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BUILDING- INSPECTOR RECORD
<br />IDiSIG.COMMENTSDATESITE-WORK
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />{ /,e',,Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf looriVenVlnsulation
<br />Rool Sheathi
<br />Shear Wall
<br />Fram i
<br />lnsulation/Ene
<br />wallD
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonr
<br />Pool Fence
<br />Handica R
<br />Final ReDe rtU
<br />rtEnineer Final Re
<br />Flood Zone Certit
<br />FINAL
<br />Certilicate of Occu anc
<br />Notes Remarks
<br />ot!Nllli Bt'll-l)llR lrEl,crR
<br />l lErchy .llirm unicr rcndiy ot Pc.jury rhar l Mr crcn tun rhc Contacbn l,icen{ ljw lor rhc nnloqins rea$h (Scc'?{)ll 5
<br />Burinc\r arkl Pn,ft$n,n Colc) Any Ciry or Counry whrh eqnrcs x t,.m h connrucl' !lle! imtrorc deholrh or rcIlIt 'ny
<br />sldcrurc,pri,rdnessufrc.sorcqui,csrh..rplicanlrbr\uchtf,lmrolikrsdncddarc'ftthh'oishcisli'{n{dI'Urs'anr
<br />b rhc pu*Fons .f rlE ConrBcrors Lienscd Lxq (Chlprcr 9. clnhnrn.rs wnh Sarbo 7000 tl Dtvton :l of lh' Br\i*$ 'nJ
<br />PoL\soNCo,jc)orrhdhcorshcN.rcnflrhcrctlodandrhchds\turrhtallcSc'lcrcmFonAnvviol'rioooiSccrionT0''l5hvanv
<br />{'tlE!nr ltr r pcrn srl,jc.k rhc rmli.rnr b a civil lfnllrv ol nor lnorc rh nv. hunJEd nollds ($5OO)'
<br />L as owkr oi lhc lnrFny, or nry .nlloyes wilh ,rs8 $ rh.tr $lc .ohP.nsd ir)n. * l do rhc wo* *rl
<br />'tE
<br />(ulF { nr
<br />i,r-,r.r "."n"^l r*.oLlS-704!, Busircs ind Pnrfcsions C{ricr Thc Cro a.ttr's Ltcnsc lie des nor aplly lo !n o*ncr ot
<br />rhc pn)pcdy wh! ta'ilds or ihprovcs rhcE,h, ,Jil whr ics \uch k),* hinscll or hcncll or rlnruth hh or hcr d*n cmll'yccs'
<br />6,i ,r rir .,.L iminiwrrcds d nr inhnd.rl o ol].rc! nr elc ll. lNw'rt. rh' builtnls or in{nrcmnl ii $L] wirhin 'nc r"r
<br />;,onphron, tlEOwmr sullcr *iI havc llE bulcn ot Pmvin8 lh.r tr ot rhc d! Bn hu tIt in{mt rhc p$Irnv for rh' !uqr{ or
<br />-L
<br />as owncr or rh PNPcny, rn crchnrvcly contr.tltr! wirh liccnscd uonrr nn h onnnd rrr PoF_t (Scc 7044 Businc$
<br />Pucsru C"4., i l,c conrratn*'\ Li.cnsc l,!w Jt*.or nl)plv b rnowrc! olPorcrlv who hxilds or imPovca lhcrcon'
<br />ind who conhcB nn such Foj.ch wirh r Conka.n(, li..n\cd purusr b rhc Conlractr's Liicnsc l-aw)
<br />I amclchfl rndcr Sc.r
<br />IIORKERS' CONTPENSATION
<br />DECLARATTON
<br />I h.rcby arfirn undcr p.n,lry ot pnjury om of ln. lbllowins dNliErk)nsl
<br />-Ihrv.{willminlainiCcdirrcdcolconsnrbsclllnsurctarwo*6rconp'nsarbna\a'ovi'lc'inthvsc'rionrTmofrhcbhor Cslc, for lne pd{o'mrc. ol rt m* lor vhnh rh. p.mir n issncd
<br />I hrvc aD,l w'llmrnrlaio w.rkcrs uomlcn\rron murinc., ri r.quEJ$yS..rtr)nl?OOofrhcl-rhotCt ' ntr rhe P'dnmrrn'c of
<br />dr w.rI nr *h'(h r]n\ |t'trrr ,\ry2'1q'Zr trr rnsunnc. dnicr !n,l FI'CY num 'Y"s cr^(t-,(t"i C DV
<br />I r.dily rh[ in lhc Erftrnrncc ol rlE work tur wh'chrhRlt.rnnr '. '\sucd,l shrll norcqnoy anyl]cron 'nr v DanNr
<br />\o as h be(rft bj.d ro ihc wotlcn' conPcn\arn,n bus or Cirtu,n s, ann.grc rhar il I {tJuld hcuoE {hl.d nr rh.
