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BUILDING. INSPECTOR RECORD
<br />SITE-WOHK IDiSIG.COMMENTS 01!NER BUILDER I'ELCAI!\TION
<br />I hr.hy rfllrn undcr l.hlr, or pcrjrr, rhri I n g.mpr imm rhc Conrracror' t,iccnsc lf,* lor rhc r{,lk,sin8 rN)n (s..70.11 5
<br />Burincss lnd Pdlssio' Colc) Any Cily or counry whi.h nquncr a Ff,i b .ondflcr. alr.r. inl)k)v.. dcrrelirh or rcl[n dy
<br />nrurrrrc. pri, lo ih issuune.oho rcquncs lhc apdicanr rr su.hrrnnil ro rlc, siSncd shrcmnl ll[rhcor shc h liccn$cd nnruanl
<br />ro rhc provkiotrr of*r Conra.lor'i Lietr{d ljw lchrrr.r 9. Co'n rncing airh S.dion TUX] .f Divki.n I ofrhc Bn(im$ nnd
<br />Polcsions Codc) or thal hcor shc ncrcmrr
<br />'hercfnnind
<br />lhc hnsh hr rhcnlle8cdcxcDprion. AnyviolarionolSccrirtr?0.ll.5hyany
<br />q'tlicanrr.rapunirsubjehrh.,mlican'|oacivillcnlllyolnormorcrhlnlivchund.cddollus(S50o)
<br />-1..s
<br />o$rcrol'lh. pmpcny. or my cnrplortr\ wirh wrg.s ds thcn $l..omFcn$tnrn. will d. ihc work drd lnc slrElnrc n frn
<br />inr.dni or.frcrcd for slc lsa ?o.lJ, Busim* lnd l,rofc$tuns Cdc Thc Contr.ror's Li..n* La* doc\ nor +tly b 0n oqkrol
<br />rhcprcpcdy who t uilds or imlrorcs rlE on, !d who d@s \uch w* hims.llo. hcrrltor rhrough hi\ or hcr own cmtbyccl.
<br />Iruvidcd lhar such inDmEmtrlsemt i.lcnd.t or.rcrJ forsb llh.*cvcr. rhchoildin8.r irrlormnl k sokl wir[ir' nnc tclr
<br />orconrl,Lrbn. rhc Owtur auikio *ill t!!. rtr hurd.n olrmviry rhlt tc or shc did.or tn'ild or i.rpmE rhc pd,rcny rd rhc purF,ror
<br />_l.rro*nerolrhcpropcny.tuncxclusilclyconrtucriryqirhli.ctr{d.onkrcrosrocon(rucrrhcIrolcd(Sc.7041-Btrlncs
<br />md Pi'fc{skr Cod.: Th. Co.krckx i Li.cn\. Lru docs nor lpplI b an own( otlrop.ny who l,uild\ or imtntrrs rhcmon,
<br />rtrd sho conrads lnr su.h lmj.crs wnh, Co.rnckn(, lk.n{d nursnnr tu rh. Conk.ct, s Licnsc taw)
<br />-l
<br />un crcnDI uods Sd ion- a & P.C. nx rhis rclson
<br />Drler Owncrl
<br />]IABXEBS]I:OMITNTAIIQ!
