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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS ()\\'NER lrti ,lrl,:R Dlll-( ARA l ()N
<br />I h.ichy rfiirn under pcnalry (,r p.rjrry lh,l I N cxcnrfl lmn rhc conkdom Liccn\e l-nw ror rhc nnlowirr rc,sn (Scc70]15
<br />Ilusirc$ md Pnfesion C.dc): Any Cily or Cotrory shich rcquncs i Pcrnir k, on{tucr. alrcr. inrPr,lc. d.mohh nr rclLn trnv
<br />srtocrurc, pri{n tu irs Gsu!..c, aho rcqutcs rhc lprlica.t lor such Pcn.n h fih. siSncd slolcnrnr rhar M.rshc is licnscd pxHunnr
<br />tu $c lrovisions of rht C.trrmcrols Licensd Law lchaprdr g connncmins wirh S.ctnrtr ?000 ot Divir'on l tl thc Ausin'$ rnJ
<br />Proicssiotr\ Codc) or rhnr hcor shc hcicmpl rhcEfrondd rhc bisn ior lhc slllsdd c{cnl,'riotr AnrriolarionolsarbilT0-ll5bvanv
<br />!ppli., r{tr, pcnnir suijNlsrhc rppli.adr ro a.ivillenrltyoinoi Rncrhrn,ivc hundrcd Jolhs ($50o)
<br />l. Ns owncr of rhe ltrortdy. .r my cnrloles {ilh {trgci ,s rlkit slc comPd\dion will do rhc Norl sd rlt stnrluc t nor
<br />irtc.(H nr oftcred for slc (ss.ro44. Busim$ and Eor.sions Codc Th. ConrB.ktr s Li.cnsc L,* d6.s .or amlv to an osnf or
<br />rhc lmldt wlf,r tuilds or inDoh dmn. ,rd wtD des suct st)rl hin(lf o. hcre lf or rhrclgh his or hct own cmpLtccs.
<br />provacdrhar such inDorcNnrs d mr inrcndcd or.ficGl for $t li howcvcr. rhc t{ildiru or iryro!.ftnr h $U wirhinorc,tr
<br />Df.odplcrion, rt* l)wns Auiklcr eill hnw rh. holdcn of I,rclin8 ltun hc or sh. dil nol ttrild or i'nPn,t rhc PmFnv lor rhc pu{,rr of
<br />-1.
<br />,1 owftr of rhc tmll.ny. 0n.r.lusivcly .onrrclinS Nilh liccnsed .ofiacrols lo coidru.t rhc pmral I Ss 7(N4. Bnsims
<br />,nd Pm,Bsi,n Code: 'l he Conkmtols Li.cnsc l,a* dms noi apply ro M o*nct of f,n,Fny who builds or inpii'vcs lhereor'
<br />ond lho fl,nrdck ftr such nmlccls wirh r C.ma.to(t lic.nscd Pu^tanr k' rh. Co rucrols l-ic.n{ kq)
<br />lr cxc rfl undcrS.cl
<br />Drr. o*ncr
<br />IVORXI.RS (:OrtPENa^',rlaN
<br />DICIA.SAuUN
<br />I hcrcbyrmrmunderDcnalryorD.iuryoncofrhctullo*insdc.lft ions:
<br />Ihavcn will roinhin ! Cenifi.{r of Conscm b Sclf- lnsurc tor soikcs conrPcnqrn,n ss foridcdlhrhySccrionl?U}oirhc
<br />UtorCulc.lnrrhclEriornuac.ofrhcaorklor*hi.hthcpclnril niss!.d
<br />Scci6n.l7m ofrhc tnhor Cod.. n lh. P.rf.nuNc of
<br />.rtricr rl$'ii.ynumisud:
<br />slriur n\urrf(r. tr\ katrl
<br />tu qork lnr shich lhi)r$
<br />'ir
<br />I ccdify rhrr in rhc pcrio'nrn.c ot rhc qork h! whi.h rhn F mn is iss'cd, I rlntll nor cnlt)k)y rtrv pc600 in riy nrtrrcr
<br />sr tr nr h{(rrc {rhj.d r. rhc $.rkcri conrFr\rri(,n lrs! ol Crlilalnia. rrl !o. rhd ifl sh)uld bt.otrt subjcd iorhc
<br />snrkcr( s,nUf, \arn r F)vi\ionr .l Sccr ion .l?Cn .f rhc LHtr Cqlc- I \hrll. fon hwilh comPly $irh rlr)( Pnrvnirff
<br />wARNtNc: Iiailur. tu s.ur. workct{ c.n,Fnsrrion o\.ru8c i\ utrlawtul rnd sh ll \dhj$r Ir cmplo)tr b d'nnNlr4r ics an
<br />u'-l-il I ;T"*Ii I J\t :! il"; XX',
<br />- w
<br />nsrt,n. dam8.s as providcd lnr rhc
<br />LICENSF'N CONTNTTCT(III
<br />DECI/8ADQ!
<br />I hcrchy,ffir uMcr tcn0llyofpcrjlry rhd I.m lian$'d undd lr,vtn,n oi ChrPrcr , (ommncing silh Secrion 7(xn) nrDivti'n ll
<br />of rhc tusincsand Pdr.ssionsCodc. rfrl 'nyli..n\c
<br />is ir tullJorcc and clrda<q J."..^.,,,*,,/ a-l.,,,"C:a1/L
<br />llJlsr.BI1-IIANlr$UIillCErl!
<br />I hcr.bv ltlrrflundc! rEnally of p.ijury rhd rlEre is aon{ocri,n lendin8 rgcncy lor rh. FrfonMncc olrhc *ork loi uhich rhis Frmit i\
<br />ksredlSN ll]97-Civ. C )
<br />L.tr,1.'. \t],l,c..
<br />-
<br />AIELICINLIE(IIBAIIAN
<br />I hcr!, n&nn undcr pcnllry orrcqxry.trc olrhc lollowir8 d(lnrrrions:
<br />Dunroliri{n Pcnnik sbcslos Nolificnti{,r FMcrrl RcBuhl i(,rs 1'l irlc .l1). P,rr6)
<br />-Rcquicd
<br />lrnd or Notifi cdion
<br />l..dilyrhrr lhrvd r.rd rlric rDplic rrio, xrlnrrc rhrr rhc dh)vc irniDrnr isronc.r I igrcc rocoryly *irh allCiryand Counry
<br />lrhi\ Cny d Counlyi0 cnrcr ular lhcordinrn.cslnd Srrrc trq\ rcldin! lobuil ingrotr{fldn .
<br />nt-vc trrnriorcd Inrpcnyir in
<br />Atplidnl or AAenl Si*tr.l
<br />\ z(,.\ACr
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/Vent/l nsulation 1^\
<br />Roof Sheathinq /n4:-ot-7Ll-lv Xr.t/lbt Ffuh Gtr-
<br />Shear Wall
<br />Framinq
<br />lnsulation/Enerqy
<br />Drywall
<br />Ext.i lnt. Lath
<br />Brown Coat
<br />lt/lasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputv Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif
<br />FINAL lelflRio tXtttra)vt
<br />Certiticate of Occupancy t U
<br />Notes, Remarks, Etc
<br />v
<br />I hNcr.d *ill mai rin
<br />_Err1rcs
<br />l.cniiyrhar r hc lcdcra I rcgul,r tns rc8 dirs!sbc\lo{rc mvrlarc nor ofPlicrblc tr'hi proFcr.
<br />0
<br />Olto,/tL ?t *t/ ol liltl )t
<br />tL)
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