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BUILDING. INSPECTOR RECORD
<br />COMMENTSSITE.WORK DATE ID/SIG.
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Root Sheathinq
<br />Framino
<br />lnsulalion/Enerqy
<br />Drywall
<br />Exl./lnt. Lath
<br />Brown Coat
<br />Ivlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif .
<br />{rr)FINAL /-2;t-/8.J/d>t,
<br />Cerlif icate ol Occupancy
<br />Notes, Remarks, Etc
<br />O\INER BUILDER DEt.('ARA'I'ION
<br />I hcrcby liirm unJcr pcMlty ol F.july rhir I h cxcm0 lior. rhe Li,nrtr,r l-i.cn\c lr* ,nr rhc n,lL)*in! r.qn (Sc.7o.rl 5
<br />Ausiics rn l Pflncssiotr Cdc)r Any Cily ot C.Lnry \rhich rcquncs i licnnii h $n\nrcr. rllcr. imtro\t Jcmli\h 'r rcinn n v
<br />{ru.rurc. I'rior h ih i\\uamc, aho rcqutc\rhc 4nli.Mr Lt such Pclrnirn' ilc. (i8ncd srlrcftir rhirhcor shc i! lrc'scd rynurnl
<br />r(i rl( B,visiotr\ ol llE Conrdct \ Liccn\cd ttrw (Chalrs 9. Co rmrcing triih S..rn 7000 ol Divi\i.tr I ol rhc Btr\i'rcs tnd
<br />Profcrsnni\ Codc)o!rhrl hco!\hc i\crciIl)r rhcrcli.m m(lrhc hrn for rhc rllcs.dqc Uion Anv!i{'hri{ olSNlionT0ll5hvanv
<br />rfnli..nr ror tr t'.flnil (uhjccr\ rhc iPtlicrnrro a.ivilp.nrlryormrnrcrhrd fiv. htrndrcd doll, ($5(x,
<br />l. r\ uwrcr of rlr prolf,ny. or nry cmnk')ec\ \ irh sr*cs as I lrct {n. coif.nsrrion- will do rh. work od rhc n'urure is mr
<br />inl.ryh,l orn,i.n:.lr'ord.(S(7(114.Ausirrcsrlndllofc\\insC.tlc:lhcContrckr'rLi.cnscl-rsdo.s ol nlnlv t' rn osrd 'f
<br />ihc Dror'.ny who huikl\ or nllnl,Nc\ lhcN,n. a'klukJ des such sork hi'nsclror h.^.llor r)mrah his or h'r own cnrlirv'c\'
<br />pnrvidcd rhri sx.h imprcvcnr* te ior Ncfrlcd .r oil.Kl for srk ll lN\trq rh. hrildir! or imPnNcmN h solJ { iihi'\ otrc ,cir
<br />;lc. Ukri l,tr Oq mr BuikLr will hau rtf, hurdcn ol pilviD! rh 1rotshc ilnor l^rildorinPrd\t rhc |x lcnvforrh'iluFxc'f
<br />L asowncr olrhc rtuNny. rcx.h\ivclt..ntnrin!sirhli..nscd..iracnnsb.oiifl.rrhcPni.t(sc..r(}1'lllu'i'(\{
<br />r l PinLs\ir Conc -rhc Cintn tn { Liccnsc l-r{ (n'rs ror rPply b M otrncr ofnrop.lrv qho huild( or ifl]Pmlc\ rhcrc'f'
<br />!trrt $ho conh.r tu \uchpmids Enh . C.mador ( s r li.cn\cJ tusutrr rorh.Coitn.ktr's l-iccn{ l-rw)
<br />-l
<br />rmcrcnpr xtrdcr sc.ti{n,
<br />1!Ol{(l{..{ (ItNtPtiNs,\',l l()N
<br />Df,.CLTIXAIIQN
<br />I hcrchy rlnn, utrdcr Nr{llyorJtriLq u ol rhc tull(,*irr8,l..hrr o \
<br />Ih crn(l*illruink dCcnilic,rc.rCoscnrrosclf_lnnrci,tr$orktstn\Ensrriinr'a\ln)vi(lcdrirbtsc'lotrl7lx)orrh'
<br />Irh.r Orlc. ior rhc lcrfornBnc. ofrhc uork lorwhich rltr nci,nir h issucd
<br />-lhrvcandwill'nnrmsork.rs.orNnsdmninnmm..6rcquncd[vS(iim.]7iX)oflhcLnho!CoJc.forrhcn'rfonnanccofrhc uork f{r*hi.hihi\ I'crmir is is\udl My workcts' (onrI.n\rrirr nNrMcc.aricr rd Bni.vnunrh(rrc:
<br />,r,., *,.u-, 'q2O2-3EB -20\a ,,,,,,., '\z/al 1=vA
<br />I.cnrfyrhnr irllfn nnnmNcollh.sorkfr$hi.hrhitNmil is n\rd. I lhrll nor c'qk)y rtr! Nrvnr in r y t'rNr
<br />v) x\t)c(coN \ublLrr tu llt *orkc^ co ]lEr I I I \h,tr'l,l l\.otrr {n,i.Lr k,rh.