<br />wo*cn uonpcn!$on pnvtions ol Sccr io! ]700 of thc Lin, Grlc.t \hnu. tunhwdhd,mnly qilh lln * ltuvti,ns.
<br />WARNI\(i lii'|tr'. !) \((rn' No'k.'\ roDrFtr\rrnr .ordrlc | trnlawtul, Md shau sultiul rn c.Ploycr h (]ainllFoahal md
<br />.ivrl l,ncs up b dn. hundrcd lhousiD.t douan ($l0!,uxl). n' J i(r lo rhc co\i of.onlf,nsrlDn. drnMlcs
<br />Sc.rnr roTa.lrh.l-rtrtr (i!lc. nn. r.trtrt->-lq
<br />l)l:( l.It,\1()N
<br />.r 9 (Nmektrr wilh Secri,n ?000) orDivNnrn 3I h.ftby ilrmr uftlf Pcn.llyol P.rjuiy rhd I an I'dntd otrdcr tl,vi{dn or Ch'3pr
<br />ol rhc Bu<incssa Pn,li$io,s O c. anl myliccnic t in tull ir(c aftl c,1tcr
<br />-12 I 4o\sq
<br />$NiI8IIEII9ILLDXPING.AI;ENCI
<br />r hcrcby. th utut.r JEnatry df rrrjury rtrar r*o r a mnsrruii,n L.Ji,s rs.ncy tar rhc Fnnrnr.trcc ol rh. *ork tur *hah rhis Fmit ir
<br />nru.d (Scc 109'7, Civ C.).
<br />I rnJa t $m'
<br />Lcndcas Adrltc$:
<br />ATTEANLDECIABAI,!9!
<br />I h.rcby all-m uid.i F*.nlry ot frjury on. ofrh. Lllowing Jn hr'rrn\:
<br />Dcml[nr t'rrfti$Asbc{os N.rili.rlbn FcJcnl R.SulrliqF ( Inlc'10, Pan6)
<br />R.,t,'tr..1 l..rd ol N.rLli.rf,{,
<br />I {nilyrhal rhe lcd(al rc-uhli,,ns rc8dd,n8 lshcnos rcfr'v.l!F nor rlTlrclhlc b rhis Pn+cr
<br />-t
<br />c.rlifythlr I h,tc r.&l rhisalpl
<br />orddranNs an'i Srarc uws rchriDs rd 'rxrrn d,l rrrrc rrrrlE alrn. 'nl,ti]rril)n N.o'rc.t. I rer( b c(rnDlv srh all Cnvrftl Coonrv
<br />condd.rn,n. { hcdhy ,ulhrne rclEscnlarilcr dt lhn Cnv Md Cou
<br />rhovc nrtrrkrnl nn)F'lY l,n
<br />a \l
<br />Appli. torA!€ntSixn.
<br />Lq7
<br />t?
<br />T-Bar
<br />Etc.
<br />e (,
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