<br />DI'I:IA&IIION
<br />I turch!rrtu'nu s pctrrlryoipcrjuryom or lhc hll(,+inr dc[rlriotrs:
<br />lhrvc itsilln n inr(cnifi.rrrofcon\.nrhScl,lrNtrrclinsork.rrconD.nsrri,ni.rs ptuvidc turbySccr nlrrx)rlrhc
<br />I r'ltr C{ic- fir rhc p.rtumaocc olrn. Nor[ rhr $hich rhc rcm]r n i$ucd
<br />lhrv.rtrdrillnhinrnnrao*cr!conlF.nsrri.ii'rurancc.asrcqtrire{lhrSccri(rl7lx)olrhcUborCid..I rhc|{rhnn .col
<br />Ih.LV.rkli,rtrlri.hrhi\,rnn,(^sucdMyuoik.^'.onfctr\dtnrnr\urnn.c.rn'crafrlNli.ynurbcrrc
<br />I ccrtifyrhtrr rn rhc rcrLi,un.c ofrhc w.rk tor whi.h rhi\ pcrhir i\ i\rrd. I shrllnot cnlPloy rny Dcsotr ir ony nrtrrcr
<br />w, d !o trcom suhid ro rhc rorter' ompcns ion hss .i Crriiomn. 0nd l8rcc lh if I \lxruld &sm subjcd hrh.
<br />workers compcnsdion prolhions ofSccrion 3700ofrhc l,atior (.ic.l rlBll. lonh*irh mmnly wirh rho{ pmvisionr
<br />WARNING F,ilurc kr h-..urc workcs comFnsarnnr .ovcagc i\ unlawrul. and shJl {rbjcl rtr cmploycr lo aiminllocMllts a
<br />.ivil fincs u! iJ .rc hundrcd thousand doll|* ($|fi).({x)), imddirion t, rhc .o{ ol.ompcnqtion. drnnScs rs Fvidcd lnr rhc
<br />Scctiotr 1076 ofrhc tjhor G r,irler.sMd orfty'\ fe\
<br />D.rcr Applidn!:
<br />LICFNSED.I}N NACTOR
<br />DIS.AAAIION
<br />I hcrch!dfir uid.r lcnrlrtnfp.lury rhr Iro li.di*d un,lI pmvisi.n ofChrnrcr 9(..nnmn.in! wkh S(rbn TUDlolDNiion l
<br />ol lhc Busincs md Polcsions Codc. and
<br />'ny
<br />liccnrc h ir tulr fM.c ffil crccr
<br />coNslau(IraNtElDlaclc[Nct
<br />I hcrcb! sllim uMcr lEn,llyofncrjury lhal thcrc $ d on(fl.tirn lc.dir8.8cn.y tor Itu |Erformrcc oithc wo.k rhr *hich rhn Fnnir is
<br />hrucd(Sc..l{197. Civ. C )
<br />A.BELICAILDICLIAAUA!
<br />I hcrcfi,lnimundcr n ulryoln riury onc olrhc r'ollo*ins dcclitilionr
<br />D.mlili()n Pcnnih'Astrsros Nolific.lion f{dcnl RcSuhnrns (Ttld,1O. Prn6)
<br />-Rcquncd
<br />bllcr of Notifi crlion
<br />lccnil,vrh r rhclc{lfrulrrlrlari.n\ rc8rdi'rsr\tf,!os'.nn,vrlrr. n.i ff!icrhld trrhis nx) (
<br />-l.cnily
<br />lh{l I tutrc rc0d tht apflic,rim and (ntc thar IIE rbvc inlormridr ircorNt. I rsrc h.onrrly wnh ull Cnrund Coliry
<br />ordinrnccs ond S!0rc Law! rclorins !!-huildin8 con{ruflhn..nl hcrchyiutb.nc rcprcsntdivcs olrht Cilyand Counry ro corcr uF,n rhc
<br />Gd,.n .$nar-A - /',
<br />n,,ru.^*nr ,*-,"(z:11ffi ** z:zL-(6
<br />*^,*****,.///ltho./ G;/l,a-.- I
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/Vent/lnsulation
<br />Roof Sheathinq
<br />lnsulation/Ene rgy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lvlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />FINAL 6-2,/-20 lL0s /t/rzo3-1ry
<br />Certificate of 0ccu pancy
<br />Notes Remarks, Etc
<br />DATE
<br />Shear Wall
<br />Framinq
<br />Flood Zone Certif .
<br />i 'rcr\r ( lx$ I i..D\r NLnL(.
<br />Dtrr.
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