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BUILDING- INSPECTOH HECORD
<br />ID/SIG.COMMENTSSITE-WORK DATE
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />I I
<br />Rool Sheathinq o ?3lr$'-l-4o71YShear Wall I
<br />Framinq
<br />ln s u lation/En erg y
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lVasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif
<br />-41/rst<',zr{2?)FINAL
<br />Certilicate of Occupancy
<br />Notes, Remarks, Etc
<br />d6 'to .to
<br />OWNFJR BTJILDI,]R DEI,CAN TIoN
<br />I h.{by ,ftn nMcr |Enallt .f Frjuiy lh l ar cxctrrpr hnn rhc Contr.r.n' Liccnsc li* in rh. rollNir8 rclvr isc.70:ll 5
<br />Busrc$ nnd Prolcrsi.n Codc): Atry City or Coudy which rcqun s I Frnir lo con{tucr. rlrcr. irProt. dcnnrlish or t$rn .n!
<br />ntu.ruc. lni.rlo ih ksuan.c. rko rcquircs lhclpplicrnr tn \t.hlf,nnirlo file.sign.d nritmn rh hcor rh. r Ii.cn\cd turnranl
<br />io rhc pmlk nsof rltr (i,nkicior's l-i..i\cd Liw (Ch.Prcr 9. Connncicii! silh Scdi,'n 7$l) ofDivsiotr ll orrhc Busint\i rnd
<br />Prolts\ion\ Gdc) or rhar hc or shc h cicnr rhcretrom Md rhc br\i\ lor rhc (llcgcd crc rfrion Anv\blnrionofsccri( 70:11 5hvrnv
<br />dmlritrrr(tripcrmirsubjcckrhclPrli.rnrror.ivilFnilryornoltrxtrcihtrfivchundrcddolh*($5m)
<br />I. $ ow.cr ol thc I)nrIEnr. or my cmllottcs wirh ! agc\ a\ rhcn \,b .oDIcn{ ion. will do rhc rork rnd ltr (nd$ n 'r
<br />inrcfrkn oroncrcd f.r qlc lSe.?(,'l4. EusirEss and Pmrc\sbn( codd _fhc Conta.rof\ Li.cnse l-iw does n.r amlv ro rn o*mror
<br />rhc thllxnt who hurlds or i.lporcs rhcmn. ud \h. des \uch ro* himlclrot hcFcllor lhrolSh hk.i hcr own cnrkry..s.
<br />prolidcd lhrr such io,I'oEmnk m d i.rc cdoo,Icrenntr$b lt howcvcr. rhc n{ihins or i@n,v.'m nsohwirhin ncF
<br />ofconrhtun. ltE Ouncr ,ruikLr will h,vc rh( hurdcn olrovr8 rhd he ot sh. did n.r btrild or iDlrorc rhc pn,Pdv fo. rhc puqrs.f
<br />--l.a\.sn.rofrhenr.Fdy.rmrr.lusivclyc.itrcring$iihli.c\cdcontmftnh.otrnru.lrhcPol.dlSc.70!.8u.inc\'nid Pmlaqrr(.dc: lhcContach \ Li.cnsc Lr! d.cs,r.r a|ply nt r own.rol roPcny*ho huildror i p()rcs rh.'..i.
<br />rnd who .oiknd\r.rnrch DioJcck $irh r trr\i'..rql Nr$rDr [) rhc L,nirx.tn s l.ie.tr\. 1 r\ r
<br />I e'nc!rnnI nn.l.rS(rbn
<br />I hochy rflnrundcr pcnalry orp.rjuryonc ofthc lbllo
<br />Ihavcirdwillmsinroin!Ccnili.ar.!rConscnrloSclf-lnsorclorworkcscosPcnern,n,itrovidcdrirbvSc.riotrrTmolrhc
<br />ljlnr Cod.. Ior rhc p.riormoncc.trhe wor* rorwhi.h rhc pcrmir h hs&d
<br />-l
<br />havc lnd sill nhinrain workcn c.mpcnn n,ni.sunk..ar l.quiEdhysedn lTo0 oilhc Llhor Cod.. for lhc ncrlonuncc or
<br />rhc work iorwhth rhkl)cmir is h$ct Myworkc^ comp.nsrtn,n nNurlnc..ricr int IFlicy nunb.r {c:
<br />-Ertn
<br />sr
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<br />I rdifyrhd r rhc ricrioflnrm.,n ihl wo* for BhEhrhi\ Pcrnrir i\ i\$kd l \hrll nor cnflry riy fc6on ir rnvmatr cr
<br />$rsloh.coN!'hrdn,rhcwo*cn'conlPcnsrrionl3*\ofCalituria.rnnr8r.crhdill(houldhccon*srhjc.rhrhc
<br />workrn conrpcn\dn,n thvisions ofSccrion.r?mofrhc btrtr C(xlc.l \lBll. i(,nh\lrh.onlt'lr_ wirh lho{ Pntri\iotrr
<br />WARNIN(;: l'iilurc r. T.ur *orkcrj co.4rnsnr .o\crugc i. rihvlnl. .n,l shill {,bjc.r rn.nrr[,]cr l{, cnhirrl lf,nrlris rnd
<br />.ivil l_m\ nn lo oDc hundnd rhousitrd dollar I x).1[x)). i'r rJdiri', r h rl*.o( t,f conDrtr\trn . (l0r gt\ r\ ttrrnlc ntr rh.
<br />S..ri, 1lr76olrh.lrhn (_iir. tr c,cn
<br />I)11 1.tR\Ilo\
<br />I [crcny]ft o .lcr t^_nrlrr_ol J--rjuryrhriI 'n
<br />li uM.r pro\ kior of Chifld 9 ( con rcnc i',8 wirh Sc.rion 7(Xn ) ol
<br />.l rh. {}Ni'rcss rn,l l'.olt$i.iN (-odc. rM nryli.cn{ i\ i',lulln)rec rd clrr.r
<br />l-iccnscClNsr-
<br />(](tNSTRIJCI1ON Lf.NDIN(: A(;TiNCY
<br />I hcrciv alfirn!ftcr pcnnlry olrrriury rhar rhcrc n r con\lrucrinr lcndirB rgcncy ior rhc Ptrfonmn.c ol th. sork fd shi.h rhn Fnnir i\
<br />isskd rsr. 1097. Civ C.l
<br />t rh''\ \Jn'c
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<br />APPLICAN'f DI'(I ARdTION
<br />I trrby.iltN undcr nc.nhy oflr.rjury.rc ofrlrc foll.*ira dcclararions
<br />Dc nt I d1 Pcnnir! Arhc*.s Norificdn,n f{dcri] Rqlhlior ('l itlc 4}, Pari6)
<br />Rcquncd lrrlcr oa Norifi urinr
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<br />ccnify rhar rh. r. cmlrcSulalions rcsardins $.{or n nril .rc nol lPplic,hk b rhh projccr
<br />na i.lnmhrtr ir corer I xgrd t, .onrtly wirh all Ciry ind Connr,
<br />rurkrizc rcprc{Drrrir.\ or rhh Cny Nd Coxtrr, lo cnrs ulx,n rhc
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<br />Subf loor/VenVl nsulation
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<br />lctrJc,'. 'lJ'r$
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