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BUILDING. INSPECTOB RECORD
<br />SITE-WORK ID/SIG.COMMENTS o\rNrR nr n r)raR l)t:1.( ,\RA l l()N
<br />I hcrchy rftun unicr pcndry or Frjuy rhar I $ cxc rtr lionr rhc Qnnrd.km Li..r$ Itrw for ric lolbw'n8 rcd$n rS" 7l):ll 5
<br />Busi,rc$ rnd Poic\\nnr codc) ADy Cirt or couNy which rcqut \ d Eanil t) ro {fl.r. rlrcr- ihlovc dcfldi\h 'r rcltin rnv
<br />{ntdur., priorro ir\ (rurncc. uho.cqrndsrhc rPnlicitrl iot soch,innirro nb J ngncd (iretrcnr rhdr hcor shc i\ liccnscd PU Urnr
<br />k' rh. Pn,v^n r\ ol rhc Contr.roa\ l-iccnscd l trs (Chrfl.r 9. C mtrlcici'rg qiih Sccrtnr 7{rx) It}iei\i{ f irhc Bn\iics\ rnd
<br />Prolcssion\Co,lcrorrhrrtr.rshch.rcnPrrhcrclionrtrdrltrhs\i\fothc!llcgcdcrcmtrionAavriohrirolSccrionTll:ll5hvnnv
<br />appli.r r f(tr r f.irnir e,hjcch rhc llflic.nlro u.irilPcnrlryolrornntcrhd fivc hundrcddoll r(l$5lI))
<br />l.r\o*ncrolrhc,rcllrly.ornryc,rl.iLtswilh*lsc\r\rh.irv,lc.onPcn\dir .Blldolhc{orkdrdrhe( rurci(mr
<br />inr.ndcd or orrrcd r; tt (SN ?r,.1.r. Busincss nnd Prrc\\on\ coJcr'lhc Qrdta.rois l.iccn\c l-xs docs nolrPllv i. rn o$Nrot
<br />rhc Frr.ny who In'ik\ or nnpi*cs rlErn- rid sho tlou\ ru.h w,rfi hnn(lfor hcrclior rhrongh hn or hcr own cmtl'vcc!'
<br />pn;nlcd rh i \u.h iqrrrmnG m nor imc cd oroittnd lir r lc lt lx,rcv.r. ihc hiklin8 or in|trltlcnrnr s v'8 sirhin onc lur
<br />;fconlndirn. lhc O$ncr Suikln *illluv. rl[ hnnlctr oiPtr'viry rhl lt or {E did tror hui[] or i'nDmrt ihc pn)Fnv tur rh' pur{r)t ol
<br />-l-
<br />i\ own r ol rhc |Io!.ny. rn' .x.hrnely conlrucr inA sirh hccnscd coftr.rom b .on(tucr rht |ni ircl lS$ 7Ol-1' lnrinrs
<br />and l,\-(,L(\iJn Codc:1hc ContNrof\ l-iccnsc l-ar du.\ nol rpfly k' M.wtr.t oinrcPcny qh(r buink or ii{trovcs lhcrcon.
<br />a qho cotrtrhf{trsuchpn)J.cr\ qih dC.Mrc(r(\) licc \c(t fur{'xni t"h.Conr{.loi\ I-icci* Irsl
<br />-lrmcr.nrpi
<br />ufldcr SNri{,n-. a &PC li).rhtrcrson
<br />ttrlr O*ner
<br />rvoRKEis, contPl.NsaTIoN
<br />I h/lyrrr mun,lc.prdtri.t *rn -.,r,* tu.*,r*[E**11*q
<br />Y I h,* ,,Ll *,ll nEr dJin " Cd 'fic c ol'Cotr{d n. scltlNurc lbr so' lcd ..mprnsot ion. a\ pmvilcd a'r bv sccr ior 3?u) o r rhc
<br />/uN_ c,.1. n, rr'" r"an,n,un\c r rhc null lur *hi\\ rhc Pc"n ir r.ucd
<br />I hrv. rnd willnninraih workcr{ comPtnsdion innmncc. as rcqun.dbvS.ciion.lT(X)ofrhcLlhorG'dc.lorthcl)crfonnrrccof
<br />..rri.. u tx)li.t nun {r r,.
