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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNTN BUILDER LIDLCARATION
<br />I hcrchy nl'ftni undcr Fn ! of pcrjury th,r I m.r.mIr fn,n rht conta.ro^ Li..n\. tiw r(r rh. toll.wing kav,! (s..7011 5
<br />Businc$ md Prolession Codc) Any Cny or C.u.ty whi.h rdquircs , Frnn k, .otr{fl.r. alr.r. nnpn,v., dcnrli$ or qun any
<br />docrurc- n,in ro ils issunrcc, ols rcquircsrnc rmli.atrr roi such p.nnn ro,ilc. siSncd ndrcmnt rh0r hcor nr is licctrsd purua
<br />ro lhc Imvtions.flh. Co.knctoCs Lic.trs.d ttr* (Chlpr.r 9. c(,6m.n.ing wirh Scdn,n 7(XXl.r Divhbn I of rh. Bxsincs rnd
<br />Pr,ft$n,.s C.dc) or thrl hcorshc hcicnrl thcrclionr Md thc bisis lor thcalkacdcrcmp'ion Anyviol.rionotScclionri)ll.5hyany
<br />aprli.,nr ror a p.inir subjcch rhc rtplica.r kr !ci!ilpcnlhyolnor mrrcrhan llrc hundrcddollas (5500)
<br />-1.
<br />as oNtrcr ol rhc rollcny. (tr nry c.nployccs wilh waScs ,s rhcn bb drnp.trs^riflr. qrll do tlE sork and lhc iMl@ is nor
<br />inrctrdcJ oroltto{ lor eL (Sd.7044. ausnEss and Profcsi{,ns c(dc:'Ihc Contactr's Liccnsc Liw docs nor.DDly ro on.sncrof
<br />rhc ptuFn! who builds or inrpK,v.s rhcnnr dd sho docs such {ork himrcllor h.rcltor rhrcuEh his or h.r osn c.l|,lo!ec..
<br />,rovidcrl lhrr sucn impmE,mnts N Rn inrcfrhd n oficrcd lor s,h ll hlwcrcr. lh. hoildin8 or i 0nnctrE h $ld *ilfiin nn( rerr
<br />of.onplcridr. rhc Oen( Buiki.r willha* th. bnrd.n ofrovin8 oEr tE or shc nid er tuikl or irll)rolc rhc pmFl, for (lt lnrl$* of
<br />_l.rsoqncrolrhc[,olrny.rrcr.lusivcly.oftrcri'rg*irIlircn\rdrotrrn&r\rr..fnr.rrhcpn,.,cd(SLr.70,]-{.I]u{nc\s
<br />rnd hnfca\imCodc'l'hcContrctr'\l-iccn\c1,,+d{{\no!rpnlybrnosncroinloB-nywhoiuildsorimprcvc\rhcr.oD.
<br />rnd *ho co mcls lar such tnolccrl qirh n cu0kd.rtrl\) liccn\.d pursrr r brhr('.nrafrr'\ Lirctr\c trN)
<br />-l
<br />amcxcmpludcr SNtion-. B &PC f.rrhisE.son
<br />OPner:
<br />]raatrl:all:()ltfrNsAlror
<br />ILCLdAAII(}N
<br />I hcrchyrllirfl undcr!c alryoltcrjuryotrcolrhclollow rf Jc.lmri,n\
<br />-lhovcaiuillnuinrdnaCcnifi.arcofconsrnrt
<br />s.lr lnsurc ror *urkcrs.ontrnrarion,0c providcd lorblScction]T0Ooltlrc
<br />ubor d)dc.Ior rhc,.fonruftc ollh. wolk for whi.h rhc peroir is hrkd
<br />I hrt r8l *illnuinrrin *.rlcri conrpcnsllnnr insurrNc. as Eatltcd byScctior 3?il)ol'lhc LlhorOnlc. fo! rhc pcrtonunccol
<br />M y uorkcn conrp. \.rion iNumNc c.Ficr lnd policy nu mhcr arc
<br />L
<br />q ULr(t 0-( k
<br />I.cnily rhrr in rhc F-rforron.c ofrh. {ork fir *hich rhis p.flnir is issurd. I \hrll tror c Dby rtry pcr$tr ir any mrnncr
<br />$ !s h bccom subi.rl lo rhc *oikcc' co mrcnsir ion lnws ofcahnmii.,nd mEc rhar ifl should hcconE subicct Io rhc
<br />$orhcN co'npe.\arion !rcvisions o, SNtion ST(x)olrhc tjbor Codc. r stull. fonhsirh co'nply with rhoc tmvhions$ARNIN(;: F{ilur. ro sccurc wor*cr omPctrnnn .ov.itrgc is unlruful. rnd sh.ll suhj(r arr rmploy.r to dimird pcrukics.nd
<br />ciril 6nes uD ro onc hundrcd thousand dorla^ (SllD.mo), i. addi'ion ro lhc cosl ofconpcnsnlion. d.m8cs {s nmvilcd lor lhc
<br />s.crion:1076 ofrhc LltnrC.de- inlcre(anda onEy\ lccs
<br />;,:,""4-ik;r- - ;ilv -F--r-LfFrsED coN rR,{cror
<br />IIECI,ABAIION
<br />I h.rchr rrfirm hdcr pcnllryofpc{lrylnd I !n liccnsd undcr pmvnion ol'Chrprcr 9 (qnn'rcrcins *irh sccrion 7txx)) oroivision 3
<br />ol rhc Businc$ and ProfcsionsCodc. onl my liccnsc n in lull rora {d cl'fccr.
<br />C-l o lb oY eo 7
<br />1 irsl 'r
<br />kst.d (Scc 1097. Civ C.).
<br />lxnJ.,'. Namc
<br />-
<br />AfIII!]ANLDECIIBAIA!
<br />I LEr!, idonncrrEnrhyof pcrjuryore ollhc lolloqinsaccl .rnnN:
<br />rJemlibn Permik.Ashcstos NotifEarion lrcdcrnl Rcgnhr,.ns (Tirlc 40. Ptrn6)
<br />-Rcquncd
<br />brlfi oi Nolifmli.n
<br />I c.nilirhrrrtu frJcrxlr.EUhn)n\ rcgtrding rshc{os ,cn)ul rrc mr rt,plicahlc k, rhn pn+.r
<br />-l
<br />cenifyrhtrr I hovercadlhn applicltionnnd {0l hatthcatnr irhrmrion n.oEccr loexerocomplywirhallCirylndCounry
<br />ordidnccs and Sx cLaqschlitrslobuilditrBconnrucrion.udhcrcby,urlnriz.rcprc{trrarivcsoflhiCityandCouDtylocnre.!tx,nlh.
<br />.trrk nrtrriotrcd proFny lnl in\pc.'ion
<br />/\mli..hl or AAdl Slgnaluh
<br />L
<br />qlrrlu
<br />Set Backs
<br />Erection Pads
<br />Subf loor/Vent/l nsulation
<br />Rool Sheathinq
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />It/ason ry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Leputy Final Report
<br />Engineer Final Report
<br />Flood Zone Cenif .
<br />FINAL
<br />Certilicate of Occu a
<br />Notes Remarks Etc.
<br />Forms/Steel/Holdowns
<br />UFER Ground
<br />SLAB Floor
<br />ailzhtn I
<br />I
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