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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNER AUILDER DIILCANATloN
<br />t hcrcby rfllrm u cr ncn.lry ol lcrjury lhar I m cxcnlpl lrcm rhc Conkict,r' Liccn\e ljw r(tr thc lolro$ir8 rcrvr lsr 70.11 t
<br />tju\ircs d Profcssion C.dc): Any crt or (bumy whi.h r.qunc( n ltnnir lo con{ru.1. alrcr. i'nprtrld. dcnFlth ,t rcFir rny
<br />dtuciurc. I,ri{rio ir\ isurn... rh. rcquircs rh. +tlka lor su.h |Enni k,lilcs \i3trcd idr.trrhr rhd h. or shc h lic..\cd r]ursurnr
<br />ro rlrc p.ovi\ion\ ot rhc Conrractn \ t.ic.ircd l-rw ichrprcr 9. OnnDrncirs sirh Sccrion 7fi ofDivi\i(,n,l olrh. Busnrcs rtrd
<br />Pdasstrns Codc ) or rhar hc.rshc iscx.'npr rhcrcfr.nrrnd rhc hr\is lorlhc rllcscd ctmfri(,d Any vioLrn[ ol Scclion 7ll.1l 5 h, rn,
<br />rpliicr ntrdl)crnrir\uhrc.Blhc.pllrc0nrrorcivilpcnrlryol'nornxrcrhufivchundrrddollttrsl$5U))
<br />-l.rsosncrotrhcl]'olicny.{,mr.lpk,y..swilhwrg.\d\rhcir\n.(nl'Pcn{'li,)t-willdorlf,*orktuxllh.slnicrurci\nori c'{lcd or oficrud ftr srh lsr.?o,l-l. Busircss a Pnnc$nns Codc: 'l he c()ntmk, r l-i.crsc hs dcs nol qrply ro a. o*tr.r of
<br />rhc nmJrny who huids or ilrll,(ns rhcE,n. Ml who dm\ \R-h sorl hn \clf or hc6ctf ot rhou8h hk or h.. o*n cmpk,yccs.
<br />l(,lidcdrhrsu.hi'nFxcnrir:iNnorinrcftL\t.roftarcdnrqhlfh.N.vcr.rhctuildin8ori'nprorcrnrk$ll{irhhonc)err
<br />oi cotr{,lcrion. rlE Owncr Buiklcr will ha\r ihc burdcn of pn'ving rh r lf, or shc rlid mr tiuitl or inrp.ovc rhc F)pcny tu ltr NrFt .f
<br />l, ns.sn.rorrhclrJFny,,mcr.lu\ivcryconlndils silI licctr\ed conkndm n
<br />'
<br />.on{ru.r rhct(iNr rscc 7(Ir4. Btr\i'rc\!
<br />nnd llolisiin (odc lhcConrrs.ror'! l-ic.nsc uwdocr nor rnflyb otr.$ncr olp,onc y+ho huildr ornnnn,vcs rhc..oi,
<br />and *ho c.nrd.G lnr su.h pojccr s wirh r conrr{crtri s) licctrfd nlrurnr h rhc conkrtx\ Ln ctr* tiw)
<br />a-to -l
<br />IEIIAAAII()!
<br />I ho.by rnirnrund.r l-tnally oincriuryonc ofth. nnbwins ncrl&!ion\r
<br />-l
<br />h.vc zril will huinrain rC.irill.atcolClotrs.fl l. Scliltrsurc lor w.rkcrr conp.nsdn,n, r\ F)vidcd for byScclbn:17(Xlofrh.
