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BUILDING- INSPECTOB RECORD
<br />SITE-WOHK DATE ID/SIG.COMMENTS OlINER SUILDER I'EI,CARA ION
<br />I h.rchy afinn udcr lcnalry ot Frjtrry rhnr I o crcmp' Itr'm rh. G,.rdDs LEnsc tj* n, lhc nnbs i!3 rov,t ( scc ?0.1 1.5
<br />Br\ind$ and Pfl,f.srn,n Codc) A.t Ciry or Q)utrly ehi.h equtcs a ,crmil lo consrrucr. alicr. itprovc. Ltnlolish or rcprn rtry
<br />*ru.turc. prior lo it suancc, !ls) rcqunc\ rhc oplliianl lor su.h pcrmir h filcn siln.d {xr.nf,nr rh,t hcor shc k liccnscd Puisu!trr
<br />h rhc F,vhi,,i\ .I rhc C.nhcnn s t-i.cn$d hw (Chaflcr L ComnrNins Bith Sccrion 7Ol)O ot Dilhn,n I of rhc susinc$ and
<br />Prorcssn,nsCodc)orrhnr hcorshc hcxcml lhcrcfromMd rhcbnsh tor lhcallcgcdci.nprn,n ilvt'ldionoiScclintr?o:ll5iy!try
<br />npJ,licenr lor a pcmir subjcch rie lpplicaor ro acililpcnolrroanor frncrhan nvc hundrcddouan (S5m).
<br />-1.r\owncrol'lhcpnrt^-.rlr.(trmycnDLoycc\wilh,,gcs(1lhctv,ldconl{tr\
<br />nnr. will do rh. Eo.k exl rhc ntrh n fr
<br />inr. ldl oroltidd for sld rS(7(N4. ausirc\srtrd Pmlc$ioisCltc: Thc Conrridois l-i.cnsc hs Jo.\ oramlrrornotrncrol'
<br />rhc pmncny who huilds or i.ll0mEs lhcG,n- rnd who d{Es slch $r( himsclfor hckll.r rhiox8h ht or hcr own cnDk,y.dc.
<br />nRrvidcd rnrr \u.h imp(,vemn6 m ton inrc cd oroffcrcJ fir w'lc ll horcvcr rhr h^rildir8.r inl|nrvcm isddsirh',,nritrr
<br />olonrrlclnn- Ihc Owncr Burtls oitl hr$ rh. htrtrlcn olpoi"B rh0r h. o' shc did nor huild or imnfttrt rhc PmFny rbr rtE Ptrrln{ol
<br />I. rs osn.! ol rhc FDdy, tr r cr.lu\ ircly .ontr.rirg wilh li.ctrrd .onrricioG lo sn\rtucr rh. prcFcr ( Sd 7()44. 8urircs
<br />nl Fhfc$iotr codc l hc ConrEdor's l,ic.nsc l.a$ .locs mr !!ply t, rn o*ncr or rrop.d y sho huildr or inrprov$ rhcrcon,
<br />rnd who rontract for su.hpma.rswirhi conimdonsl li.ctrs.d 0ursuanl lo lhc a)ntuch r l-ic.n\c ljw).
<br />I rnrlrn,fl nndcr S.rrt)
<br />D6le: Orn€r
<br />WORKT'I{vCONTPIJNSA-ION
<br />IrICLISAIIQN
<br />I hcrcby amrnrnd.r Fn.lry ol pcrjury om ollhc folloEiry dcclnrlnins:
<br />-lhlvclndwillmlinrain.Ccnifi.dcofconsnrt,sclfl'r\otuntrw.rkcdcoflrDcnsri{,n.aspn,eidcdfttrtysccrion:t70oolrh.I jnor Cfrlc. l'or lhc pcrlormancc o, rhc soA for *hich rhc pcro,ir is t\u.d.
<br />Ih vc ndsill'nni' nin *urk.ri .on[.ns[i insuritr.c.r\ rcqntcih,S.cri{n1.]?(nofrhcljhor(bdc.inrrhcPcrt mrmcot
<br />'h.tr,rrI{trhrlrh'.mnn r.'skil AI\trt{lorcon'F1L'r'.n'.\u,'r.t'nqrJ{F,l.'}tru'n&rr.
<br />cJtrtrr Mrdwest cish lhs
<br />**.,^".u" BfilU l{C4Lt4D1?l.ll.l't
<br />_lccnilyrl[ri',rhcpcnniiu'r.ofrhc*.rkturwh(hrhnp.rnrirssqrcd.I\tullnorcn]pbyrnypcHhnrryDMncr
<br />s, a\ ro trcotrr suhjr\r !o rhc so,kcF ompcnllrn,n h$s or C{lirbni{ Md rEft. rh,r ir I th,uld tEii.E suhi.r lorl*
<br />uorlcr.onpcnr.lionpmvi\ion\oisccrionlTmollhclihnCodc.l\hrlltudhsi'h..nrdywirhrhosrrovhions
<br />WARNING: Iraihre t' $.u( wo*c* .omp.nrnrbn.ovcasc i! nrhwful. ind shnll luhFrr Ji c {lotcr ro riainrl ltnahies rnd
<br />civil finc\ un (, otu hrndrcd rh.u\r dollt\ ($l(X).rxx)). in ll(ldi , rhc co{ ol c.nlrnsdrn,r. dnrmlcs 0s arnvntd ,or thc
<br />Sc.ri,r.ll)76ofrhr I rhtr(irlc. ir crcqrMr onrr'\icc\+'2.t0
<br />l)ll( I ,\R \'l I()N
<br />I hticb, rrm und.r r.mlryolp..jurr lhal I nn liLrn$t undcr tnvhnnr oIChpr.r 9 (.on'ftrcr8 with Scdhn 70(U ofrrilnion l
<br />of rhc B!si.c!slnd Pmfc\shncCod., Md my li.cnsc s in tullfor.r{ndcils,
<br />B I oo4
<br />?z.l6 P-4*atuol
<br />TaNSIBIJcII()NIINI2INCTICENIJ
<br />I hcrcbydrfiflnuNlcr pcnnltyolpcrjurylhtrllhcrc n!$nsrndnn bndinsisci.y n
<br />'hcl,cr,i)trrunccotrhcwo,kforshichrhi\tfnnir
<br />6
<br />\\dcd (S.c 1097.Cir { i
<br />AITUCANLIECIAEAUAN
<br />I My,iinn und.r Fn0lry olp.rjuryotrc ofihc lollowinS dccl0rfllion\:
<br />Dcmolirion Pcrnrirs A\bcdorNoriicaribi F.dfial Rceul.tt,nr(Till..U).Pd6)
<br />-Rcqtircd
<br />Lrricr of Norifi cark)n
<br />l.crril_vrhri lhc fcdcr.l rcEnhli,)ns rcgr in! a\t{dosrcnr)vrlrrr n.rrttli.nhlct) rhs Poiccr
<br />lhovc mcnriord prot.ny lar ins!.cri('n ,drr,\c\
<br />lDplicrnl.r A,lrnl Si!nnlurc
<br />rcl AaaS
<br />v -L.to
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />Sublloor/Vent/l nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Eneroy
<br />Drywall
<br />Ext./lnt. Lalh
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />FINAL '6( 1,49 >48{
<br />Certilicate ol Occupancy
<br />Notes, Remarks, Etc.
<br />UFER Ground
<br />T-Bar
<br />Flood Zone Certil.
<br />I*nd.r's dJn s
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