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BUILDING- INSPECTOH RECORD <br />SITE.WOBK tD/stG.COMMENTS OW\ER AI II DLR IJLL('AR TIo\ <br />I hcrcby annm undcr pcnaliyolFduiy rhd I nm cxcnlPr lirn rh. cnnucro^' Lrcnsc L1s 1.r rhc rollo"'ns rciLv,l (s(701r.5 <br />Businc$ lnd Prcfc\sioh cud.): Any City or Counly ehich rcquircs r Dcnn lo conso.r, trh.r. inDt.xc. d.mlish 'tr tnrn rnv <br />iflcruic. piiJr b irs issutrmc. lko Eqrit\ rhc {plicr.t ld such Frnrir ro lilc I \igncd stdcnrtrr thar hc.r rhc k licctrsd puruonr <br />nr rhc nmvisions of rhc contacrols Liccn\ed Lrs (Ch+rcr 9. crNnEncirs sirh S.cri(,n TIxx) ol Divisiotr :l Df rh' Bncnr'\ 3nd <br />Pdt$ionsCodc)or lhrl hcorshc is cxcnfl rhcrcrron Md rhc hosk nxrhd Jlcg.d.rcmllio. A.yvtarionolSccrionT0:ll5l,vrnv <br />applicnnr fu a r.rmir subic.hthc lpllicunrk, Dcivilrenrliyornor 'tutr rhrn fitc hundrd dollds ($500) <br />l. ns owEr of thc propcny, or nry .ndoyccs wilh wagcs rs lheir solL conP.nsarnnr, s ill do ltr wort ,rd ihc dnEtr is nrl <br />inrcndcn or ortircd n, sh (Se.?Lr1-4, lrusincss and Profcsions CGlc: Thc cbnlmcr(tri Liccn* lle docs trol rodv r, r( owncr or <br />rhcomn n, lho hurlds or i.npows rhc@n. aixi who des \u.h so (him*lforh.*rlrorrhrouBhhisorhcro*n.'nployccs. <br />prclidcd rhar such imrn,lc'rmr N nor n{cflLd n oliqcd tnr $E lL howdv.r. rlr hoiklinS or improlcftnr is sold wirhir olc }c!r <br />ol conrthrio.. rlE ONmr adud will hsrc ttE budcn offlovir8 rhd hc or shc did Rn hoi[ or inqmrc rh. PmFn, t,r rtu nlrF$ ol <br />nkr rh. Doirrr rs.. 7(lrJ. rn^inrsl. is uwrcrol'lhc prrcny. !rd.lu\ivcly.onr <br />and tn,icsin,Codc: rhc Co r r{'s Liccfsc l-xw y trho build\ r imtrtrc\ rhc'$ <br />t,lira .,",,".x-\ <br />I hcR.ht xlfi" urdd ,cfihy of I{Dui y or ofrhc rolhwi'r! dcrldrrioN <br />Ih.v.d williuir.inrCcnificareofcon*nrbSulfl \ur.lin*orkcn.o'nNnsdi.n..s ProvidedLrhySerbiS?00ollhc <br />lju,C{xlc.turrh.J).rfonmnccof rhcwork lorshichrhct nn i\n\ucd <br />lhrvc M silln[inrain *orkcri c.n]|f,tr{ri, irsurrrcc. $ r.qbtrd hySc.rFn l7(x)olih l-rborCudc.lar lhcOrnm ''i:r'r <br />rhc work L.wnichrhi\ pcnnir i\ $nidl Myworicr conDcnsari{,, i'rur ftrcrricrrDd F'li.y nunlb.r rcl <br />PoliryNunr6.r:- <br />l.cnilirhlr irrhc n.rtunni.cofrhc sork hr *hirI r[i\ p.nni i\ nwl <br />v' x\n'h.co f, lubj..r rolhc sorkcrr co'npctr\ ni Uw\.fCtlittrtrir. rn(lxg <br />, \hrll nor cq)loy dt t tron in onynrnmr <br />rhar irl druld tt onrc slbj.cr h rlr <br />\rfr[.^ .oflt).tr\11trr] l)ni!hioN oiSc.rim:17{X)olrlr Lnhr C, <br />I <br />I hcrcby.rfiirnu.dcr pcmhyotFrjury thit I rm liccnsd undcr <br />of rhcBusircssrtrd Prcfcssi(nx (id.. i d yli.cDt isiDlull l.rccr cliccr <br />(:oNS RUCTIoN I IJNDINIi AI:ENCY <br />n\ucd (SLr 1097. Civ C ) <br />.4ITLICANLIJECI.AEA:TION <br />I lircby dnm und.r p.mll y of F jky onc ofuhc tullowiir8 dcclarnions: <br />Dcnxnirn,. Pdrn rs As$.dos Nolificulnn Fcdcrdl Rcguk'nJns (Tnt 44, Pan6) <br />R.quncd brlc. ol Nnlilcari,n <br />I c.niiyrhrr thc fcdrrJl <br />l.cnili rlur I harc rc*lrhil a rrri,r is.otud I r8ra loconrnly 'ffiaordinrNcs nnd SIarc Ijws rchring t,horir. rcprcsc0turiv.s ol lhis Ciry <br />itx,vc rcnrn,ncd pn,!cny lnr ins0txlio <br />lppttcanl or e*enr Srgnsrum: E <br />Forms/Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />Su bf loor/VenVln s u latio n <br />Roof Sheathinq l&,8'A)aorq.U'9 ,) <br />)( <br />Framinq <br />lnsulation/Enerqy <br />Drywall . l-1 lt--n ) <br />Ext./lnt. Lath Y*(? <br />Brown Coal <br />lvlasonry <br />Pool Fence <br />T-Bar <br />Handicap Req <br />Deputy Final Report <br />Engineer Final Report <br />tZeJ-olu +!brv,xu-;arr) <br />\Hr' V E <br />FINAL St -tiM Lw)l,I IrCertif icate ot Occupancy <br />NoJes" Remarks, Etc. <br />DATE <br />Set Backs <br />Shear Wall <br />Flood Zone Certif . <br />UI 'ttd <br />,.p <br />L ta <br />I <br />lr 4RNIN(; lil'trc !1, r.Ltr' qrlc^ <br />. tr r rd.\ nd 'l nnc htrrLrr rhi ^ !J <br />':::"-1\nyryb" <br />t <br />tr lr Sr.1htr r(nlrrrr l)trAif r l <br />lrnJc''. \um <br />- <br />Lrrxl(''\ AJd.$ <br />-