<br />h$or Codc. for lhc Dcrfornrncc of rhc sod< r.r Bhi.h rhc n rnrir h nsucd
<br />-l
<br />ha\ c ud *ill Nainllin *.rkcn co'ry.isarhn iNufuncc, as rcauircd hy Sccrio .l Tm or rhc t-'hur Codc. fot rhc P.rlbmmcc o{
<br />rhc uorln)r slrich rhhrfinir r\ issucd My sork rs conrNnnrliotr insurucccr cr dl F1licynu $cr trc
<br />Poli.yNunrbcr-
<br />-lccnilyrhd
<br />irrhc perlb'nDncc olrh. *or[ for which thi\ nmnir i\ isucd.l shrllnot cnrpl{)ytr!} Pc^on ii rnynr rncr
<br />v, a\ ro hr{rtu lohjcr k) rhc workc6 onDctr{0rnnr h$s.ICrlilortri!. sRl kArcc rhri ifl sh.uld rEc.nrc sublcd b rri
<br />trurkcr\.onpcn\rrtripn,visionsolScclion:l7t]()ol'rhctntnr(dlc.l\hrll.fonhsirh.onrtlywirhrnoepnvnion.
<br />W,{RNINC: t.rihrc t, *.ur. workci\ conrpcnsdnon cotrrr8c is unh$tu|. r d l suh.J..r rn c.lllols ro crininrllcnrlriL\ x'
<br />civil flncs uF b oic hrnd,&llhor\.Dd nolllrs lsllx).()()()). iI rd(liri,,tr r) rhc c.ol conrFn\rrr{r. dtrnngr\ r\ tr^nlrd n)r r[r
<br />scrrirtr, :10?6 0r rtr. Ljtrr t crcn rnd irronry \ ltcs
<br />Q- to- t ?
<br />TECI,AI{IIO!
<br />I lrcrcby sllinn under pcnalry orp.rjxry rhar I em liatrk{ undcr rmvision.l'Chaprcr s l.omftn.nrg wirh SNtbn ?Ofirr oiDilisiod.l
<br />oi rhc Busincs Md Pmfc$ions Codc. aid ny lkcn* is ir lullLr.c Mdcrlal
<br />g}NII8IJCIIANIINDINC.A!,ENII
<br />I hcrchy rlfirnuodcr p.Mhy.fp.rruryrh rhcrcisa.on(rucrionhndingrgcn.yr(rrh.p.rf. tuncc ol lic sorl fitr shi.h rlft Nnnir i\
<br />n{rcd(Scc :1lr97.Civ C )
<br />trn'lcr s AJtire$.
<br />-
<br />AITLIIANIDLELAItrII1IN
<br />Itmh, rliin utulcr ncnrlryofpcrjory onc orrhc f.ll.qing dc.lirtriotrr
<br />DctrFlirnnr PcirniNAsh(sro\ Noriiicrrion Fcdcrrl R.8trbrn \ (Iirlc40. Prn6)
<br />Rcquircl lllrcroiNorillc kn,
<br />-t
<br />c.nilyrhd ihc tcdc'rlrcSuhrnnr r.8flding $he(.srcnnulrrc nor n0pli.xblc b rhisprclccr
<br />I rcn,fv rl[r I hr\r rc rhxrffi. i,nr urlsrntrhxrrlt fitrd i',lnnnii,{ ^.orr..r lrPrL{b.on{,
<br />onli'r cc\ rid srnrc l-rsc r.lIirr! ro6trildirS i:lJ,tl-n. lltr.hyrtrrl'.'rrrr!u\rrrdtr..Lnrhi\( r
<br />rhovc ff,fliotrrd pn,ncny n, in\pc.r
<br />,\!plicnnl o..\srnl Sixnsturt
<br />t
<br />I
<br />ly*irhrll cilyntri C.unry
<br />y and C.u y$.trrcr nljon rh*
<br />?:LL4
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Sublloor/VenVl nsu lalion
<br />Roof Sheathinq
<br />Shear Wall ,A
<br />Framing t0-^1g x"wa
<br />lnsulation/Energy (./
<br />Drywall tt/lo /u Arnzr4 -//\-,'' /@Laigb
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lvlasonry
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />FINAL /1//4//]-fr/lr>/lx -/rt--
<br />Certilicate of Occupancy
<br />Notes, Remarks, Etc
<br />Pool Fence
<br />Flood Zone Certif.
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