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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNEX BU!I,DER I)EI,C RATION
<br />I hcrchy atfirm n.d.r !.ntrXy of l). jury rhd I an cr.mrr fro'n rh. Cun6ckm Li.cnsc tiw f.r rhc follo*in8 rc.xon (S.c 70115
<br />Bt\incss 3rn Proic$ion Cmlc) Any Ciry or Counr! $hich r.qutcs . Frnrit l() co.(dcr. .llcr. irynovc- &mli\h or rcpat xn,
<br />ru.rur.. Pritrb ia i\\uancc. ah. rcqoncsrhc snplicanr lor \uch pcrnirro lilc ! sigocd {arcmnr rhai h.orshc i\ li.cn$d prrsunr
<br />h rhc nnvi\i,)ns olltu Conh.rfft Licctrscd lj{ lchll,$ 9. Co ncnci.g wirh sccrion 7000 ol oivision I oirhc l}$inc$,nd
<br />Pn,r.ssions C.dc)orrhrr hcor rhc i\ cicmrrr rhcrcrRnn and rhci,.sis lnr rhcalbscncrcDprnrn Aoy!i,n!rtunofSccit,n70.ll5byriy
<br />apflic,trrroraFiinir(ubl.chrhc,mli.arha.ivilp.tr!kroinotnx,rcrhJnfirchutuhdd.rlar(S50o)
<br />f,{tr7*, *,* ,"*", "r nD cninr,,yrcs w h q
<br />'scr as rhct slc co,lp.nsrion. will do rhe work ud rhc nturk i\ mr
<br />Ylcn,lcd '{ ofrrrrd fi{ iL ls( 7U44. Bu!n.$ Jn,i Pr,rc\\ions Cod.: Thc C(nnrrcnr'\ Liccns.I-'s Joc\ noraPply ro rtr.q0.rof
<br />tht pn)pcn, *tn builds or improvcs rhcmtr. lrd qho d€s \u.h *1r* hnnscll or h.iscli.r thrcu8h hh r hcr os..nDloycc\.
<br />Irovidcd rhar \uch in[mvcmna 0a nn inbklcd or ottcrd rt r eh lI ho*cwr. rh( hik]i'r! or irymrc'Enr ( $ld $ irhi" ,
<br />'c )u
<br />.i.onpLrion. rhr Owncr Buildq will htrlt th. btrr&n of povin8 rhor h. o. shc {lid tr'r tlild or inlrorc rhc ptr,pcnt fi, ihc l)lrF)sof
<br />,r,,r"07 1,={),Qzt:/qt8a
<br />t2lr;LdrrrraN
<br />I hcrcny rfii'nunic! pcnallyolp.rjury onc oilhc nnlotrirr dcchftrions:
<br />_lnNc,ndwillmri(6iraC.nilicrhofC.ns.nrroS.lfln\xrdlbr{.rkc*.unpcncdiotr.d\ fir'vidcd lir. hy Scclir lTlDolth.
<br />Ltrhor Codc. f(r rh. p.rformrn.c.l rhc work fn*hichihc psnrir h h\ucd
<br />lhi\candaill'nrlnrainworkcrrco'lncnurionin{mn.c.rs.cqutcdhySccri.nlTlX)oirhclrhorCodc.fltrrhcli.rfr'romcof
<br />rh.\orkl(tr*hirhihi\pr'trr lsis\ucdMyworkcF.oarFnsnliorin\trrncccrd.rtr F,lkt nun$.' rc
<br />Csier:_
<br />Qr!)9t.,,r" *""*^"-.n.c, r,hc s,trr ntr shich ihh ;.nnrr i\ iisucd. l fiarr nor cmpby an, pcrson in ri, nrnn r
<br />vr L.L,b.. n'!dh,(rL'rhrtr,1kc,.',,.trt'i!rh'nl,(.' C'' r'n.:.JnJrE"rrh ll.h,u'Jhr'{a.ul^J.flr.,h'
<br />rork$( cotrrt,ctrs n$ tmlisions of Sc.l Nn llu) .r rhc Lrtxtr Co r. l \lrll. nd hsirh .!mdy w iih rho* pnrvisi( \.
<br />WARNINC lailuE t, *.urc *orkc6 .onrplnsrr(D.ovda8. i1 unksnn. rnd \hrll suhiccl u cnDloycr t, Ln'n,ru] p.mlrio\ trd
<br />.r'l inrt\ up b otrc hundrcd rhotrsJnd Jolhrs (lSl(xr.(xxD. ir 3ddiri,)n n)hc cod of c.trp.n\arii,,, drnB8.s a\ fn)idcd l{tr rh.
<br />8../.,.,",@7-l?-/ F n*,,-.i .y't<z'o 1
<br />DES,AAAIION
<br />I rf,Ehy arfirt undcr pcn,lrrofpcrjrry rhar I am lien*d undcr pmvi\ion otChrprcr 9 (ehEncin8 wnh sccrion ?ur).rDivtion l
<br />ol rhc Blincssud I'mlcsn,nsCodc. anA
<br />'ny
<br />liccnr is h tullforcc od cll(l
<br />T!]N5IB]Jl:IIONIEIDINC.dCII.CI
<br />I hcrby rflirn undcr rEialrr.fpfrjorylhar rhcrc n uconslrucrbn lcndinsqcncy for rhc pcrlornEnce ofrhc wotk r, wh.hrhNFnn is
<br />hsucd (Scc.1097. Civ C )
<br />Afftll lu)liclll8augN
<br />I h.Eby nnnundcr f.nfllr) orjlcrjury om ofrhc n,ln,sine dc.hrarions
<br />Dc,ftn n,n Pcrnrir\ A\hcdo\ Noriricarion l:cdcrrl Rcculilians ( lirb.r0.I'n6)
<br />Rc+rcd lrncrolNorific rioo
<br />I rltre.s rc hv.l dc tror .mli.ablc k) thn prclcct
<br />rhr rhcrh,k i',tunnrri(in n.o'r..r I xlrlr k).f trinlysfhrll Clryntul C'{ny
<br />W;:Z
<br />rhi\ Cny,nd Counly to colcr u!.n lh.
<br />,"," g7/?=1V
<br />e,A-
<br />rtn)rc nrnlnnrcd |x)t.ny li)r nymr z/ r/,L
<br />4.,?z''$.t,I
<br />Set Backs {
<br />Forms/Steeli Holdowns
<br />Ereclion Pads
<br />UFER Ground
<br />SLAB Floor
<br />Sublloor/VenVlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framinq
<br />lnsulation/Ene rgy
<br />Ext./lnt. Lath
<br />Brown Coal
<br />Ivlasonry
<br />T-Bar
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Cenil.
<br />FINAL K/?7/()ux(
<br />Certificate of Occu pancy
<br />Remarks Etc.
<br />-i
<br />Drywall
<br />Pool Fence
<br />Handicap Req.
<br />Notes,
<br />l.nsostrcrof rtulln)n dt. mcr.lu\ircl!contrri',9trirhliccn\cd..nrrctr\n)coh{tucrrh.lx,jccr(S.c 7(}:l4,8u{i.s
<br />rn{llt(isionCodc:rhcCotrt..l,r'\Li.cnscL.\'dN\trorrp!lyk,rtruwrrorpr)fcrry!hohuild\orimtrclcslh.rcor.
<br />rnd uho conrn'ctrtur\khpnuccr\sirhrContxctrrlrlic..scipursrnrn'ih.ConrrGioi\l,lcctrEI:trvr
<br />L.rdd's Addrc$:
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