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BUILDING- INSPECTOR RECORD <br />SITE.WORK DATE ID/SIG.OIINER BUILDER DEI,(-ARATION <br />I hd.b\' a llrm trnds ,.nak, oa pcrjury lhal I on .r.mDr fton rlE (inrlacroE Licm. L.\r t rh.lollosinr reaqr (Se70llt <br />Busi!$s and P,ofsion Codc) Any Ciry o! Counry *nich rcqun6 a p.nnir ro c6 sl,!(, ah6, ihprovc, .ls olish r r.rDtr , <br />sttu.lua llir lo irs i$u cc. ale rcqutB rhc applica tor such Frnit lo filc a slsn.d st0tm. rlh h. or nE is liccNed pu6uMr <br />lo the provisions ofth. Conlra.lo.s tic.ns.d La$ (Chaprd 9. CoDn.i.ins (ith s..lion 7000 olDivision I oirh. ausiocs and <br />Pof.ssionsCodc)orlhat hcorshe t.xempl llrrcfr om and lhc bsis lorlheoll.Bed crdn hn Atryviolalionolsslion70115 byd, <br />applicant for a pdmir strbjdrsrh. drtli.anr ro a.ivilp.n.hyoinot morerhtu' fi\e hrn&ed dollais(t500) <br />l, 6 orvnq olthc ForEny. or h) oplolc with wag6 s lncir $L comp€Galion. s ill do rh. $orl d $.$rNu. n nol <br />int.n&d or oracd lot el. (Sd ?044, Busin6s and Prolcssions aod.: Th.Conlracto.s l-ic.ns. t-aN do6 nol arnly to an o\rdof <br />rh. proDqly $ho hilds or inprovG th@tr ud rvno &6 su$$Dit nnnself or hNlrorfiioush hi. or hd o$. enpl6rc6, <br />provid.drh such inpoven.nts d. nor inrdlded oroll6.d lor eE.l[ hoNBs. the h'ildin€ or inFo\ercnl Ls sold lvinin on.,a <br />ofcompldio( lhc (\td Builds Njll hov.IIE hr&n ofpo\in-q lhal hc or she dil noi btrild or improlc E pmpcly for tnc Durrosof <br />L s o$.d orrhc pmpnty. m c\clBively onrractin3 \rirh licdlsc<i conracros ro consrruct rhc pmjd (Se ?0.1.1. hrF[6 <br />atul l\ofessiI Cod€r'l hc aonirocrois l-ic€nsc Law do6 nor apply b ano*n.r.ifiopdy Nho btrilds or imr'or.s rh$6n. <br />and $l'..onkadsfor$d'trojdrs\ynh,Contd.ro(rlics.dpu6u olhcConrraclois l]cc6eln\r) <br />I &n cxcmpi u.de' S.clion ,l] & l'( forthisree,n <br />WORKERS' COIIIPFNSA ION <br />PEO,AAAIIOI <br />I hcrcby amm undq poaltyofpqjury on€ ollhe tollo{ins d(le.rions: <br />Iharc ad $ill Dainrain. Ccnifi.ar.ofcoNdtr ro scla l6ur. for \vo 6r .omr.nsar i.n. .i [rovidal fo' hl sccri,nr 1700 ofrh. <br />tnhor Co{., aor rhc pGfomanc. oarh. so* lor s hich lh. pmir b isu.d <br />I have a.d $i11 Nainrah $ 0116' .onp.6arioi iau' a c.. dr rcquir ql hy S.rl ioi .17(x) o f rhe I nur Q\te, itr rh. rrromance ol <br />lhc Norl forshichlhip.mn is isu.d My*0116 .otr1p€6aln,n insurdc. carir and F,licy nurb6 uc: <br />lcdif}lharinrh.Fformrn...frhesor!for{hichrhispe.mirisissu.d lshallnor qnployanyn6son inan) ra.d <br />e a lo b..oru subjel to rh. "!!tm olnncnsnlion laNs olcaliaomia, and osrc. lhal it I snouu b{.ome sutjccl lo thc <br />*od(s..ntcnerionro!is,o6oisclionlT00ollhcliborCode.ls'rall.fonh\ilhcom,l)uiththoeprornnrns.v RNINC lailu,. ro sr. \yorks cohll.$ariod .o\mr. is u.lawfll. and shall subj*r d €nplo)q ro tnnnml !.uhi6 dd <br />civil lin.s up 10 one hundrq.l llnuend dollm ($lL\).ur0), in .ddnion lo rlE cos otconrpeBdtun. d.nqcs as pktrided for rh. <br />Stlion 3076 oflhc Latoi Code. inlEesl d otlomcy slB <br />LrcE!SE!ICAXIIA!j1A <br />llpcraldltQx <br />I hftby amrn rndd pnolry o f pcju, rhar I m li.dE d undr FolisFn olcl'dptc 9 (co'ndqcins sirh Secrion 71100)olDivision l <br />of rh. Busin* ud P,ol6sioN Codc. dd my licas is in full f.rce ond ealsl <br />I cd ily rhar rh. a.ddal r.tuld ions elddins ab6k s rmoval de nor apphcahlc lo this pro i( <br />I cdily rhar I ha\. ead rhis applic,rbn rdlralcrhal $c ahoLc infonndion is cor(l.l a-!.8 ro comply $nh allCir) and County <br />ordin6n.G and SraE l-.se relarins to buildin! conshrclion. rut h6lby.nrhonrc rcpr6dlativ6 oltlis Ciry atrd Qrunry ki drq uron tn. <br />abo!. nhrioncd ptr'psry for insp.<1ion pullns <br />\trDriMtrr r, \!.trr si,rnilurc <br />r€rmll.e nx'ne (Drl"t): <br />Set Backs <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />Subfloor/VenUl nsulation <br />Roof Sheathing <br />Shear Wall <br />Framing <br />lnsulation/Energy <br />Drywall <br />Ext./lnt. Lath <br />Brown Coal <br />Masonry <br />Pool Fence <br />T-Bar <br />Handicap Req <br />Deputy Final Report <br />Engineer Final Report <br />Flood Zone Certif <br />FINAL 5-*t a -/)eSt4 , €u) <br />Certificate of Occu pancy <br />Notes, Remarks Etc <br />COMMENTS <br />Forms/Steel/Holdowns <br />CATSIBUCIAII.INIIICICEICI <br />I hftbe amfln undo p.n.lry o f pciury rhat rh6eisn consrodion l€ndins ascncy aor the po lonnaicc ofrhc $orl lor \rhi.h rh6 p6nn is <br />issu.<l (S( 3097. Civ C.). <br />L.nJd s \rme <br />AEUCAILDECIAB{IqI <br />I ho$y amm u.d.r pdahy orpsju',- onc oflhe follopins d(lilalions, <br />D.'nohrn ltrmirs-Asb6los Notilication r€deml Re-rolarions ( rnk 40, Pad6) <br />R.qui,cd latt6 of Norifi cation <br />=