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BUILDING. INSPECTOR RECORD
<br />SITE.WORK COMMENTS OWNER BTJII,DER Dt:I,(-ARA I(}N
<br />I hd.b'v lmm ntuld Ftrlry of pdjury rhd I m danl,I tdd lh. (i,mr&1oc' l.ic.M h* lor rhr foln'r'nt l@n (sa ?011 5
<br />Usrs .!n Prof*r. (-od.) Anr (Uo.(-oud) $h.h r.qun6. pamn ro mdrucr. !ha. imr'I,rc ddmlish.{, r.rEtr r
<br />nrudd( Fnr lo hs arltrq .l$ rcquG rhr q'rlkut ror su.h Ff,n ro fik i t{r.d ndNr ltd lE or nE ! licosal ,uean
<br />to th. pmvqbN olfi€ ('onrr.cloir l-ic.nsal l,u (Cn4rd e. Commocin8 wirh s(tbf, ?(xxr of Divbion I of rh. llusincss and
<br />Prol6rn! Cod.) or thlr tE o, s,E s 6.npl lhd.6oE ud rh. b6is lor thc .lks.d crnplirn. An) rbLlior oI S.clio. 70 r M} !n\
<br />.{,plic.d f.r ! Fmn {bcl' rhc qrrh.ar ro . oril p.uh } o, mr fr)E rhs, fi!. hund.d &ll{s ( l50O)
<br />I. d owd of lh€ F!p6ly, or Fy mploy€ lilh w.sd E lh.ir sk conFNl ion. sill do llE wort a'd lh. drutur i! B,l
<br />i dr.Ld or 6lt@d aor sh (Sc 7o{-{, BdiB Md Protc.lioB Cod.' llt Co'nn.r.r3l-ice l.tr &6 rer lpdy ro s o*E.l
<br />lrE FoFll who hlilld nEo6l,E@,n whodGrn** himllfor hd*laor rlf WhhitrlsoMmplolB.
<br />r'o\ iLi ihd rEh imFnrgrtd E mt -ra&l.r olEcd tor et l( lD*6q, llE hl'!n4 or nrqarqnd 6 irtd *'.nr o& !E
<br />of.om9laio.. rhc O*na Butk *ill h!!r rhc llrdor ofF.\,i.s lhi k tr !h. dij mr hrild or inprov. t
<br />'c FoFry ft'r dr FiFr* or
<br />l. a d*E otlh. Frpqry. mdcl6ndyc.nnlin8 $nh l'(aE dcoddoEro llnirucr llE Fol..1(Se 7ol.l, &!d6
<br />Md Plotu ir CorL: I h. ('o trroir Lic63. l-!w do6 en lpply ro o o*nd ol ptuFn, who hu'ldi 6r imptu!6 rh6en,
<br />ind *ho conld.lor chFoj.dsqirfi!(on'Bcro(I li.qE dpu6@ !otlEConk clois LiccM L.*)
<br />I d.rdnfl urd6 Sdrn .ll & P(- forrhsr@n
<br />Drl.: O*ner
<br />\r'oRxtiR\' ('dntPEt\slitoN
<br />Dlsn&ular
<br />I hd.b) lmrm undd rcnah! orFrtrn oncofth( tulloring (Ellraliotrs
<br />I halc od *ill
<br />'Mrmiin a Cglific.t. of Con$l !o S.lf- ler. for $ 0116 compa$lhn. 6 rmlid.n lor br Salion 17m of th.
<br />hbot Coda lor rlE Faoll14. o f rh. " orl fd $nf,h th. Fh a ie.il
<br />I hN c lnd r ill n!'nrain sork6 comp.roarion i6uran(., a r.q!tr.J h, Scl Dn .r 7l)0 otth. I lbor Codc. rff lh. pdromM(. or
<br />rh. wotk ff,r tr hich tha l]@ir i! i!u.d M) wo' L6 com!..s ion iNur Nc trE ud polic} nu'nbq {.
<br />l .qlra) lh.l i.llE Ftomd. of th. sorr for $hth rhB Fnn n iscd. l 3t ll { dptD xy F$r r uy meF
<br />$ a ro bdom 3ubjat r,r thc m*d comFM n n h*r ot ( slironi.. &d as6 rhd ,f I 3hrld lr(od suber tu rlE
<br />Mrt6 comFnslion pmvirioB ofsdrion 1700 ofrh. tlhtr Code I rhlll fonhNirh.ompl, wirhrhospmvir6B
<br />WARNIN(i li6ilu.lo suc *0116' @FrEsalion svdt. ir unL*t!!. &'l3h.ll 3!bj.Tl s ddoF lo siniMl,Eunii dd
<br />.nil fo6 uD ro oE hundEd thduqrd &Ue! (t100.000,, i. .ddnirr ro rh. colr orcomF!.rion. {hrus6 B ForiLd rd rh.
<br />Crct/z-<-:/16
<br />ucf:.$l:-r!.\ll$(l!BDl( l,\R.rll{r:\d
<br />I h6chy innm u.d,r p.n.l'yoapdjury $ar Ln lrcs.d trnd.r FrtDi olchaprd q (ium6trinE wnh sds.7cr0) oll)nBion l
<br />of rhc llurins ed PtulBioB(bd., rt m! lic@ i. r lull ruc. &d.natt
<br />tlu!1v 'x"*"7,@5'-
<br />catilf,!]ljuoll,tilDlNc_ac[!(r
<br />I h.eby rmm un&r Fulry ol Fdury thd 'hs. i! ! .odtudi,. lodiis .go.r f6r ih. FfomD.c .f ih. "..1 tu uhich rhi! Fmn ir
<br />i$u.d (s( 1097.C:r. C )
<br />attu(lllDE(lJ&rllo!
<br />I ho*y arlinh uidd ,.n!lty of ptjury or 6f rh. tollowi.s ddlert ions
<br />l).tuhr,. rcTnlArtElos Nol ifi.ll hn Fqisll R.3uLlions I lnh tU, Pi6)
<br />R.9un.d kll6 ot f()lrlEdion
<br />I cdifyrhd lhc f.n6alr.8ublioN Es6nin! abdosrmo\rl &r to dtpliclbL k, rhi! Fojd
<br />^
<br />l(d'[thdlh6cr..drh6q'9lrd'"nddr{.rhdLh.!h]\.i.aotuio.scotrd I alc ro ompl, r nh .ll ( hr a.d (tunl!
<br />(rd'n (6 u'j Sl.!.1.w! Eld'rB !, }lrldrns coMrud'otr srn h6.byaurhtru.r.F.srdrv6 ofrhi! Cnt ed ( oomy lo 6rs ulrn rh.
<br />,hr. nrori,,n.al nrcp.nt ntr i6!di.n nurres
<br />^pcrisnr
<br />o.
<br />^rnr
<br />shMrrn 2(^,, rf ttf tt
<br />cHPtt cL
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lns u lation/Energ y
<br />Drywall
<br />Ext./lnt. Lath
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />FINAL 1//2*/.+#)u n
<br />Certificate of Occupancy n L(./
<br />Note Remarks, Etc
<br />DATE I ID/SIG.
<br />I
<br />I
<br />Brown Coat
<br />I
<br />Flood Zone Certif.
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