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BUILDING- INSPECTOR RECORD
<br />DATE IDiSIG.COMMENTS OWNER AUTLDER DELCARATION
<br />I hcrhy rr,irm undcr pcElly ot Frjury riar I m cxenpr tmm lhc Conrractor' Liccn* lj* n, rhc r!'llowint rrd$h (s.c 70ll 5
<br />ausinNs rd P(na$bn C.d.)r Any Cnt .r Cou.ly shich rcquirc\ r Frnir k, .on{fl.r. dr.i irnfiov..'dcrmlisn ur q)u nny
<br />slruclurc. pri, ro its issuncc. sho rcquircs lhcnpplica r.r \uchlrrnil ro 6lc. siSned st,tcnrnl rhal hcor she t lienso puread I
<br />io rhc provick,ns ol rhr C.nta.ror'r Li.un*d l2w (Chaprc, 9. Co'nnr .in8 qnh S..rbn 7(Xx) of Division ] of rhc Ensim$ ud
<br />Pmtcsions Codc) or rhat ncorshc n cxcflr,r lhcrcliomond rhc btrsh lor rhc rk8cdcrcmplioo AnylnnalionolSc.rion 7oll5 hyan,
<br />rppli.lnrfdsp.rnirsubj.rrrrhclppli.rnrror.ivilFmlryornornbrrhmhvchundrcddoll. (S5m).
<br />-l-
<br />u\ owncr o,lhc pn'pcny. or nryenrploler uirh wisc\ !s th.n dc.onDcnsarion. $illd. rhc work ud lnc {tur!rc is ior
<br />inrcidcd .r olTcrcd tur { . 1S...7(I]4. Busi'rcs md &.fcsi{,n\ Codc 'Ih. Coftacrol s l-i.cdsc trq docs n.r ltlplr lo .n owm. of
<br />rhc pn,ncdy who hilds or iq,rorrs rhcmn. aBl *ho d{r\ such }rnk hnnsclfor hcr\clfor rh()ush his or hcr ou cnltlovc$.
<br />ptuvi,lcdrh $ch i,npn'rcnrtrh 0rc nol irrctrdcd n onad for \rh Ii houcvcr. rltrltril(lir8 or tnplovcnEnr t {,ld wirhiroic ttrr
<br />ofc. !,Lri,n, rtrO*ns BriU.r $ill lDvc rhc hurdcn otprnlinS rh lIor{rdid n hdill or ir\rovu L\c pm!.n, ni Ilr purF)r ul
<br />I. \.w.rolrhcpn,tdy,arcxcluciv.lr.onrrcri'rgsirhlicctr{d.onhNlor\r.con(rucrrhcan,jL{r(Scc7r)44.Busnes
<br />Md Proission Conc lhcCoorrrru s l,iccnsc l-rw des nal l|plyro anoqncr ofrropcny sho buildrorifrprovG rhctcon.
<br />rtrd \ho conrrrr\ lnr \!chpiojc(rl$[ha Clnnrrt,(\r lrctr\cd n!^ur rr
<br />I amcrcfrlr !trdq Sccr _z
<br />I hcr.hy rlfi nundd N.rlry oilx4uryonc
<br />I htrvc drd w,ll nun .in i Ccnirr.arc of Cl(nrrnr ro Srll.l.\urc fd qork.rL .onp.trsd ion. $ [ovi{lcd ix hy Ssr i6 ]7tX) ol thc
<br />trbor Culc,lar rhc !€rn]ntutuc.lIh. wo.k lnr shi.h rhr p.rnrir i\ is\0td
<br />_l h0vc rtrd willnri trin *orkcrr conrltnsol ion nsurorcc. $ rcqu ncd iy s(l ion :l7r[) ofuhc l rbo. Codc, ttr rhc Prronn n.c or
<br />rhc suk for which rhhI,c mir i\ hlucd Mrwo,ksr compcnBrion in\u.ancc caricr a'rdlx,ity numh.rd.:
<br />Pohcv Nu mbcr
<br />-E\nit\
<br />lcdnify rl,rr in rh. pcnnrtru cc.trtu aork f{n rhi.h rhis |[rn,ir i\ i\n'c .l shrlltr r cnr oy ltt n 60r n rny nimrcr
<br />$ Nlo bcconrc subjcd loihc workcK ompctrr otr hws of calil.hin. .nd l8rc h I {hould hccoN ulrl$r rorh.
<br />*ortc^ conrJ)cn\.rionpmvsio.soiSccrion 1700olrh.lihor(odc.I shrll..omfly $irh rho\d pmvisnnN
<br />IVARNIN(: Frllu'c k) \ccur. sorkc.( mn,ihJll suhjccr rn cndoycr rd dirnnrl lEMhi.! n
<br />civil nncs uI ro one hundlcd rhouen.l
<br />SNrion :1076 ol lhc Lltnr Gxle- iDrcrcs!
<br />cod ol confcn\rrbn- drrugcs rs pnridcd li,r rhc
<br />.-.
<br />I hcrchr aliir u.rls pcnrllyol'Dcrjwy I I aD [ccnrt utrdcr Dmrisim oIChlnrcr 9 (connN!.inr sirh Setbd 7(n0) orDNision.l
<br />ol th. Burir.$rM PDic$idN Codc. n myli.ctr{ t in rull f.rc. rndcllccr
<br />I hcrcby 3fiinnundcr trtr lyofpcrjurylhltI
<br />issucd (S.c.:109?. Civ C )
<br />is {consru.rnr lcndira r!.n.y irtr ui rl,. *1, ( l,r {l'kl, rh \ tunr r }
<br />APIIICAITIIECLTEAIII}!
<br />I llrrhy atnnn undcr pcnlr, oltfijury om ofihc followinA Jccnmrnnr\:
<br />Dcmolirion Pcrmirs A\lf,{os Norili.arnrn Fcdcral Rcgohrions (firlc40. Pd6)
<br />Rcqutud Lcrrr.l No0li.rri(nr
<br />nNvrlir. norrppli.rhlc b rhi\ pstcr
<br />rt.rhddratx,lr intrnuri, is.oftc.r I r8rero.onulysirh0llCnylnd Coutrly
<br />sctrhtrv$.lrhir Ciry.nd Connlyr..nler uBnr rlE
<br />fuZZ€ P
<br />^"a/,=//{
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Rool Sheathing
<br />Shear Wall /-,
<br />Frami l^/ bd t - t4 -l'1 Y'V,il,)
<br />nsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Ceftif
<br />FINAL
<br />Certificate of Occu an
<br />Notes Remarks EtC.
<br />OV lLv u 0 (r't-c
<br />SITE-WORK
<br />Lxndd \ Addt!$
<br />/+4
<br />Subf loor/Vent/l nsulation
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