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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNER B!II,DE[I DI'LCARATION
<br />I ha.by .mnn undd Fnalry of !.rju.y rhar I m .r.np( no,n rh. Co.lBLloR Licdsc l-as for lhc lollowi.g ra$n l s(.70] l t
<br />aosinBs .nd Proa6sion aod.) Any Cily o! ('ounty shich r.qut6 . p6nil to conslrucl- all6 inprov., d.rnolish or nP.t dv-
<br />sloctuc. pnor ro ns iss@ce. ako rcqurd rh. apphc.nt fN such Fflnn ro fi]. a siln.d {ahd th.l n or sl'c G li.osld p!^uant
<br />lo ihc prolisioN oflhc (ontactors l,iccns.d Law lchapl€r 9. Commcncins r h s*iion 7000 ol Division I oflh. Busin.s ed
<br />PreGsions Codc) or rhar h. or sh. t .&fr rh6.Fom and rhc hais for rh. all.g.d.rmplion Anyvioktionols€dion70ll.5byary
<br />apphc. lor ap.f,nir subj(hrh. dppli..nt to a.ivilp..altt.l.or morcihd fiv. hundr.ddollaAit500).
<br />.&i(, a\ smr orrh. roFny. or my dnplorc wilh wasB s rhdr elc compdsarn,n. \rrl &r rhc rort dd rh. sMlm is nor
<br />intdded oroll( d for el.1s6.704,r. Busin6 Md Prurssn,N C.d. thc Grnradois t.i.o* lrtr 1106 nor aPply lo an osr6 ol
<br />rh. fmfEr) \vho bull.Ie or im,N€ rne,n. ed qho doe su(h (oi( himsclfor h(s.lfor lh'ough his or hd osn.mplo,.6.
<br />provid.i thar such i,npmvcn ns e mt imod.n or olTod for el. I t notr 6'6. rfic toildin! or iqroronflr is $ld *iihin on. ,a
<br />orcomphnr thc O"rd Buildo *ill ha\. $. &rd6 olFovins rhd h. or sh. did 'Ft hrild or impro\ c thc pmpqly lor lh. lntrIre oa
<br />L {s.sndolrhrln,pdr, dner.lusn.ly.onracrin! unh li.ms.J..nlr.cro,sro consrru.l rhc projd (s* 70.14, aBlndr
<br />alld h!t6si'n aode l.ll. Conlraclors l.iccnsc Latr do6 nor applr. kr m f\'.s o r lrotd y r ho huilds or inlpro\ cs thsFn-
<br />and \ho..nt..cfn3u.hprejRrs\virha(n.hdonrlicns.nptrBudlolhc(i,ntracloisl.icds.l-!$)
<br />I an€r.,npl und6 Sdlion . B. & P.C. for rhis 16..
<br />b", 8'-2?.:/q o^*" -92^/ Hrt<:e L-
<br />$oRKLRS'COITPE SAIION
<br />DECIdBAUA!
<br />I hd.br.illnn ondd Fnahy ol pajury onc oi lhc lollowiry d(lenlio.s:
<br />I h.v. aid will n.int!t! a C.dificsrc of CoMl ro ScltlBurc for wort6 comldelnrn, d irdidld tor b, Sdion 1700 of rh.
<br />t bor Codc. for th. p6aomMc. of thc sodr for which th. ponil is isslcd
<br />lhareand NiLlnrainlain Norl.rs con,p.nslfon iisurance. a\ r€qutd hr s(ti.n rTlr(roarh. t..bor (.o,l€. forlhe lrroman.cor
<br />rh. \ork fir\hichrhs lcnn ,s issu.d My q orlEr .o'nFns^ri,,n insdan...adi6 md poli.} trunrberuc,
<br />ZU (enify rhal inlhc Fformarce oflhc *ut for shich lhis p.nnn is irstred. t shallnor ontlo) an! l.6on in any mannq
<br />$ as ro b.(on. sbrd lo rhe Nork6' co,npd3lron la\ s of Crlitumir. .nd rlrc lh ilj snotrU tE omcsubjEl k lh.
<br />\eorr6l .omp.ns ionrovisioaofs<rio.700.frh.t-.htrCod..lshall.fonh\ithcomply\rithlhosprorisioB a
<br />WARNIN(;: Failurc ro HUr. sorkds compoelion covBasc is trnla\ful. and shall ruhi(l tn .nployd ro 6imi.al p.naltis and
<br />.i!il fin.s trtl ro o.. hudred thousand dolltrs ($100.000). in .ddnion to thc cost !r c.mr.nsrnrn, dant8.s a Prcvid.d for lhc
<br />s(ri..1076 of'h. t-ah.r ( odc inldd and atlomcr's t6
<br />2-2e-/ c/,-*, .€2o/ 74ct1z?/..
<br />I(:ENSIII-CONIBACIAA
<br />DECIASAIIA!
<br />I h@by arrn trnds p.n.lrt oi pdjury lhal I dn licdsdl undd rrorision olChapr6 9 (conmdcing $irh sdion 70m)olDivision l
<br />of the Busin* and Prcf*ions Cod., ard h, li..E. ii i6 aull aor.. md .ital.
<br />(AISIA!!I]O[!E!D!!Cr!C!:!!!
<br />I hd.t! alIL n cr lmalrrofpsjr'r- rhartho!s! (onslruclntr lendin!.!.tr.r lor rh.tElonnnnceollhe\o* li{sh'chlhrrrnd a
<br />*slrdlS.( rol)?, ( '\ ( )
<br />ASTIICANLDITIABAIIA!
<br />lhs*r'afimu.dcr pdalry olt.rjury on. olrh. followinS d{lfalions
<br />Demolirion Ihirs-Asb6ros Norifi carion F.dr.l Rcsularions (Tirl..l0. Pad6l
<br />R.quiEd I €1r6 of Nori6carion
<br />l.6iify rh.l rhc lcdcral rcxulations Esgdinr 6b6tos rqoval arc ior aptlicabl. b rhi! tmjd
<br />A, cdily rhar l h.\. rcad rhis aprlicarion a'd sral. rhal rh. atFve rnronnamn is .on..r I agra lo comply \ h alr ( iry and C.unty
<br />ordina.c6 ed Srar. hss El.rins to buildins connrudion. sd hscby surh(rl'. rcpr&rarir* ofrhis Cny ed Cou y to dl6 uFn lhc
<br />abo!. ndrional pmp.ny for iBp.dion purFc6.
<br />Apprionr or.isdr sicnirurc Qe./ fl,/Z^CA</a
<br />Pedhe n.n,e (prrri): 22E"1 rlA Cedd
<br />r>*",3-11<>-,/7
<br />Set Backs q- tl- t9 A<rtl tz'
<br />Forms/Sleel/Holdowns q -t, -ti N9/9 ,t 3
<br />Erection Pads
<br />UFER Ground q-E-tt kt,o /a,
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathing
<br />/t- ?-t -t Nrdlo,
<br />/o-74 -t9 t=h?lot
<br />Shear Wall /c -?/- l g
<br />Framing t-< - lq lYlrtl to,
<br />lnsulation/Energy )/ - 2-lQ1 N-.1ry^t
<br />Drywall /t- tt-t q
<br />Ext./lnt. Lath /6.24 - tq ,e5r<+ lo,
<br />Brown Coat
<br />lt4asonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />-n-off- €a.aar.l-4r R-r.r-11
<br />9LaLJ.-L\\ C,,b.-tl-"f- |I qt('' ,94
<br />FINAL t2-t4-l?
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
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