<br />406/,o L- d?-a/-rtls/-a/ ,,rlc.\ I ?- 3r
<br />I ccnily rhrr in rh. P.rroirnamc ofrhc work lor Nhih rhi\ r.nnir i\ is\ucJ. I nrll nol cmPk't riy l'Nr in rn! nhtrncr
<br />v, trl(,b$drE Nbjccit, rhc so rkcm' co nDc n\ar ion liwsofcilili,nir' trd r!rccli lill shonld hcconr \ blcd lorhc
<br />wo c $trrpctrqr bn pn,vsons ol Sc.rion .lTm ol rhc L1lxtr C,xlc. l rltrll. fon h$irh co'nplv q ilh rhos Pr'visions
<br />WARNING I'rilurc io rcurc *1 fi c.r[cnsarid, covcnu{ is unh*tu]. rnd $rll su6jccr i c'nplorr h di riDrl Fnrlric\ rn
<br />.'r'l ltr,rsu.n,onchu r.d rhousrtrd ull \ lSluo.lllj). irr rddirnnt ro rhc ca{ .f conlp..sr ion. dr'tugcs as Pr'lidcd n' rhc
<br />s(1u,1 n,76 ur,hc lrh^tr. t1!. .r"r
<br />",,1
<br />u,"L" rl'.
<br />,,,,". ?5-2pfi ,*M----- - L.l!L SELrc!-IIdfjAA
<br />DECLAXtrI'IJN
<br />lhcrchyulliutrnd.rtcnrllyotpcrjfiyrhrl.mlienqlund.'lno\hionofChrprcr9(connrf,cnUwfhSLrrt'n7(xxr)'rl)irnion]
<br />ol rltr lr$ims od Prft\\.rrsCdnc. u{lrtli.td.. i\ ir inlLi(nr ki!&t\
<br />L,2
<br />2o/Y
<br />Ihcrciy lltrnnlcr pcnrlryoipcrlury rh3rrhcrc is u con{ru.rir hMrng !rhc pc.iontun.c ol rhc*ork for$iic[ rhis pcnnir i(
<br />'\e'.d rsd. lo9? Ci!. C )
<br />Lcr,tci\ AJd'c\\.
<br />-A.E&IEANLDICIASAIIO!
<br />I lFlby rrnn uftlcr |xnnlry.rliriury otrc oirhc rolk,wint d(hnliotrs:
<br />Dcnmlirn)tr Pcrr rrAih.(os Norili.athn I'.dcrulRcluld(flr (lirlc 40 Prd6)
<br />_Rcqrncd t.ncr olNorili$ri.n
<br />l.crrit-vrhll lhc icd$rl rcgulrri,,rs rc!mli'i3 iltii.r rcN)vxlxrc ror i,rl]i.trhld n' rlrn tnric.r
<br />l(.nilrrhi lhr\. 'crlr[is tnli.sr(n]a d nn, i\ coftc.l l !g.c t)o tni, Nirh rll Cirr" ttrd Cou v
<br />/.turr{nrirncsof rh^Cir) r rdC unrtk,crrcru|xrrlf,udtr'n r..\ ind Srxrd l x$\'.hrlrg ro hn'ldi,r!.,u
<br />rh{r Df,trrn{(ii Drrt,crry ntr i'r!l
<br />,\Dpliuni nr Arrn( sirMl"lJ 7- {-24'
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Sublloor/VenVl nsu lation
<br />Roof Sheathing 4/to ltx t ''.rwlb/*16-\-
<br />Shear Wall
<br />Framinq
<br />lnsu lation/Enerqy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lvlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif
<br />FINAL I ?/h l/.k #ztlrvl Hm
<br />Certilicate of Occupancy 'L' l vcE)-f. I L--
<br />Notes, Remarks, Etc.
<br />\
<br />DATE
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