<br />\orlt.^ .o r|Enqri(nrfn)!i\n,n\of Sc.r(rl7(xrol rlrl.rhtrC(
<br />$4klrl\l(i I'l'tr..'.,'. r- \,{\,'.',,'tra.i*rr.',.{('i.s'
<br />irh..mnlt $lrh rho\c |rivi\idN ,*'3.,,,!lHll {'1!r.r r ri,tn.\.' r, (rnrr,'!
<br />(n I 1tr,.\ trl) 11),ir lrtrr
<br />s.r iitrr .ri)7. ol !l'. lnli,
<br />,,"*311/
<br />h.:11 rl't uitr \L! ll.tr-ill(Ir.lx[)r. tr,,.,' -.-"..,r.,",X,'1".,
<br />20rq,,,,,,.;\
<br />co( .I.o rt,cr\rli,)n. (lxtru8c\ i\ nrrvnlqJ f(tr ilt,
<br />q (.onnrtrn. nE trnI Sccri,r 7(rI)) ol Di\isio,.]
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<br />llr.k1,J rlri Ntrn(l.r 0.rxlr\ ol t,c'[rr] rh l)n,1,..n\.(1,
<br />ol rh.llu\i',rs dnd nr.fcisi{nr\ Qrlc. itrd nrylicctrsc
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<br />t,,,,\ lrl l2o,4 C-6e-co \,-.LC_ .
<br />c()Ns'l tll(:'r!()N I lNDlNc i\(lF.licY
<br />i\\!rd (Sc. :l(11)7. ( ir C )
<br />litr,l.as Nrnr.
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<br />I.difyrl r rlr lrdcrilr.!trhl ra no\rlrr i rl)tl'.r|,.r)il \l)n,l..r
<br />l.cnil!rhir I hrr. rcrtl thr n rrl'rrrr)\. nL,nitr), \.,rrrr Irrr..r,.rtrDl!\rhxlLL r\ rtrtl(,trr \
<br />r(li'ixn.r. r rlslrr.l rs\ '.il'ri(,n. rd hcrchr rurhorirc rctrcsctrrarirrs olrhi\ Ciry nnd Cou y tu ctrrcr u0or rhc
<br />rlmrc 'tuiri( cd lnrnrdy lui,
<br />Itlt)li.hnr or Axr l Sknirt
<br />Shear Wall
<br />,,",. 6fte!€-- 6.sr+,e. -
<br />AIfLIrrlNfDlllLlSAIlO!
<br />Iltrcbyrllinrutulcr|x rlrtof Nriuryotrcof rhefolltNnrndctl raln,ns:
<br />Ucir)lniotr Pcirnirr Arh.(o\ Norifi.rliotr I:cdcrulRcSrhri(nr\ ('lill. '10. PanO
<br />RL\tutrcd Lrlcr oa Noiili.didr
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