|
BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNER BUII-DIiR DELC RATIoN
<br />I hcrchy ritfl lndcr Enrlry 0l ncrjury rhlr I Jn cxc"lPr ioN rhc G'nrrturu( Li.cnsc liw ror rl[ l'ollo*inE tcNnr (S$ 70'll 5
<br />Bu\ircs\ rnd Pror.\sn (tdc) Any Ciry or Coutrry shich lcqrir\ I Ennil lo onnflct. rlict. im,rmvc. dcnhlish 'tr ftr n rrv
<br />ntu.rorc. pri(trk) ir\ i\surmr. xho rcquirc\ rhc anPlic r ntr \u.h lrc,nrillo hlc a \i8ncd srllemtrr rhJrtEor shc i\ li(iscd Pusumr
<br />ro rhc pn,vni{,is ofrh. Conlr.doi\ l.i..nscd l1B (Cnrrl.r 9. Co nRmin8 $iih s.crn,r 7t{U of D'vi\tun 1 oi lhc Bu\inc$ rtrrl
<br />Itolt\sioNCo.r.rrhnrtror\hen.rc.9rrhcrcfiomrnJIhch!\(krrh..llcgcdcr.nfrio. Anvviohrii olSccrbnT0ll5bydflv
<br />rpnlicrdrlitrrlr nir suhFcrsrhc rPpli.dtrrro ucivilt.nrlryornor nrordhrn filc hundlcddolli (sto)
<br />-1.
<br />r\ oqkr of rhc ,qrcny. ,, ny ctrPloycc( wirh wag.r rs rhcn vrii o'nPcnernnr' will do rhc work tnl thc slnl1uR k tror
<br />i'n.'xlc{l ' onai&l lhr \rl. rse.?otl. BusirEssand ftorc$ir,n\6rlc lic Codtr.nn rLiccn\eIf,sdoc!nolaPplyhrno*rcr'l
<br />rhc nnlldy s ln, hu il,h or innmrB rhe@n drd qho des {th lork hinrsclf or hctsc lf or rhn)u8h his or hcr o*n c Dl')tc"'
<br />|trovntcd t hrr such irr.rcntm( N mr inrcadcd or ofiitod fr, \rL ll- ho*cvcr. rlt huiklitr! or inDn)vcnEnr is v'kl wirhin onc $r'
<br />;l.1,nplcri[ rlf,OwNr Duikhr sillh.vc rhc hurdctr ofp(,ving rhni lt or rh. d d dor build or imProt thd pn,F lv lhr r1r NIhs ol
<br />L ns oqn.r oi rlE nn)|r.ny. rr cxclusitrly cofilcl iira wirh lrcnscd .onrndon lo ..r(tucr rhc l)nrccr (SLr TIl]4 ltu\i"c\ '
<br />rnd hni$i'n(t c: ThcConrrmrtr s Li.ctrsc Lrwdocr nor r|rllyk, dnowncr.ipnrpcrl,who huil ornnlnovcsrhdco[
<br />ind who .onlrxcrsi, \u.h roiccs sirhaCofr d(s) lic.nscd PDrxrir h rhc Conkrnt ( Licctrsc l,asl
<br />I r rrkrnt,r nnd.r S.rri,)I1 & P( ln'rht rcrnrl
<br />]illBtrI;B{..c1)ulr sarloN
<br />DIiCLiIBADAN
<br />I hcrby,ffinnuodc! pcnllryorp.tjuryorrc olrhc bllowi.S dccl.riti,)ns:
<br />I hivc rl will roi.rain 0 Ccnificarc oI Con\.nr r. sclf- lnsurc li, workcrs' c.mPensdnrn. .s f.vidcd 'd
<br />by Sel ion :]'7(x) o f rh{
<br />Latff Codc. l.r lhc p€rlomsn c ollhc wo.t for *hich rhc Fr n nslcd
<br />-l
<br />hrlc !tu] will rnrint0in sorteB .omPcnsalbn irsurlh.'c s{ rcquir.d hvSc.rnrn lT0ooflhc &1,or codc. fo. rh' P'mvnh'r' oI
<br />rhc Bork tur qhi.hrlN ncnnir i\ isuNl Myw.on,p.n\r(nr rNrrnn...rtrid rr Fni.y numtu' 3r.
<br />artirc\: _
<br />I .crlrlyrhir i,r thc pcnnnnnNc ol rhc $uk t)r rhi.[ rh \ Fnnir i\ nqrd. I ntll tror.n f l rtr]_ n.Nn' rtr n rl' r[D.'
<br />$ r\k'bcco r suha.r ro rhc *orkc ..nDcnnni.n L*aofcrlif.atrd. rnrlrg(_crhd ill shouldbccoitr $h]l'clt'rh'
<br />sor[.^ .onw \lri(] r|m ni\i,nF.lSc.ri{rl7(x)ollhcIrlxtr(i..I\lnll.lrnrlrtrir[.oNl]l]qirhrlhcl)r.ri\idr\
<br />rr \R\llr, l,,ln . rifi ri rl' . rr cnlnk,wr r,, (ri' trrilPcnr]rior r
<br />, tr I rr, \ ri r, , . htrrlrrJ rl't u..tr !L tlu
<br />...,,, ",,,,,t,, ",., r",.,,r,,r,"".,,.r
<br />,^e: 1/et /rS,
<br />//Ll!:!! !1!!ll1
<br />I hr(.hr xinm rftlo ltnrhyolI.rJUry rhrr I lNn{,1tr!l.r,x,\ni'nrol('hxtncr9rcoirrcf.ir!\irhSccri(rir(xxr)olt)1^xtrrr
<br />or ihc Insincs\rn(t Pfl,fc($onsCodc. xl nry li.c \c i\ h li'lllhrcc d .fih_r
<br />1
<br />a1
<br />1,","q
<br />( ()NSt Rt:(t ION l.l,:IDIN(; ,1(;lilCl
<br />Ihcrcbyriftntrlld.i|{nllyoINauryrlr rhcr.isr.on{n'.liotr lcftliu i!.tr.y n)' rhc Pslonnrncc ofrhc
<br />APPI ICANTDIi(I AR{I'ION
<br />I ltrchyrlljrmundcr pcrx[y or pcrjury om orrhc n,lkJ*trr8 dc.lxrrriut{
<br />O. tuliriotr I'cnnirs A{tE(os Norific.lion Fcdcrrl Rcguhrnfi flirlc'{}. Pd6)
<br />Rcqutcd lxrrqorNodi. ion
<br />I (cni!rh i rlr 1!,l.rrlrogtr lln! r\hcio\rc krnlrc nort,lnnrhh ti rhG Pi{il..r
<br />l.crr l-v rlu I hx!. rc rhi\ {0 r nxrit, r i{..rr.1 I xlrcc t)..nrtly
<br />rrllr. r.\ iin sr r.l x\\,.lii'rt
<br />x$\c nr. rorc(lJ,r,t[ ry n, i']
<br />,lpplir l or ,\grtrr sirnxlurr
<br />utr
<br />' iltl{J\ ,,! ' /', ' ]ll
<br />,qA7 /rt
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />Subf loor/Vent/l nsu lation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq
<br />lnsu lation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lVlasonry
<br />Pool Fence
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif .
<br />FINAL 4 trl6 -T'l )'?/,
<br />Certiticate of Occu anc
<br />Notes, Remarks, Etc
<br />nsucJ lscc .1017, Cir C )
<br />lxndcfs NanE
<br />-
<br />l.cntlur'! i(ic\\
<br />Set Backs
<br />UFER Ground
<br />T-Bar
<br />\
|