|
BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNER BUILDiR DET]CAi TION
<br />I hdcty .fim uilq p.nrlry ol pdiuty rhd I M .rcnpt 6.n th. Conhdoro' Lic.n* lle frt lh. tollowing r@n (S.c 7011.t
<br />Bui.G .d Prof6ion Cod.) Any cily or Coul, which ,.qui6 t Fni to on tucr, .lrq, ir.{mve ddElbh or r.?.n ev
<br />sdc Fnr lo i3 isllee ll. tqui6 llt 4dEel aor $cn Fnn lo frk . 3t.cd fidld lht lE or iE a ltoE d FDd
<br />b rlE Flvii,B ol rr Cont*i(', LirN,ld L.* (ClEFd 9. Coffiins rnh Sdlio. 70m of Dirilir, I of lh. &niB Dd
<br />Prcf6ioNCodclorrh.rlEorltEiramFllE.iionedlh.bG66.ttrdbscds@Fio.,\.,iohlionofsdid?0115bv&v
<br />lppliclnr lor a paml llbjdts lt€ rpllicm lo a civ il pcn:ll y o f not mor. tho nv. hu.&.d .lolldr (1500)
<br />l, 6 of,E ortlE Foodry, or my dpblc snh s!s6 s Od sL otpasiFrl. *nl d, lll {at tn dE ndi@ ir d
<br />itnod.d or oltsld ld i.n (Sa.7O,l,{. tiBi6 Dd Proldiod (-od.: Tn codn r 't La* Lw dd mr .r'pl) ro e osG of
<br />th. pftipqty wtn hil! or inqt6 tlEaa !d wlh dc sh wrt hielf or h*lt ot ltmush h! d lE om oplov6,
<br />provid.d rh.t Mh imFovol1d N rcl inldrtal orolk for sL l[ hoqd6. rh. ttriLtin* or inlmEEtr i. $ld snnin orc )6
<br />orodpldirl! dE (xr6 adda *dl h.E dE hda of Fatiry rhr lr ot tE dit d hlild or ins.lw nE Fpd! 6r tlE F,po.. or
<br />-1,somdofrh.FoFlr,m.rclN,v.ltco.lr&1ingsnhli.4tdco'nraturhotBrucltlEprcjd(Sd,0'lr.Bc6drnd P$ftsbn Cod. t'i. conlflclol r Licd. l-!w do6 nor arply lo e ownd ollretcny *ho buildr or imProvd thdon
<br />lnd sho coMdr aor !!ch FeF!*ilh. (odko(.)ltaEal p6ui ro rh. ('ontmror'r l,ic@ t *)
<br />I s.rmpl url.I scnt
<br />D.r. _ Otn.rl
<br />WORI(ERSI COiIPENSA'I'ION
<br />DiOJAAIIAT
<br />I hdcb lmm u{d Frty of FJu)- oG of lh. follo*inA &<ltdioB
<br />I h.v...dwillmli ain a Ccdi6.d. of Consl lo S.lf- lBurc ror workgt on,r.n!!rio.. s rmri&i lor hv S*lio. l7m or fi.
<br />khrr ('ode for rtu FtollrM. ofrh. *ort for whi.h llE Fnil i! Gu.d
<br />-l
<br />h.rc lrd $ all mi.r.h wtdt mnpdE{ion ilBlJrec s rcqliEd br Sd.n t7m of E t t'or Co&. lor rlE Ffql,e. ol
<br />th. sort f$shrhrl$ Frn a
<br />(.mis . |Jarco
<br />isr.d My rulnt NoFMb. iclljd. tff in polry nlmbq ac
<br />,vAL u.tEo P FiA,q
<br />'UJco"q3zbg "-\
<br />l.diayrhar in lh. pclo.r]e. olrlE work aor which lhs rcmn ! &u.d. I il6llrol dploy 4., Psen in &) !l,M
<br />e B l0 bdon. rubjer ro thc woda' codpddio. bws of Cllitumi4 ud ,r.G ihd if I sholld b..onc tqat to tl'.
<br />{ orld' comFNli. pmviioN .lscriof, 17m olrlE L.hot Cd. I !h.lL ftrh$ nh omdy *nh lho* ,mvLioB
<br />$ARNINC: F.ilre ro sw worl6'mmFnrio. ororyc n u.hstul. iln rdl obj.( 6 dpkF ro aimi..l Frli: ad
<br />.'vil ,in6 up r. or hu.&.d rlFusn (k'ItB (1100.m0)
<br />DECIJ8AIIO!
<br />I hdlby rlrm und.r FEXy of p6juy lh, I o licqs.d undr Fovsioi of (-lrpIq 9 (onllreii8 *in Sdrion 7000) .l D irion l
<br />nl !!Le lrustr.\\rn(i I"f
<br />1,.9,
<br />l6ioN (irdc. ad hy lic.e G in tulllott.Id cuerct o
<br />4 o c3 q"qY s-o e
<br />ry'B CRKHrc,>@4c
<br />coNsnucTlotr LENnIM; l(:FN(a
<br />I lE br.lIm u.dc pdBty or F!u.y lhi tlE i. lolrnMbn Errn8 {dy for dE Ffm of llE @l tu wftl' lhit Fmi i!
<br />ntu.d (Sc 3097.Civ. C ).
<br />L.ndd'r ilrm.
<br />-
<br />I.ntn r AJdd
<br />-
<br />AIII.ICAILDICTJAAIIOI
<br />I hddry rlEn u&ld p6!hy otFjury of,. ofdE fouowi,s dcchr ioN:
<br />D.!tuh.o P@hetuh6rG tlolill..lio. F.darl R.gulrirN tl nb,r0. Pm6)
<br />-R.qutcd
<br />krd of rdrift dDn
<br />I cdify lhd rlE Lnd.l asulxi,B r.sdina stclos @oral d. .or 4''llic.bL lo rhir Friel
<br />-l
<br />cqiiry llld I hlvc r.rd thit .pplttlirn n ir.ord I 4re lo cond, snh.llCnytnd Cou.ry
<br />ord'oe6 0d Srrt.lr*s Ebliu to
<br />ab.!. nBlnrn€d ,,np.ny for
<br />,4 QQ4a5
<br />,:""r"tw;);.
<br />Set Backs
<br />Forms/Steel/Holdowns 1/////Y ra4luk k>
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathing ulaL t
<br />Shear Wall \4l/ '/ ll,(r)-.
<br />Framinq t/mh)-Ottt>+*7r>-,
<br />lnsulation/Energy
<br />Drylvall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lvlasonry
<br />Pool Fence
<br />T-Bar ,4loltQ'tl nA)
<br />Handicap Req U
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />FINAL O.lttlt( 1 W,aatr<,t &vIJICertificate of Occupancy
<br />Notes, Remarks, Etc
<br />2*.,t2.)
|