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BUILDING. INSPECTOR BECOBD
<br />DATE ID/SIG.COMMENTS o\1\t.]t Bl I t)t,]t I)11.{ \ll,\'lI(r\
<br />I hcahy.lfirn undcr n nrlry or lfrjur! Ihal I an crcn!,r il.,n rnc ConrE tn l-iccn€ 1,r* fot rh. r.UosinS.rcrvxr (Sc''1'115
<br />BusiN$ aftl Profi$bn Cdc): Afy Cir, or Counry whrh rcquirc\ a lrnnir r. !_ondtu.r' dlr$ nn|tr'!c. thnmli\[ or EPrt rnv
<br />ndcrur.. filor b irs issuancc. rko rcquircs thc lpplicxnr lbr \dch Pcrnril Io filca rilncd inrcnN lhd hcor shc is lienssl pu$u tri
<br />tr rh. prori\n)n\ nf rlE Contrctn s Li.cn$d Lr* lchrPrcr 9, Comnt{.if3 wirh Sccrn i 70(x) ol Divnn r :l ol lh' Rusl '\\ nl
<br />Prnis\ions Codr) or rhsr h.orshc i\cx.mpr rhcrfronnnd rhcb!si\ ior rtu rllc8cd cienrPrion A yvnn{riorofSstionr0ll5hvanv
<br />uplicnnr tu.apcrrril suhjcch rhc stplicatri h a.i!ilP.n!llyor or nx,clhrtr lirc hun,tr.d oll$(S5U))
<br />L ,s osncr of rhc p&pcny, or my crnPlolccs *il h eas* .s ih.n s[ compen\aitn:. uill do lhc srk trfl1 thc sltrrm i\ nn
<br />idc .n or ollcred fn \nlc lse ,044. Busincs anJ Potc$ions Codcr Thc Conkrttr s Licctr* l-tw docs nor trprly b rn owmr oi
<br />rhc lfrI).rty qli)hiklsor i'npn'tsrh.Nn. o.d sho dms sk-h work hi$s.ll'or hcr*lforrhmu8hhisorhcr.*trcmPloyccs.
<br />F);idcd rhd such inpmvcrns m mr ificMcn ot ofttJ.d l'or $lc. lf. lFwcvc' rh. buitli.S .r impmrdxtrr is sld within nnc Fr
<br />;t conphinn. tu osmr suiHs will haw rh. hndcn oI nmving lh:r h. or \h. dil mr bnild .i nrpmrc lhc Pn'p.nv ror thc Ir!,F)s 'r
<br />-1.
<br />!s o$n.r or rh. t()ncnr am cr.lu\ilcly .onrdins $ilh liccn*d ..ilr.cio6 ro con{d.t rhc Piojer ( Sc. 7t!r4. Bu\ims
<br />int Potusbtr Co{lc ThcCofi,.rols t,iccnse Low doc\ nor rrPlrto itrowncr.r[opcnysho hLildror inuovcsrhcton
<br />aNl who .o.t(N for such Inojech wnh , conrncron, liccn{d N^utrtrr h rhc Conrra.ttr { Lkc$c ljw)
<br />I rn.xc U nDdcr Secrio
<br />t.te: Ouer:
<br />rvoR(Dtls' (:(r\ti'iris,rTlor\i
<br />DF(:I ARATI(IN
<br />I h.tohr,filrn uMcr pcnrllyolpcrjury oic otrhc hll.*in8 d.llrrnrid'sl
<br />l hrvc nM erll nu irlnin r C.d ilicdc .f Consnr k' Sclfl Nrc for qor kcr' coml.rsd i(,n N fiovidcJ fu by S..ri'n .]7(x) of rh'
<br />hbor C{d..lar rhc fnirnnrrre ofuhc*ulk f(} whi.h rhc ponrir i\ i\\ucd
<br />rh.wnrllnr{hichrhi\trnniirsis{tdMyrv.rlcr\'con'$n\nritnirr\trrtr.cc rcr |hlicvruDhcrrt
<br />-lccdifyrhar
<br />inrhcpcrfo Mtr cofrhesork ntr w[ich rhi\ t'clrnil ir i\\ucd.I $rllnol cnfk,y rtry Pc onininydMicr
<br />v, rs b hrco r. subjc.l ro rhc {olk.n .onWrsrlior hws olCtrlir.nrir nnldstc rhrr ir I \hould t'cconE shtd ro lhc
<br />so't..orpctrs.liurprcvisn,n\olSLrliotr:lTIXJoflhcl.rhtrCod..lshill.fonh*irh.ordy*irhrhoe!flrvisi(,r{
<br />WAI(NIN(; trilxr r) {cutc worlcr\ comptns ri,D corurllc i\ unh(tu|. und shtll suhicct nn cmPk,tlr 6 $i'niml Irinhtl ii(l
<br />.ivll fincs uI k, oic hundrcd rhon\aftl tlo lrs (sllxr.(xx)). irr i(ldiri{nr r) rhc.o{ .i..trlPc \al$n, rmrsc! rs tmvidcd Inr lhc
<br />Scdiur.rl)76 ofrhc IrlttrC.dc. irlrcr.n rd rrnncr'! lcc\
<br />b"1", 3' Jd -/ :l
<br />I h.ehy rfinnundcr pc@lry or Pctjury thlr I !m liccnYd nidcr pmvision oaChrlrtr 9lconlmncins wirh
<br />oI rh. Bu\incssrM Pr.ics\ioN Codc. d nryli.ctrsc is ir lull lam ind cilicr
<br />Drl.,i
<br />l-icc \c Ntrnrtur
<br />30'/ (
<br />(]ONSTRUC ION I FNDIN(; AGI'NCY
<br />I hcnhy rffirr undcr l{mllyofNljury rhll rhcrc n ! condtucri,n Ltrdir8 rAcmy for rhc Frlimuncc ofrh. *ork itr whi(
<br />is{rd lS( :lo97.Civ C).
<br />AIILICANfDEIL]ISAIION
<br />Ilmhylilir rundcr rctrrlryof p.rjuryoncof rhcnnl,nvingl..lffarnnts
<br />l)cmolirnrn Pcnnirq Ashciios Norilicrrnnr I'L'd.r.l Rc3trlarior (Tirlc.10, Pm6)
<br />Rcqui'cd Lcrl$ol Ndilicrrotr
<br />l.cnilylhd rnu lid.ful rcguhriotrr rc3r'ding r\h.{o\ rc k,vrlrc Dor,'mli(*lctu thi\ prolccr
<br />_lcrnlty rhrr I h !. r.&lrhis rJ,flicdi(nr ,kl s
<br />o i'rnNcr ri shtc li${rclaritrgt' huiklin3.of
<br />fiirc rnli.n.(lpnlrny tu ir\tf,.l nurFx$
<br />I ll3r.. h..nrfly \nh rllCiryrf(t (in'nrr_
<br />rlhn Cily$d Cortrry to cnrcr upor rlt
<br />Al,plit{nror^rorsl!tu'trre Df
<br />Pcm r.. non,.rnrinr,: Zcz-z
<br />?.lq tl
<br />/,/1,, / a,"4=a
<br />Set Backs
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/Vent/l nsu lation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq
<br />lnsulation/Enerqy
<br />Drywall
<br />Brown Coat
<br />Ir/lason ry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enoineer Final Report
<br />Flood Zone Certil
<br />FINAL v/,q/r I >r,r^.,4r--/r) -Certif icate ol Occupancy l
<br />Notes, Remarks, Etc.
<br />SITE-WORK
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />Ext./lnt. Lath
<br />fT
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