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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE COMMENTS
<br />l.nsowncrolth.!m!cny.o.mycmployccs*irh+asc\6rhcnsoh.onrr.nsrio.,silldollE* andrhcrflomn.or
<br />intcdcd or olTcrcd tor eh (Se 7t|r4. Bu\in s rd l']n,rr\si r cGlc Thc Contrscrois Lijcn{ ljw do8 tror ,prly r, m owrr oi
<br />rhc pmrcny whl builds.r in{rovcs rlfMn. d ul[dessu.hwolthinNclforhcrsclforihniughhisorhcroqncnrPlo}rcs-
<br />lr)!nb.l rhar such inrovctrrft er mr i' cnlcd or otlircd f(n slc. Il hoacvn. rhi builtitl3 or inuownrnr i\ rld *irhin oft Jtr
<br />olcoryhhn. rhc Osmr Buildcr willh$c rhc hrd.n.f pmving rhd tI or \hc did ior buikl or nun,vc lhc tFFny t'or rhc purr)< of
<br />I. rs (
<br />'Encr ofihc 0mt'cny- rnrqclusivclycona!.rins wirh liccn\.d contr.l(r( b .onnrucl lhc pfl+cl (S ?ol,r.3u\idr*
<br />a l Ibfssin Codc 'I'hc Conkr.ktr s Li.cnsc L.E dds Ni nm ly lo un o{ncr oi pn,En! *ho buildr or $nrov$ rhcrcon.
<br />n who .onrrh lor \uchrrujc.r\ wirh rCdnrackn(r) lir.n\cd purui iorhcC.nk.crois l,iccn* tis)
<br />I J'ne\cnrprunJ.r Sc.ri,nl .B &PC forrhnrci\on
<br />lhle ()sncr
<br />lY()RXERS C(,\tIt!]NS/tllON
<br />Drrt .EauoN
<br />I hcrchl rlfii,nun'l.r lrnrlrtol Fruryo .ol rhc lolk,tri'rg d..l dtnr\
<br />-l
<br />hrvc afrl * ill mriorri,, rC. ilicni..fCoNtrrtuScll:lisur.forloikcr'couU).n\xrt,n.a\ !fl,lidcd ntr by Sc.ri lT([ollh!
<br />l-dr (-{dc,lar thc t^_rl'ornrL.^c ofrhc {ork fttr*hich rh. Fm,ir i\ i\n,c
<br />lh v.rnd willirnnrnr eolkcr{.o r|Etsrriot $\urrn.c. rl rcquirci bvS..rnn,:l?iX)ofrhr L'b.rCodc. tr ll[ ntr,nilnrm.ol
<br />d. M) witrkcr! !olu)cns. r nin\u'r1.c,trni' Jn'lr.lic) trd,rh.rtrcF,r^aL
<br />,u''.. *,-U. - 6
<br />-lccnily
<br />llur in rhc pcllormicc olrhc *ork lor ohich rhk pcnnn is 'ssrd. I sh.ll tror ctrrpl,)y aD! r.ron ir rtrt ntrnncr
<br />a r.L,Lr. trr.uhlarrorh.trd!"F!. t1srnnlJtr..r(rinind.r'JJcxtrh 'll \h,ul,l l'{!,{m .uhE!r r,rhr
<br />(,,r!{. ,r rt'.ls r',nrrnrF'ntr,.lsccrnr.r)(niirhcl,hr(iJ".l J,:ll. i, rhtr h..{nnlttrrrrt"el'- 'L".
<br />IVARNING: tiibrc kr *.urc workcs'conqEnsariotr covcrJg( '\ unlJsr r. xl \hrllluhrlrr rn {''t'|.,)rIr, otrn'nJ p.Mlrics a'lJ
<br />lrtt
<br />\{ rhou..urlL,,llur\ 'y!,t.ix{". rn JJ.liri ' ", rhr,..r u,.orrp.1.Jro1. rlJ,tuF^. J\ f'r!iJ''l ru' rl'.
