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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS olvNuR BUTLDUR DUt,CARAl-t()N
<br />I hcrrhv nlI"n un.. p.trrlry ol l.rjury rhnr I n.rcmtr fn,nrMCo tr.ktri L$tr{ h}'ltr rhc lnll,,trirE rcavn, lsc. 7o.ll 5
<br />Bu\ircs r&l Pn tr{iotr Col.): Any Ciry .r Counly !hi.h rcquircr r t^-oir b .otr{tocr. rlrrr. nnp(r!u, do'ml6h .r r't,.'ir . ry
<br />N crurc, pritrir ir! i\sur d. rho rcqutr.\ rh. iptrli.rtrr tur rurh Nnnir ro iLr s8trcd {dcnrnr rhd hcorshr i\ lic.nsd prrurir
<br />lo ihc pmrisiotrs oi rhc Conlradols l,iccn\cd l,s (Ch{rc! 9. Comnrncins trirh s..rnr 7fin nr Divisi,'. .r of rhc llurirrcsl Mi
<br />Proli\\i.n!Cod.) orrhar heorshc i\.rchpr rhcrcliomrnd rhc hr\i\ lnrihr rllcg crcNlnnnr Anrvi(nrri,r.lSc.ri(nl7(r.ll5l,yrny
<br />rmlicrtrr turrpc'nnr subjc.rsrhc r!!lrdnrlo JcirilrcMlryolrcr no.th{n livc hu rclddlbsl55(x))
<br />-l-J\o$nc.ollfupmpcny.,xm!.mpl,,tcr\siih$trSc\x\rhcn(n..onrFn\nrio.willdorh.wurk
<br />d rlr nndm i\ mr
<br />trrctrdcd or olIL r cd tu qlc ( Sc 7ll4-4. Bu\irrs and Pnnasslotrs Conc Thc Co lclof\l-iccnseliwdocsmrapflyh ow $of
<br />rhc pmn ny who bnikh or i'nprorcs rhcErn. a *hod{f,s\uchsorthi'n\.llorhcrslrorrhn,ulhhi\orhcr.qncmflqrcs-
<br />of.u Dlcri,,n. ilr Owtd Buildcr *iU hdr rlr lad$ of |mrrr! rlhr lI or \hc dd n.r huild or ino.vc lhc tmpqly lor r,f Prtx)\c ol
<br />L rsoqrcrofrhc |nolrrry. nnrcxclrsnclycrnrcrin8 wirI li.cnsci co ru.ror\h coi{tocr rh.I(Uc.r lscc.7()4-]. Bustrcs\
<br />and tlnlssirtrCodc:l'hcConrrrcroisI-iccnscl-rrdoc\norrpplvn,rnosncrofl,()rcdyqhobuildsorinpi(nc\Ihcrcon.rnd whD.oirhcr\fitr\u.hrtujccr\$irhdcotrLr.hds)lttn\cdpu$urflr,rhcGnrrrcroisLicen\clrtr)
<br />I rr.rc Jn un&' Scrr
<br />Dole: osne.:
<br />w( )RKIRS', C(
<br />']\rPri\a^iiloiI2li!:L trug!
<br />I hcrchy r,Bnr undcr |[tulryoipcriury onc oirhc tuli)$]lr! rrcclirnriors:
<br />I htrlc dwill hnniirdCcdilicrrcolCon\cfrl.Scll.lrNrclnrtr.rkdi.onrNDvlior.!\!!)ridcdturhyS(hotr:17fl)olrhc
<br />L lir Codc. for rhc I[ form ncc ofrlt tork f.r whi.h rhr lrt. n is istrcd.
<br />rhc$ortiorNhichlhirrcrmirisisrucdMt$orkcrsc.nrpctr\rrnDin\dr"nc..rrr.rMNlrynuNb.ruc
<br />Iccni!lh.l iDrhcpcrhr trn.colllrcwork r'orshichlhtncrmil is h\ucJ.I \hrlln.rc,rloy ny l.rn,r inrtrynDnncr
<br />\o ro hcqim rhjccr x, rhc Norkm comFtr\rrion la$s ofCrliionrir, and rsto hd irl (h.ulJ bc.onE su$F_l h rh.
<br />qukcr' conrr.n\arion lr'visions ot Sccrian .1700 ol rhc ljiin Ant. I shf,ll lnnhqi(h .o rplt sirh
<br />'ho*
<br />p$vnionr
<br />IVARNIN(; FiilDrc ro $.ur. wolkc( .omFtrqlion. vcrn.lo is rDlrrlul. rnd {hullsut'}ccl rr cn,pl{,rs b LrrnflJ n mlrics rtrd
<br />rivil fi.r\ uO r, o c hutulrcd rhoDsrtrd dollrr ($lU).U)Or. nr ,'ddiri.n b rhc cosr ol conllcn\trrion, dlnrgcs rs Ptovidcd f.r rhc
<br />sc.riotr 1076 ol rhc utrtr Codc. inrcrcsllnd$orrcy\ ltcs
<br />Dole: Applletrl:
<br />LICFNSFI}..NTRACTOR
<br />DECI,AMIION
<br />I h.Ebyafirnrndcrpcn ryofpojuryrhdI lien*d undcr povisn r of Chrrlq 9 (co rmncing wirh Scct bn TIXXD .f Divisiotr .l
<br />of rhc Busirc$and Pmreasi.is Codc. sid nry li.c.ic i\ intullfn$uricff.c(.
<br />CoNSTRTICTIoN LFITDIN(: AG!'NCA
<br />I hcrch, ntlirnuMc! Enrlryoip.rjury lhrl rhcrc is..on(ructi,.lculing agcrcy lor rh. Fnanrun.. olrhc Rork fur whlch rhi\ r.tnril n
<br />issucd ls(.:1097.civ. c )
<br />AIIIICANLDICLAIAIIOA
<br />I M,y ntinn Dnd.r lEn,lryof prrjur, onc orrh. rollo$ ins.lalnErtu.s
<br />Ocmlilion Pcnirs Asbc(os Norilicariotr lrcdcral Rc8uhri,m Ilirlc,10. P!n6)
<br />-Rcqutcd
<br />tdlcr of Notificllion
<br />l.cd,lr-rhr rhclctlcrlrcguLi,riri \ n!rdi'igrslf,n,^'c r,vxlrr. ,I 11,Il1.rhlc r,i]n\ l]n,tccr
<br />-lccnilyrharIh!!crcldrhnonplicarn,nuld\rarcrhrrrhcrh)rci',tonuinri\.odc.rLBrNb.ondyqnh.llCnylndCoutrlyor.lininccsann Sr c t:rqsrurins t,l,!ildinscondrucrion, and hclcby rdhornc rqJrsc rtivcs ol rhis Cny inJ C.unry ro .nrcr ulx'n rh!
<br />$.v. nrnrioNd pft,tcdy for inslEtion purF s$
<br />/\plli$nl or AAoi siAnntur.
<br />I'ernril.u nnn!r (prirl):
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />/1-
<br />Rool Sheathinq 4//2/t, .ffir/
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />l\4aso n ry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />FINAL /tc//A E lr'l,LsrA-/t 11 _-..-
<br />Certif icate ol Occupancy /'-[
<br />Notes, Remarks , Etc.
<br />Set Backs
<br />UFER Ground
<br />Subf loor/Vent/l nsulatron
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