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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE IDiSIG.OWNER ATIIT,DFJR D!]I,CARA I0N
<br />I hcrcby.rfirm und.r pcndry or Frjury rhar I d cxchpr r6n rh. G,.td.to^ Licctrs bq lor lhc hllo*iu rcr$n (5(7011.5
<br />l,usinc$ rlt Profc$ion Codc): Any Ciry or Cou.ty whi.h rllluncs r pcrnrir r,' consrrucl. lltcr. improvc. dcmni\h or rcprn sny
<br />srdcrurc. pri(trro irs i$uatuc. lho rcqun srh.Erlicsnr lor s'ch pcrnrir ro filc ! si!tr.d irrcnf,nr rhd h.or shc ir li.cnscd nunDanr
<br />to rhc pmvisiotrs of lhc Codmctol\ Liccnscd L.w (Chanr.r g. Conrncncing wilh Scctn TuD ol Divnion.l ollhe Businc$ and
<br />PDttrsion{ Co.lc)or lhlr lrorshc ncicmpr rncationund rhcbacis iorlhc trllcscd crenpriun Anyviol ionors*ri,n70.ll.shyany
<br />!ntli.nnrf(rrFrnrirsubjc.rsthcntrlicarriorcivilrcnrlryofnorrmrcrhrnllvchundE{dolles(150O)
<br />-1.0!o$ncroilhel[,Ilcny..!nr,r'npk,yecssirhtru8c\rslhcirq,Lcompcn\rrtnrwilldorhcworka,
<br />rtE(turmisnor
<br />ticndcd or ofiarrl fir {lc (S( 7l}llt, Bu\in$\ and Pn]fc\\i{,ns Gxlc: Thc c(,nr .r.r'r l-i.cnsc bw docs nor.!ply ro rn owrcr ol
<br />(hc pmpcdy *ho blilds or impmr.s rirNn. dNhodocssu.hworkhi'nscllorhcr\clforrhmu8hht.rhcrownc 't'loyc.s.
<br />of.onflcrion, rhr Own.r Buildd rillhaR rh. hdcnolF'ving rhr lf,ornr dx] nor huild or nryovc lhc pmpcny lhr rhc pu.F)E ol
<br />Ln\osDcrofrhcp'o|[ny.rmcr.tusivcly.okr.ri,rswirhli.c\.dcofituttr\h.onerudrhclojccrrscc7lu.l.Bunnc\\
<br />and hrri\\irCodc:rhcCo.r!!.r.isLiccnrl.nwdocsm'nnDlyr.rtrosncrotnropcnyshobuildsorinpdvc\rh*con,
<br />rid who conrncrs fn skh !n+d \ trirh r C.nhc()n n li.cnrd nu^unnr h rhc C.trtr.ttr\ Licns. Las )
<br />I mrcxcn,tn uidcr Scdtrni .ll & PC hr rhi\ rcrsnr
<br />Drr.: oPner:
<br />WOXXI RS' C.MIF'YSATX)N
<br />DI:I:II&IIION
<br />I lrrhyaflln undcr f Mlry ol Nrltrry orc nl rhc ldlos irE d(ldr rnrN
<br />*lhnvc{rl*illnri,rir0Ccnrllc0rcolConsntroScll-ln.urehrsorkcr'comncnsrrion.!sprcvidcdlohys.crbnlT00orrhc
<br />tj}ix Codc. l'or rhc pcrfonnmccolrhc $or* lorphichlhc lcnnit is h$cd.
<br />I hlve and will mainkin *orlr.ra comJ,.n{rrbh in rarc. ar requt d by S.dn,n lTtD or rhc tjbor Codc. lor lhc Frlolnnrc of
<br />rhc wort tor whichrhnrcmir i\ iifl.d, MywDrkqs m.Dcnrarionin Btuc .mifi ad r.li.y nun$cr m:
<br />caricr:
<br />^\
<br />/.
<br />A1) y) - rz6.'(-t
<br />I cdityrhrr in rhc p.rlnnuncc ofrhc*ork f{tr *hich rhi\ pcrn,ir n i\\ocd. I\hrllnor c pk,!.trypcrsotr ir 0ny nraDNr
<br />i, Nri b.ortr subjc.r lr)rhc soltt.n'conrNrr im lrw\ ol Calrronrir rtr(l 33Nc rnlr il I $oukl lf,co'N \uhjc.r n, rht
<br />workd\.onrFnsntnnrUovisionsorScdi.n:1?lx)ollhctrtrtrCodc.lshxll.rinrlNirh.on,dywirhrho*!ovisi(nr\
<br />WARNIN(i: t.nihrc b *.urc *orkd^ cotrrtrtr\r.oi .ovrrrlc i\ unldqful. rtr{l \h.ll srht d !n cNphycr to dnrinrl pcnxhi.\ md
<br />.\' r 1,. ,ti ' i.r. ri tr.l.,l 'l
<br />.r.,.'ilJi'rtr. (li".i 'i:2o rhc.o{ olc.nr|ttrsirion. nama!.s ar prcrntcd nn lhc
<br />Srcritn 10T6olrhc l]htr (ido. i'rrrr{ r a xnonicy \
<br />S - 72 I v
<br />of lhc Busircss and Pmlcssions Codc. aod m, ltcne is nr tull for€c ud cflcl
<br />a-- ( t/1qo g bs -7
<br />I hcr.6y rlli'nr ntlcr pcnrlry of p.rJUrt rhrr r,ur ir r mnnrdi,n lcn{ling r!.ict nt rhc lrnonr[tcc.lrh. *.rk liir *hi.h rhi\ p.rmir is
<br />i\{krl isd. 1r)i)7 civ ('r
<br />APzuCANLDIS,A8AI,IQ!
<br />I hrby dlinn undcr pcntrlty ofp.!dry oic otrhd n,lLsnr! drclarnrnnr\:
<br />l)cnnniion Pcrnrils Astc\los Norilicrrn lidcrrl Rcgul"rion\ ('Iirl. 40. Prn6)
<br />_R.Yluir.d krr.r ol Norifkrri0n
<br />I.dtli rlrrrhc la\tc'nlrclnldi.n\ rc9ft1tr! rshcso\r.Nnrldc nolllpllicrhlc ro rhis prctc.r
<br />_l.cniiyrhrrlhrvcrcanrhi\rppl'raii,)n3rxl{rrcrh3irlrrh)r.lnlnnnJrtrnn.otrNrl.grNro.onunysirholl(itya.dCoutrry
<br />ordinrmcs rnd Srlrc ljws rclaring nr huildi+ con{fldnni. nl h.rchrnurli*izc rrl,rc{.r.rivc\ olrhis Cily ard Counlr ro cnr.r uFn, ihc
<br />oh.rc rmn.trrrd rtun rry I'r rn,nc.ri,.n ruqr{.;;;;;;;'.-:.:' ^ . +
<br />P.m,ensme,prin,. EJ' k
<br />Set Backs
<br />FormsiSteel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Rool Sheathinq
<br />Shear Wall
<br />Framing
<br />lnsulation/E nergy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />l\rlaso n ry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certil.
<br />FINAL 6/1,f,,t/{ .d '1171
<br />Certif icate of Occu n
<br />Notes, Remarks, Etc
<br />COMMENTS
<br />o*" (-11- lk coor.*r..
<br />Lcndcis Addrc$:
<br />-
<br />Subf loor/VenVl nsulation
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