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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE IDiSIG.COMMENTS OWNTJI' BIJII,DER D]),CARATII)N
<br />I hcrcby iltlrnr und$ fi:nalry of pcrjlry lh0t I 0 crcm/ fmmrhc Lbnrd.rod Li..nsc tiw fr rhc iollo*in8 rcrbn lscc1):ll5
<br />IJu\incss rnd Pn,ltrnotr cdlc) iy Cnt or Counry which rcquncs . N,nir ro conrrrucr, lr$, i'nptuvc. dcm,lth or rpnt any
<br />nructurc. !ri.r lo ils i$uMcc, rls rcquncsrhc lPplicuir ru iu.h pcrnrit ki lllc o sisncd starcnrnl rlrr lror shc G li.cnscd lursrn!b rhc pniviiio$ ofitt Conrtu.tn\ l,iccnscd h* (Ch./cr 9. Connncn.rng s[h Sc.hor 7(X)O of Divi\ion:] of rhc llusiic$ rnd
<br />PnntsionrCodc)orth hc.r\hcisckrnrprrhcrcrronrandrhehlsh,orrhc0llcrcdcxcmplion. Atr! viohrio.olScdiotrr0rt.5 hyany
<br />attrn,nr lar3rgnrilsuhjcclsrhc 0mli.anl la 0.iviltrtraklor.or nr,crhan fiv. hrndrcd d.llar (S5rnl.
<br />-1.
<br />rs owncr oI rhc B),rcny, o. m! .mrl.,es {irh wlscs r\ rlrn $E $nrn ns(n)n. will do IIE sork dxl rhc aMm Msr
<br />n .ndlt orollcrcda{,{lc(Scc.7044.lrusircssandPmrcsi,m(trlcThcC(nnrrdor'\l-i.cnrcLssdocsnorrpplybanosncrof
<br />lhr Frr^-n, r'&) hrild\ o, illlnors rlEED, and wtx) d€\ ro.h q.* hnn\clfor h.rsclfor rhturgh hk or hcr own cmtlotecr.
<br />provnkd lhal qrch iDprovcnrnh m mr irrcnd.d or.rc' cd ntr strlc ll tn,rocr. lfu tuildirs or nnpNcnnr h sotl wirhn ,,nr Fr
<br />or.on'pklion- rtrO$ncr Buitlcr *illhlvc rhc hunknorpn,vi'rg rhn lt or \h. d! ml blikl or iqnor lhc porny for tlr lurrr* of
<br />l. rs o$ncr ol'rhc l)r,pen y. im cx.hNivcly contrfin! wirh ll..n\c{l conh.nns h cotr( nrr rlrc nre rc.r (Scc r0$. ou{Dus
<br />rnt l,rllcsiotr C.dcr Th.Conracrn s Liccnsc l-awdocs tror rt nlrro rnowNroiprof. ywh(,huitd\ornnflovc\rh.rcoi.
<br />rtrJ who contacr lr luch pnlcckuirhi CoitrrchIl\r liccns.d nr^D r r, rhc C(rnracrtr s t iccn* I-ns)
<br />-l
<br />lmcrcmpr undcrscdion_- A. & P.C.lorthis rcason
<br />Dsre olner
<br />\4OR(ERS' C(NIPEII.SATrcN
<br />IIEII.AXAIIA!
