi,E or inirrcrc.Enr i! sld wirhin onc ytd
<br />of complction, lhc O*rcr Buiud *ill haw lh. bud.n ofFUving lhnr h. or drc dil mr h ild or hoott thc PEIrny lo rne lulrrs ol
<br />l. rsown$orrrr roDcny.onrcxclusivelyconrllclins wirh liccnscd conrn.b* ro.oNtrucl lhc pro}c.l (SN. 7OI4, Businc$
<br />,'xl Pn,ftsion Codc: Thc Co.tr.rois Liccnsc Law docs nor antly ro rn osncr olpropcn, who hu,lds or inrprorc\ rhcrcoi.
<br />rnd $ho $nlmds fttr $ch lnjcctr wirh a Conhcro(9 lic..scd pursu,trr ro thc Conlncrff s l,iccn* hs)
<br />lant.xcnrll u.ds Sslio
<br />roB(!Bs:-c0!ltDNl ]loN
<br />DES.AAAIION
<br />Ilrcrchyrfi nutrdcr pcnrllyofpcrjuryohc ot rhc lalhqirA d(lrdrnrN
<br />I hrvc ,.d wil I numain a Ccdi,lcarc of G,nsnl to Sclalasurc for wort.i\' .on{rnsd ion. as pmvidcd tor by s..rbn l7m oi rlf
<br />I-ltxr Codc. tor ri. pc otuRc olrhc sort td wlich lhc Firnil k is cn
<br />4 havcrtrdwillnriiin$olkcnconrFn\arionirsunk.-a\rcquncdhySccrion170)oIlhclihnCdlc,rorlhc,toli,nMnccoI
<br />hic79i1
<br />r&
<br />p.nnir is is\u.d M! sorlr^ nnntLnsrri(n nr\urrtr.c.nriq rrllni.y nun'h.r itrcl
<br />IUft ocro (e07
<br />-lccnifyrhrr
<br />in rh. p.rfo utr.c ol rtu work Io. shth thh pcirnit i\ i\\ucd.I rhrll orc {loyrnyNrwn ir anyntuncr
<br />$ N b b..onE subFrrrorhc woitcr' comp.n\rrbn lxis or Crlir{xnix, rid alrcc rhnrill \houi! hc(,nr suhid ro rhc
<br />workc^'conrpcn\orionpDvi\ion\ofS.cibi:1700uflhctlhtrC(xlc.lshrll.lbnh*irhdnnPlrwirhrhorcPmvtion\
<br />WARNING: Friluo ro sm workcn'conlrns i(in covcmAc i\ utrhwfxl, d shnll strbicr !n cmplorr b rini.dl Fndlas rtrd
<br />ci$l tnrs up t, unc hutrdrcd rnousand doll0rs ($100.(x)0). in addin r r. rhc.osl ol conlt'cn(urion. dlnuscs ns Pmvidcd for thc
<br />I hcrchy ltirm undcr pcMltyof |x jurylhal ! trm liccislhdcr rtuvisn orChrlrq9(connftncirsvirhS..ri.n7m0loiDivisnrnl
<br />ol rh.ltr\incss and Pn, r.\ri. ns codc, drd my liccnsc is in fnll hre and efis!
<br />,_.-*,^*,8, 1.. (v). c "%,.",,." *,,,,*,'7??rzo
<br />"..", ?7V7*
<br />CONS'TRUCTI(IN Lf'Nh!N(I AGENCY
<br />I hcrby atfirN undcr ncnrlly ol pcrjury rhar rhcrc i\ a c.n$fl.rkn hndin8 rgercy fo! rh€ P.rfomnce ofrhc work lor $hich rhh lrrmn i1
<br />issu.d(sN 1017. CN. C )
<br />AIIIIIANLIIE(IABAITON
<br />l)f,fthydUnnu dcrpctrrlryoiDcrjuryoDcoiihcfollosnrgdcclir rlon\:
<br />lkfl,lirnri Pcnnih Ash(n.s Norili.rriotr I'cdcral Rcguhlior ( lirlc.lO.l'an6)
<br />l{rqtrrril I rrrrln Nrrrl.xli(ri
<br />I ccnilylh:( nr lcd.rrlrc!trldnnn ruSrdrde ({!o\r.iFLnlirc tror ltnllicahlc b rhl\ |m)Jccr
<br />I ccdilyrhir I hrvc crd rhisrpt'licariorandsrurcrlur rhc ahovc infimdion i
<br />.rdi.atu.s.nd srdc taws rclrtiry ro buikling c.nnrucrion. ail hcrcbraurhortc
<br />r[)rc nrni{]n n |noprnylar in
<br />Appliotrr orA!rtrr si[nrrurc
<br />Pemiree mm€ (pnnr): &e?
<br />\ conNt. I l8re rocomplywirh aU Ciryand Counry
<br />r.Itrc\c.rartrcs or rht ctry JnJ counry r. cnra ullon rhc
<br />^,"g/a/, a
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framinq .//--.\\
<br />lns u lation/En erq y r -3-lg k.W:til)
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lt/asonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Cedif
<br />A\
<br />FINAL l-t"t7 k,Wr0)
<br />Certif icate ol Occupancy U
<br />Notes, Remarks, Etc.
<br />SITE-WORK
<br />t nd.: (Nsm
|