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BUILDING. INSPECTOR RECORD
<br />COMMENTSSITE-WORK DATE ID/SIG.
<br />Set Backs
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Sublloor/Vent/l nsulation
<br />Framin
<br />lnsulation/Ener
<br />Dr all
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonr
<br />Pool Fence
<br />T-Bar
<br />De Final ReU rt
<br />En ineer Final Re rt
<br />Flood Zone Certif
<br />FINAL
<br />Certiticate ol Occu nc
<br />Notes, Remarks Etc
<br />OWNER BUILDER T}!'I-('ARATION
<br />I lrr.hy.lftnr unJ.r pcmhy of FrJury thar I rm crcmnr 6(h rhc c trt..n)n' I-'c.h\c tfw ntr lhc li,lkNif,! r..q'n (S.c 7o.ll5
<br />Bu\tr,cs\ xBl Pnna$Nn (irlc): Any C y dr (indy whrch rcqumr , lErmn nt drnrrtucr. alrcr. inpove. &'nol6h or rcnJt atrv
<br />{fl(lurc. nntrlo il! t\un(. rl$ rcquirc\ rh. rmlkrnr ld suchlEmi n' ik! nSncJ strlcmnr rh, It.r she i! ti.'ns'd trnrnr
<br />t, rhc Fov'\rnr .l rlr Conrra.nr\ Lmn{d tjw lchlprcr O. Comhcfr r! *rh Sc.h.tr 70Ul t Divni{nr .l of rh' llLNincs 3nJ
<br />Pn,fcsn n\ Cod.)or rhrr hcor\hc r cx.mnl lhctclionr nl rh. hrns ntr lhc rllcsd .r.nflDn. Anvviolrrionotseti T0ll5by'ny
<br />itll(anr ntr.Frm lunjcc*rhcln0licrDir)rt,v'lncn.lry.l,rormrcrhmhvehunlrcdJollaB(i5m)
<br />-1.
<br />ar owncr ol thc pn,Fd y. ,tr my cmnloyces wrrh *r3.\ 's rhctr s.le uomP.nslru,. unl dn tlE wor( ,fit rh. siMnn k n
<br />hr.nkJ or oflirc'i litr slr I Se 1)44. Ilusin.$ M,l Ptutcsn s Cab 'fhe Ci,nrr.ktr s Liccnsc I rw Joca nor lpl'lv nr an ownct nl
<br />rhc lr)F..dy who lIil& .r inlln,,ks rh.s)n, a,l *h' 'l,rs ach wort h ntcll or hcrclf or rhn'u3h hs or hcr own cnrnl(rvccs.
<br />F)vdc'l rhrr \u.h 'mf,vctrf,nk s rtn inks].{ d dtlcNl tur \rlc lll hrwcv.r. rhc hu ililln3 or uqR,hnrN s h! within unc vtr
<br />ol comphton. lh. Owrc! Builal$ wd h.v. lh. t nLn ol pn)vh8 lhd lE or shc 'lrl nn hudl r iml'n'w rhc notEnv tur rhc ltrlr){ ol
<br />l. !so*ncrrl rh.tn'ndry. am e\rlNNrly c.nta.tn8 w h h.ctrsc,l cont&n'F ir ltnddd rh. rn*cr (Scc 7044.8unnc<i
<br />anl [,t.Lsnn C dc l hc Contkttr s Liccn{ l-!w 'locs nor rmly ro in.*ncr ol loI. v who huilds or inlit'vcs lhercon.
<br />!trJ sF,.onrarhld{.hnn)F(rr*irhic.nt&t)({)le.nsc!Pufioanr!)thcC.ntrkkr'rl-it.irti*).
<br />'B & PC t rh''''r!'n
<br />!y!8[EBS]!O!![EN!AT!!)N
<br />DE('I,AR,\TX)N
<br />I h.ntrv rl1trnntrd., Nflrlry r pc!trryoni ntrhc n)l[)winS Jc(hnrnn\:
<br />-lhrv.mJwrllmainlamaCenili(arc.ta.nsenrloScll-ln\utol,r*orkcn.omp.n.ru.i..(F'rd.JkxhySclr$nll?fl)ofrh'l2htrC,rL,lorrh. P.rf,muRr ol rh. w.* lor wh(hihc P.mI is i\\u.J.
