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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE olvN I:I{ BIlII-DI'R DI]LCAR TION
<br />Ihcrchylrftru cr rcnrlly ol Frjury lhd I n crcilpr lnntrlh. C.nrrrclr\ Iiccn\c liu ntr lhc iolk'*inryca{nr lsc( 70.11J
<br />lltr\incss rnd ltori\sion Codc): Any Ciry or (ounry sh.h rcqui'cs r Nnni h.Jnntucr. alrcr. in,pn,k dcnn,l'sh,tr rcn:'ir xtr\
<br />{ru.rur.. pri(tr h n\ rruamc. rlq, n.qrirc\ rh.xndi.rnr Lr \uchFnnirro liL r \ilncd sr,cnB'tr r!n h":,'th. .li.ctr{d po^arnr
<br />k, rhc !n,vhion\ ol rhc Cotrrr(ktr's Liccnscd Lrq (chaDlcr 9. Connncmnrc wirh Sc.r0n 7(x[) oi l)iv]\i)lr I ol rhcruri'rc\\ trnd
<br />Protcssioh Codc).r rhar hcor\hc ncrchfl rhcr.lionr i rhc hr\is fdrhcrlldgcdcrciir ion.A':;vi(ilrli,ir.fsccihrT0rl.5by.ry
<br />aptlicrnr ri,r iIl.iinirsuhFch lhc q'!lic!nrro acirillcr!lryofnor rtrcrlEn fivc hundrcd dollanr$5( )
<br />l.r\.Etrcrofrhrfo!(ny.ornrycnll)loyccssirhu!c\!srhcnsrc.onlttrelion.$ill o rhcsork ftl rhc nndurc is to,r
<br />inre'{fu(l orollcrcn lnr elclScc T(rlt- Busincs and ltoics\hnr Crdc lhcCoDrracntr\l.n{tr\clrwdo.\ orrn,rlyri).troRrrr.f
<br />rhc phltny qho trilJs or i'n!()Rs rtrk,n. Md *ho d€s such w)rt hln\clfoi hcr*lfor rhrcu8h hs or hcrown cnplo)ccl.
<br />n(,!idcd rllr \uch i,npn)vcmnh m mr i .ftl.d r o,ltRt rar elc t,: ho*cvcr. rhc huiHing or impnmrnr i\ $u wirhin onc )rr
<br />olconlPlcrt,r. rh. O$rcr Buiucr willhrvc r[c nurbt ol nrovir rhd hc or shc dil nor hui(lor n{,{)vr lhc l)n)Iidy li,rrlx purx,sc of
<br />Lr\.wncrofrhcnmpcnt.rndch\ntly.otrrrri'r8sithll.cns.,l.or rnr...idfl. hc pmt.r (S... ?0,*. Auenc$
<br />rtrd hf.r\irnCodc: Thc Co ki.rr'sLi.cnscLrsdoc!norrfflyr'mostrcroiproFny{'hohuil,lsori.rprov$rhcrcon.
<br />rnd *ho coDrr.r\ntr \urhfn)ic.( wir[ r conrrrcn(r ) Li..n\i
<br />I a rcxcnfr d d.r S(ri(
<br />I lrrcht rlTn rtrtrJcr pc rLrto, t*rurtoicofrhr lall,){i,,!
<br />lhrvculdwillnninrainrCcnili.rrcotC.nscnrroScltrln\urclor$o.krR.o'np.n\jbn,n\tn,vid.dr(trbySccrn{:l70O.lihc
<br />l.rho.Codc.iorlhcpc.ioannnccolrhcworttuwnichrhcpcrnrir i\issucd
<br />I hrvc trd will nxrinun !.rkcrl cotrrt,cnsdion nr{ruNc. ns rcqxncd hy Sccr iur l7U) ol lhc I )h.r Cdc- l('r rh. lj.ni)nmtuc ol
<br />rhc qo.k li,r which rhisNirnil is issucd MyqorkcN cotrrpcNrriotr $surJtuTcatricr ffilp.lty nun[i.. !rc.
<br />_l c.nilyrhrr i0 rh. pcnnrnraEcofrhc aorl n, siichrhk p.nnir is i\\ucd,I shrlln.r cn1pk,yrny |Esoi in rtryntmncr
<br />s as ro h..orft {hjc.r rr ihc workc^ .omNnsdr,n liqs orcilitornr. and rercc rh.t ifl \houklh.com subiccr k' rhc
<br />wolkcF' cootrfls.rnnr l]nn tions .r Sccr ion 17oo of rhc Lat{r (-odc, I \n.ll. lonhsirh comtly * il h rhoE F)vnnrnr
<br />RNIN(;: F_ilurc lo \(urc worl.n .o lf,nsdi.n ..lrrugc i\ !trhstul. d shrll \uhlccr Iolcr ro crininllFnrllics !
<br />danlgc\ as prcvidcd ior Ihcln:.\ trp ro otro hu rn rhor\rdd d llrr\ (S
<br />I hcrby affifln undcr ltMhy.l p.rjury rhd I ant lrcr{d x .r vr\ion,n Chiprcr i) lc.nnMNirp trilI Sccrion 70([)) ofl)iv]sn,n.l
<br />ol rhc Bu\ims\rnn Prclcsions Codc. r rry llcen\c i\ i'r lnlllarcc)nJ cffccr
<br />Corlr..lor:
<br />qANEIAIJSIIONIENDINGICINCI
<br />I lmbyil'ft utrdc.Fnollyolpcrjurylhallhcrcnnconshrriontndinso8cncyforrhclcrformanccorrhe$o ntr ahid rhis,rrnt is
<br />issucd rsc..:1097.Civ C ).
<br />APPI (:ANT DFCI ARATION
<br />I trfthy finn un,lcr J,c.rky oftfJory.ft ofrhc foltosin! dsllhriorsl
<br />lr.m)lirn,n lcnni( Ashc{os Noririlrri()n Fd cral Rcguhri,)ns rl irlc 10. Prn6)
<br />-Rcquired
<br />l rllcr ol M)lill.arirn
<br />rions rcE dine sh.nosrc hvrldc tror rfrli.rhlc rolhisrrojccr
<br />i..tri,, I rn,L (J. rhr rll. )rrn.rnin i\.omd I rgN r..oniDl! sirh rllcnyrfd coufry
<br />xurhorlrc rc|nr\cdrrirc\ol r)ri\CirymdCortrr!r.cficr ulnrllr
<br />G:
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />Boof Sheathinq
<br />Framin s
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certil.
<br />FINAL 'e/2//A 'ffi ?/4AA
<br />Certif icate of Occupancy vu 7=-
<br />Notes, Remarks, Etc.
<br />ID/SIG.COMMENTS
<br />Shear Wall
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