<br />I hcrcbyulfi n untlcr p.ndhy.rp.rjuryotu olrhc followins dcclarationsl
<br />lhavcf,JdwillnunainaCcnnicircofconsutrrtusclrlnsu616r*orlcnconqrnsarion.aspovidcd{orhyScclionlT(l}ofrhc
<br />Lllxtr Cdc- forlhcpcrronn.nccof$c work ror which rhcl.nii i\ n\ucd
<br />I havc rnd will mlinluin worleri comfnsitiofl iNurinc.. rs i.qun.d by Scdn,n:l7tD ofrhc l-alx,r Codc. forlhc pedi,matrce of
<br />ihc Nork ktr $hi.h rhi\ rdmir n n\u.(l Nlr c. rtri(rri,r n{trrD(clanrr JrlE,licr nu ,hc m
<br />o \
<br />Irc i,i Ih r h rhc nrrt nnurc ol rhc sork Ji,r whi.h rhis N, rI is nsrc.l,I shr]lnorcmphytrirrc^otr inDtry'nJnncr
<br />s N ro tEconr subl.{r r) rhc Norkcr\' ..nrF sain hs,!ot(llirhrni.itrdJlrcclh{ilt\houldbccoN\uhjc.rrorhc
<br />$.r[cri (nnpctr\trrior provisions olScrn ]7(Drfdlc lltxrCodc.l shnll. n'nhsirhcotrUly*irhrl.ixc pn)visi,rN
<br />w]\RNIN(;: Frilrrc t' {ctrrc sorkc^ co'!pcn\!rion.o\em8c ir unlntrtul. rnd shnll $rhjc.r r ctrlllloltr h 6i'ni'rl l.rrlric\ rid
<br />.i\il Jni.\ trt ro otrd hrndrrd rl,otr\ Dd ,lo lr^ rl {xr.r)lll)]. n rldiri,,1 r, rlr ,nrtc\ rs frovidcd for rhc
<br />i,::'r'ip;fin""",
<br />I h.ruh) rllnm u.dcr pcrrlry rlpcrjurr rhd I anr li(r{d undcr porknr.lChaflcr 9 (cotrrBn.inS *irh Sccrion'rlxx)) oiOn niotr 3
<br />9o *l lnr\incsc itrd l,rolcsi(fF(_, c. r' rt li.r \c \ n lj'llli)r.crDicln..r
<br />aop=VkvllC glrrfs
<br />AONEIAIJCIIAN.LENIIIIG.&CEII:I
<br />I hcNby,tlrn tndcr pcnahrotperj!rythat lhcrc h o cotr{ru.rion lcndinA,Ecmy ror rhc p.rrornM.c of!h. wo* tu whi.h rhi\ rcrmi! is
<br />issucd (Scc 3097, Civ. C.)
<br />iII:EIIIAIiIMCITIBAIION
<br />I l*rchy dllr utr rrrc nlrtorr*rjuryoncorrhcrhlh$nr8dc(lfdrn r\
<br />Dcndirn,n Pcirnils A\hc(.s Nolific.riotr I,cdcml Rcgul rioi\ i l'irlc.lr. Pnn6)
<br />l{oqu rcd Irtrol Norili.rlinr
<br />,, rcnili rhr rhr rrJ.,"l 'rrul,'nnr rcFadin8,.h$n\ rcmrrlrrc nor EI,ltrrhh ro
<br />'h's nmrct '.
<br />jzl cud ib rhrr I tu\ c rcad thr alTliclrnn od rrarc r hJr rh. ,bvc inromt ioo is comd I aE e to conply ,ilh oU Cn, and Counry
<br />ordinanccsa Srarctiws rchrlnF lo buildnl8 .urnru.ncs ofrhh Cilylnd Counly ro cnlc. upotr thc
<br />rhnc trrnri( cn f'o|tnyntri',\t^-cri{)npurtri\.\
<br />Applacunl or Asenl Sis'Etum )!
<br />l'cm r€ n.nE(Drinr): K Ec\nc-\1t?*4tr
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf looriVenVlnsulation
<br />Rool Sheathing 5-2r-1y Y.lL{1d kz'l rcF;1"
<br />Shear Wall
<br />Framing
<br />ln s u lation/E ne rgy
<br />Drywall
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />En gineer Final Report
<br />Flood Zone Cerlil
<br />,A
<br />FINAL (-rt-tt'v.wldi
<br />Certificate ol Occu pancy
<br />3 E€2-/t uooA 2
<br />ALL arrl,,^,c€"a
<br />--t
<br />Set Backs
<br />Ext./lnt. Lath
<br />Brown Coat
<br />l\4ason ry
<br />Notes, Remarks. Etc, ,
<br />Irndris An .cs\
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