<br />I hiv. rtrd wrll 'nri' rn workcr rcqutrcJ hvSccL! 17(x).1ihc l-rhotCoJ..lirr llE I$tornrn( I
<br />rh. work lor $h'r I rhr E , nnr r( ssucn Nl y ,o' [cr' ron+-tr\rrtr{r trNurrNc LrL. drt I'lrv nunrt r !c:
<br />N{$ eric,^^ Z.,r ri cVr
<br />01 6otZ 14 ot 1
<br />l.cnilirhi rh. p.rlnrnun(col rh. wo.k Lrwhichl[i\ pcrmir n i\\uc.], I \hrll nor .nllov anv r'.ron 'nanv nranner
<br />*' xs n, hcLdn* suhFrr n, rhr wortcts' comfcn\xr ion laws .t CdllLnni, 3trJ r!t. rhd il l sh)ulJ k{otr \uh}ol n' rhc
<br />worko L uonlpensrr ion pn,v(n)nr .i S.!ri,,n ]7m nl rhc l;lhtr C,rlc, I shrll. tunheilh connlv *rrh I hrr Pr ovFDns
<br />WARNING: Fr,lnrc t) s-urc *o ct'comrctrQrr)n.dveralc '\ unhwhrl, inJ \hrll {rhj.\r an cmph'vcr b dirtrrl!'cmlti\ od
<br />.Nil ntrc\ ut h.nc hundrcd rk,u\rJ dolldr (Sl(t),000).
<br />'n
<br />r,l,! n)n nr thc on ol conrP.nsllnu dimaS.r .s J'nrvi'lc'l tur rh'
<br />S..rtr)n l(,76 otrh.lihrr C,rlc, hr.rcn rnd alotrry s lic\
<br />1- 21' lc ftn.).rcut Gr^..L c",-
<br />LICENSI'D CONTRACTOR
<br />DEC!,A8AIION
<br />I hcEhyallirmunJerFndlryol Pcrjury rhar I s lid.d untlcr pn,visi,)n ol Chrlrcr 9 (commtuoe withSdi'nrmo)'l D'vBon i
<br />ot lhc AusrE$ .toi P$ltsonr Codc, ! sy lic.n{ i\ r tuU inEc nl cllccr
<br />q1s1 4 L
<br />q-z 1. IC1 V r V,nl Sc l(^.r
<br />COlisTRUCTION LENDINC A(iENC'I'
<br />I hcrchy rlirnnnd.r fnilrydl l--tjury rhj rhac s r..ndn'!rion hnlmS 4.ncy lhr rhc n rioi,nrn.c oilhc work 1r{ uh(h rhN o'flni $
<br />Anr((lrsc( lor7. (,v ( )
<br />ATTLI.IANLOEIIABAIIO!
<br />I lx'n$y aliim ud.r Fnalry of lcrjury.nc ofrh. bll(rwm! del ori()n\:
<br />Dcmol iM PcnnrrsArhc{o\ NorrlEalhn Fcdcnl R.Sul ions rTnlc '1l). Prn6)
<br />RrqLnrJ Irrrrrol MnilndDn
<br />I ccnrlyrhi (hc liJcrrl ft8lhn,)ns rc3dJr! r\h(d.s rcn$vrlr'. nor aml($h n) rhF l}n*{r
<br />I(.rrily thxr I hr\. n,rlrh^ rnph!rrrit i,kl {,i. rh, rM I r!rcc n,.onp1! wirh xll ( rry rnJ (\{rtrlv
<br />d horrc r.f'c\.nrxrivc\ol rhrC(r_rtrJ (i yrocnr.rurDrltonirxn.c\ an't ShrcI-.w\ rcllling h htrlJ
<br />xli)v. n\r idnrlllolrny liir n\Ndr r
<br />Anpti.anl or ,\[ent Si!nnn't
<br />A n{rf^i Ce<t$*-
<br />9-zltq
<br />J'Z?Z
<br />Forms/Steel/Holdowns
<br />Rool Sheathino
<br />Shear Wall
<br />Handicap Req.
<br />tl I D1t fr-
<br />I
<br />g
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