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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNEN OUI LI'ER DEI-CAXA'T!ON
<br />I hclcby rfiiln undq !.nolry of lEriury thi( I n crcnfl (n,m rhc conkdoE Lic.n{ tf,w ror rh. rull.wing rcr$. (s( 70:rl 5
<br />Businc$ md Prolbssion Codc) Any City or County wnicn rcqutcs i t mir ro onsrru.r. altcr. iryovc, dcDFlnh nr rNn any
<br />nru.rur.. prsr k, i'\ issoricc. alw, rcqlircsrhc lpplic0trl ior such pcirnir b nt o si8ncd (!tcm lhal lEor she n licenscd ,turfl0.rb rhc proyist'ns ollh. Conrra.lols l-icctrscd tj* (Chrrr.r 9. Coilnf,ring wirh Sccrtun lOUl of Dili\ion I .r rhc Busincs\ d
<br />Pdt*i.n\ Codc) or rhrl rt.rshc iscrcnpr rhcrcfiomrnd lhc htrsis forthcrllcScdercmprion AnyviolorionolScdiotrT0.llsbya,r,
<br />aptli.&r ror a Fnnir rubjc.k rh. +pliclm ro !.ivilrcnrhyolnor nmR rhan nrc hunlrcd dollors(S5O0r.
<br />l,!so*ncroflhcprotEny.orntycnrplorccswnhsr8csn\rh.iivnc.o'np.is,nrn.willdurhcwo*,rdrh.sru*rmi\rtn
<br />intc*lcd DrorTcrd f.r qk (Se 70l:l, Brsims\and Pmfc$ions C{rlc Thca:onrft.tofsLiccnsc LlR does oor appl} ro sn orrcr ol
<br />rhc pmtcny who huil& or iDprovcs rhcKtr. nfrl who docr \mh m' hnnsclforhchcllorrhn ghhisorhcrosncn,tl,,yc.s.
<br />provnGd rhd {ch imptuvcmnhmmr inr.filcd orollcrcd for slc l(hotrcwr. rhc hildins or iry&v.md Gq,ld wirhin.ne rn
<br />of.onphri'n. rht oqncr Builld will huw lh hrdcn oi pmvine rh,l hc or rhc dil ml tnild or impovc L\. pn,Fny for rtE purl'o* or
<br />-1.
<br />asowncroirhc pmpcdy..rcrcrunv.ly..nrs.ri'rs trirh licctrrcdconlrlct'nro.o!{ru.lrhcF,jeci (Scc 7U.r. Bu!nc\\
<br />,trd Pt,f6\ionCodc:TheCodrlcro.\L,iccnscLtrNdocsmrnftlyro.trowncrolpropc twho huilds.r iNtrolcs rhc.con.
<br />and who.om.acrstusu.hpnlcdswirhI(..nrEchrlrliccnscdpu^Enrrorhccontrac'oisl,iccn*Lnw).
<br />l. '.runlr trnJ.r s(r
<br />ultB5E&[roMtlNsa:Ila!lLqluau{l
<br />I hcrcl,y !tlirar!ndcr pcnrlr, orr.rjuryorcoirlrr aoll.wi r drclarlrion\:
<br />_lhrvcir silltrhiNah rccnill.ri.orco \cnr k' sclf lnsurc rbr sorkcr' Nmpcn\rrior. is Fovilcd turnys(rinr l7l[)ol rhc
<br />htur Cirl.. fd rhc Frfomncc orrhc sork ntr \,hich rhc pcrnrir n hsucd
<br />_lhrrcrndsillmrn oinsorkcF cotrrr.nsarion in\unice, rs rcqrimd btSccri,rlTu)olrhc lnb.rAdc. furtt p.rronroncc ol
<br />rhc scrk forwhichrht pcrnrir is hsucd. Mysorkcn .o f.nsari{,n in\trimccmhrr F)licynu lbcrrc
<br />I .cnily thil in rhc n rlbrmmc oirh. $ork ntr sh'.h rhn |f,nnir i1 '\{,cd. I \hrll ior c'ntk,y rny p.^oi i'r riy nrrincr
<br />o is ro hL{o'nc suhjcd r. rhc wo*&i .on,r.nsrr ion h*s ol'(L'1il'ornir. a agrc.rl il'I \tu)uld t'.om luhjcd rnlhc
<br />trorlcrs coNpctrqiM tmv$i.ns ofSc.rotr:17(X)nfrhc If,hr Codc.ls)Dll. tirdhwirh.otrl|]], siih rhoy prcvisi.ns
<br />WARNIN(;: l:riluE lo ecuc *ortc6 compctrs.rin. covcrrlc,( unh\e,ul. d \hrll suhicr arl c r aycr t) rimirrl Jf,trnlric\ and
<br />.ivil llncs tp b onc hDndrc rhousand dollln ($l(Xl.Ux)),1n iddniotr rorhc.os ofc.nj|xnsrrrnr drnr!.s rs Dtuvidcd lnr rhc
<br />::::"'"{il?i;
<br />I hcEhy irltm und$ NMllyol trrjury rhrr I M' I rl Chrprcr9(coDnnrncn,g NirhSccrion 7(xI)r of Divi!ion :l
<br />ol rhc Bu\irtr* rtrd Pn,f.\irnN Codc. rrkl ,t I
<br />Da'e >(t,/a""r"r"r". )(
<br />I hcrcby aifiirnundcr Fmllyolr.rjury rh,r rhcrc i$
<br />issucd (S.c .1097, Civ C )
<br />fttr lhcp.rformncc otrhr *ork a(x{hirhrhnl).rmir k
<br />_l (cnify rhor I hsvc rcad rnis {'pljcation 5nd stor rhnr rhc fi,v. infdnnrion k.om.r. Lerc lo.\,mpl, wirh allCir! rnd C.un'y
<br />ordinancc\ and Sratc Ijw( Ehriry b tuild
<br />rborc nrDrtrtricd FtuFdy ld in\r.dn,
<br />Appli.nnl or,\t0lSiIndluft
<br />AALAA
<br />-'-".":'t7;' ;rr{
<br />DA r.t-AT-
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Roof Sheathinq
<br />Shear Wall tl I
<br />Framinq ilu ft .Li P
<br />lnsu lation/Energy -tl I
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lvlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Depuly Final Report
<br />Engineer Final Report
<br />Flood Zone Certil.
<br />FINAL n vtlfr 1 've)
<br />ICertilicate of Occu pancy U tl \-"-
<br />Notes Bemarks EtC.
<br />0 I
<br />I I u
<br />Subf loor/VenVl nsu lation
<br />AIELICANLIIESAAAIIAN
<br />I txrhy lliirnundcr pcn0lryofFrjur! onc otrhc rollowiit d..ldarn,ns:
<br />Dcrmlilio. Pcnnn!Asb.ios Norifi.nri.n Fcdcrnl Rcgultrrion\ (lirlc 40. P!n6)
<br />-Rcquncd
<br />Ldrer or No'irrc{ion
<br />I .cn ily r hd rhc l.dcr l tu8uhri{rN mBndnrS r\h.ios ..mi ! l c nor r|pli.rhl. h rhn J[+d
<br />II
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