<br />.irc.,rc,c\r otrdi ,,li\ . r.c\l6 J"., ?r: c Cel ..t/' urINs[DroNrsa(]ll
<br />DECI,A8AIION
<br />q.
<br />I hcrcbynlfinnul(lc!pcnalryofp.rjrr!rh,r I lien{d trnd$ trovtion ol Chrprcr I (conmknrs eirh sccrinn 7U(D)olDivision l
<br />of rI[ susinc$ aNl Pmltsionr Codc- lod 'ny liccnsc i\ in tull n,.e nd .ficcl.
<br />,f ,(jL I J**"
<br />+o
<br />51 \g srctFr t?;m
<br />c()Nslllllc-r(|N I F'I,{nlN(i A(;lllicY
<br />I hcrcby liinm ufrlcr perulry.t!.rj!ry rhrr rh.rc is a.ondflcrir lc.din8 .scrcy for lhc Frrornrrkc orrh. work hr whict this Fnni n
<br />nsucd (se l(9?. civ c.).
<br />ATSLICANLDECIAXAIION
<br />I h.lrtyatinnundc! n nrlry of pcrjrryom of rhc folbwid! dcclnhrnns
<br />Dcmohnr Pen h'Ashcnos Norifi.lrion l:cd*nl Rc8uhri{,n\ {Tirl.40. Prn6)
<br />-Rcauncd
<br />krlcr of Norill.!lbn
<br />'utr'|rE
<br />l)
<br />Ic.nifyrhar rhc f.d$rl rcBultrrions rc8lrdnrB a$c{os r.mularc norrppli blchrhisptuiccr
<br />I!dr,yrhdIidLcrcadrrTaFJrli.aionJnl.r.rh h.dh.!c' liF,rric,'mrl)(ah+
<br />. din"n!cs Jrd Srnc lrtrs rLriTrn,l'qild'n! c,'ritu\,'"n. r'rl h.h'hr iurh'./c rrrrc{nkrtr.. ,'r 'hh Cir} rnd c0';;;,:,-'^.ffi::/9q'_ -,:(l
<br />""^,.,^-.,,^^,,/ t* ,- "C,e,\ r.,,.
<br />f\It
<br />Set Backs
<br />Erection Pads
<br />UFER Ground
<br />Subf loor/VenVl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsu latio n/E ne roy
<br />Drywall
<br />Exl./lnt. Lath
<br />Brown Coat
<br />Ivlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Beport
<br />Engineer Final Report
<br />Flood Zone Certil
<br />FINAL fi-27 -t_r \i.)x v)\
<br />Certiticate ol Occupancy 1.,.
<br />Notes, Remarks, Etc
<br />ID/SIG.OWNER B(I!I-D[R DT]I,CA P-\TION
<br />au\inc\s a'kl Prof.\\i('. ((xlr): try Ciit.r C.trnty w[i.h rcquircs r licnnii k' (,dnfl.t. n]rcr. nnProvc. dcNrli\h or (lJn an!
<br />{flchn.. prntrtu irs isur..c. also rcquncsrhcaptlicNr lor suchpcnnirh lllc signcd ndctrf,,rt rlurhcor s}lc i\ licdn\.d pur{r.hr
<br />h rhc ,,r,vhions ot rhc Conrrrcror\ l-i.cn{rl bw (Chrprcr 9. CoDnncNing sirh Srrrnnr 7(XD of Divni, :l oi lhc Ru\iocs |i'd
<br />Pn,fc\sn,n\ C.rlc).r rhd h.orshc ncxcnrpt rhcrclio nnd rhc htrsls lorrh.rlbg.d cxc rlrn nyviolario.otSccrioiT0.ll5hyrnl
<br />rprlic.d br a |rflnir {rbjc.rsrhc lprlicrtrrb civilpdtulryorn{, rrrh.r livc hunnrcd dollxnl1500)
<br />Forms/Steel/Holdowns
<br />SLAB Floor
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