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BUILDING- INSPECTOR RECORD
<br />COMMENTSSITE.WORK DATE ID/SIG.
<br />Set Backs
<br />Fo rm s/Stee l/ H o ldown s
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/Venti lnsulation
<br />4/uDrzr /r|-t-.-'Roof Shealhino ,/tr /t l'
<br />Shear Wall
<br />Framinq
<br />ln s u latio n/E nerqy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />N,4asonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputv Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif
<br />/&j--FINAL nhslt*6vnur*
<br />Certilicale ol Occupancy
<br />Notes, Remarks Etc
<br />itltj\DR Blrfl ,rn:R t)td,('.\R,\l r()N
<br />Dor.: Osnr.:
<br />$,()RI(ERS, ao[rpENS r.t{tN
<br />DECIaISAIAN
<br />I hcrchy,fli.nrundc, pcndry ol pctjury ore or rhc hllowi,rS dahrnrn,nr
<br />edwillmi dnaccnificdcolconenrhsclfltrsurcirtrworkcn mtrFnslri{'i s flovidctl f{n h!sccrionlTlltlofrhc
<br />r (Glc. tor rh. fdronn{n.c o frrr w.rk lo.which lhclxnnir i ilstd
<br />sdrkcrs..ompcn\drion in\fian.c.ns rcqliBl h! Sccrion:17(D (,frhc Labo. Gnlc.lor Ihc Pcrl'nNn'c ol
<br />nnr in\urr (. nicr lndtrhcYnurbcr:mk
<br />tnc- 51-
<br />-l
<br />ccaiitrhrr i', rlrNrlormncc or
<br />$ il io tr{oN suhicl r. rhc wo.tc6
<br />rhc wort lor *hichihi\ p.irni! is i\\ucd.l shrll.or c'nrn)yrnv|:.notr in,trvounncr
<br />qnnp.iuiotr lrws ol'Cllilomir. and.EDe rhrr if! should h{roft subF:l lorh.
<br />woik.tr onlpcns ion pn,vhions ol Sccrt,n -l7m of th. tjhor Codc l shrll- lonh*irh conl'lv tr irh
<br />WARNIN(: l:li,urc ti {curc {orkc^ comnenrdnn, covc,rgc is vcr t).n itul Fulrf,\ r d
<br />cnil fnc\ LI k, otu hnndr.,l rhotr\r d doll,tr\ lSl(x).lXX)).tlrfn!(\ x! nr.\id.d ]n. rl'r
<br />') l.oN,ki(trrc sirh S..r(f rl)1x)rol Dr^ir lI hcrubr rlfirn u cr ncnalryorP,rjMyrhul I rnr liccn
<br />ol rhc Busincs rid Prolcsdo'tr Codc. rxl nry liccn\. i\ irr
<br />I h.Fh' ririrm u dcr |tmhy oi pcrjfiy rhm th..c k ntr rhc p.rftnnatrccol'rhcrork n, $hi.h rhir Fnnir ls
<br />issucd (Sa. 1097. Civ. C.).
<br />Irnd.r'( Narm:
<br />-
<br />= ----
<br />AIIPI IC N'I' IIT(] RATION
<br />I l.rby.ninn uMcr pcnrhy ofpcrjry oic olthc lollowina dc.l"rrrnnr\:
<br />Dcnrliri(r PcnnitsA\t ius Notiliclrion FedcrlRcgul ri.ns (lirlc 40. Pan6)
<br />_R.qurcd lrlrcrol Norii.dbn
<br />. 4-,",n
<br />L7/,,,
<br />{r rhc l.il.rxl rcAuIltnN rg]ftli'rS osrcnsvallrc oramliclhlc k rh truitt
<br />t hr\c r( rhi\r[,]'.rr(rriRl
<br />,\ppliQnr !tr ,1s.nrSirnnl
<br />.onuly wirh.ll Ciryand Counry
<br />h,r ci,y rnd cnunry,o cdd utnn rF*.3-tl'4
<br />Erection Pads
<br />I hercby rrfir utrdcr pcn,lry or F.iuty lhar I an cx.mpt ltum rhe Co,ta.t,s Li.cnse ljs fttr lhc l'ollowinS rcown ( Sfr 70l l '5
<br />arsircs( rftl Prot$nrn Cod.) An, Cir, or counry Bhich .cquircs tr lE lnir h connnrcr. ilrcr. impiorc. dcnxni\h or Ep0ir unv
<br />(rucrurc. pri.r b ns tsuoncc, ako rcauncslhc atplicrrfor su.h lcm r b filc I siSmd {d..ttrr lhal tr or\hc is lirci*d fturudd
<br />rorhcp.visionsorrhLConrruck,\l-i.ctrscdtjw(Chrflcrg.ConnrcrcirssilhS.crionTlxn.fDivkhn.l'rrh'Bncin'$rnd
<br />Pnfc$ion\ Codc) or rhrl hc or \h. i\.r.n]ln Ihcrcltomlnd rhc br\t lor lhc rllcgcdcrcrnlrion AnvviololionofsccrionT0ll5 hv&v
<br />amlicanr tor n lrrmn slbj(l h. rytlic0nr lo a civil p.nrlry . f trol Nnc rh3n rivc hundrcd dollf (S5OO)
<br />l, !s osncr ol rhc pturcny. ot lry edrlt,yccs snh s 0Bc\ sr rhcir blc comncn\d i(,n. will & rhl sork 0td lhc ddur' is nor
<br />inrcndcd or o,tircd ror ;h lse.7o44. BusiEs\ and t'rol.$t,n( Cod.: Thc Cttrrrlckn \ Lmnsc Lau Jocs "r amlv ro I 'wmr or
<br />rhc prclcny whr buildsor inlProvcrh.6n. fln *ho dms \xch w* hinrclr or hciscll or rhtux8h hn or hcr owo cnrlovccs'
<br />p."iid"a rru .u.rr iulok rnr lrc ml inrcidcd or offdd lar $lc ll howcvcr rhc liiklin8 or inrprovcmd is $B wirhin ' N tqr
<br />;imnphli.n. ilt owr Builder sillh,vc $c budcn olF,vnE rhil hc or \hc dil nol ttikl or inPnrt thc lmlEiv rot r'r,'uqx's or
<br />-l.rsowncrollhcrroFry.r'nci.lusivclycontldinsqirhlicctcdcotrtrcro'\b.ohsrrclrhcpn'jcd(Secr(}r4Bn\i"cs; hl6\nn codc: Tha c;nrr&ktr\ Liccnsc L!* docs nor a|!lv lo in ownn ol0,oPcnv who huilds or nnllolcs rhclcon
<br />ond wh. c.rtrlck itn ruch r{ids 'nh a contNo(\) liccnscd p!^mnr ro lhc conkNnni Liccnsc hw)
<br />-l
<br />rhcxcnDr utrdcr Scrrion-. A &f C fttrrhkrcien.
<br />I
<br />::AWW
<br />L.ndrr( addrcs
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