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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.OWNCR BTJII,DT]R DELCARATloN
<br />I hcr.bl.iflfln u ci p.i ly(rl pcrjury rhsr I!mcxcnDl from rhc Contr.r.'r Li.cn\c tiw r'.r lhc rirllo*irr! rcN)n (s..70115
<br />Bu. ns{ d'd Pr"lr.i, I Cn,l\., An)C1), C,,drr) (htrh'.qu'-rrf.fi ! (.nracr. xrrc'. trp' v.. '1.'tr,lr.h nr rrJir n')
<br />srru.rurc. pri{rt, ir\ nsrrn.c. also rcqutcs rltr jpt'li.atrr lor 'uch Fnnir r filc J i-!trcJ {rrcnf,nr rlrJrhcorshr'r 1lcnsod prAUlnr
<br />k) Ihc pmrnions ol rh. Cotrlracloar l-icen\ed l,r* (Chrprc' 9. Co'nntrNnr8 sirh Sedion 70(x, ol Divni.n.r .fuhcBudncs trnn
<br />Prnts{onscodc) orrhnr hcor\hc
<br />'s
<br />crenfl rhcrcrrunrM rhc hl\is lir rh.rll.ac'lc{ctr,pri.n Aiy!i{,l,rionorscclinnT0.llihyory
<br />rpphcnm r{, rNrnrn \ubjc.hthc rpr!icanr ro i.ivil Dcnrllyolnor nnrcrh"i fivc hundrcd dolhns($5(xr)
<br />-l-
<br />$ .srcr otrhc p0l.ny, (tr tuycmplorrcs wilh *.!.s as rhct $lc c.mFn\Jri,n,. silldo Ih. sork od lhc nn'cluru is a,
<br />inr.frft or oflrrc fi, elc ( S( 7l)'l-.l. Businc$ rnd Pmfcssions Codc Thc Contrcttr\ Lic{ne Liw tl cs rct allly h nn o*.cr .,
<br />thc pmpcd, *ho ttrihls or impro{s rh.mn. aid sho dms \uch Norl him\clfor hcr*llor rhmuSh hn.r hcr osn cmPl,ry.cs.
<br />tiovidcd rhrr ru.h irnpmvcmnr{ lrc mr inrcBred .r olT.Bl l'or {L ll tx)scr*, rhc lr ikli,E or i pur.Enr i\ nH s irhin on Jtd
<br />of$nlPLrion. rlf O$'u Buildcr willhrrc lhc buftlctr ol pmvinS lhd hu or shc did ior build or idprorc rlr Dmp.ny ft, rhc Nqrx. ol
<br />L rs ow cr ol rlr lm,pcnr, ur c$lusivcly conllcr inS + ir h liccn{J contrrkn\ k, ..n{ru.r rhr ,'mECl lS( 7()'l4, B!.i'rcs
<br />!d Etrlissb! Cod.: 'l'hc Contrroi! Lic.nsc Law doc\ nor ap!ly !) rtr ostrcr ol Impcnt rho huild\ or nntnvcs lhcrcon.
<br />nnd who .otrtr.r\ in su.hrr(+cls wirh aConlrct,(s) lic.nscd pur\lrnr t)rrrcotrticrols Li.ctr{ liw)
<br />_l anrrenor utrddsmr6.-. B &PC lorlntrcrn,n
<br />Drl. OPnci
<br />]}l)Blitr&r.l1)lluiNsallaN
<br />IIIiIIASAUON
<br />I hrrchyxlfi'nru dU J[nrhyol,rrirtry.ncotll]clnllo*irs dcchrrlnnN
<br />-lhrvc
<br />md *illtrrinrrinxt-rdiltrnrcof Co {nr k) Srllltr{n. ltr snrk.r\' .on,l}-n\rri(,1. a\ ln*nlcdnnhyS.driir.]?( ofrlt
<br />Itrhor (ixlc.li,r rh. J--r lhuumc olrh. slnk lnr shi.h rhr p{nn{ i\ n{rd
<br />rhr so.k fd*hirhr,n\ p.nnit 1s is{dl. Myworlcri conDcnsrrion insorrd.c.rri.r d Flicytrullrlrcr.rc
<br />I ccnilylhd ir rhc DcnnrnBncsol rhc sork f{n *hichrhi\ ptnrn i\ issuL'd.l shall nor cmtloyrn!Pc n'n i'r t0ynrrmt
<br />$ 0\ro hc.onf, suhJ.{r t,rh. work.n coNp.trriri,r l.wsolCnlili,nria. lndaSrcc rhd ifl \hould h.. m subj.tl ro il'.
<br />Norkcr\'uoo{'.nsrrn,ir.vnionsofS..rionlT(Dolrhcb$.rc(xlc.lshall.nflh*irh.umFlywirhrbtPovisnnF
<br />IVARNIN(;: frilurc ro scurc *o ctr conrpcn\rrn,n.oreruSd i! nihwhrl. Md (hrll {rhrd an cmtk,)$ b dirnril l}cMlrts itrd
<br />.ivil hrcs uf to otrc hu rcd llmusnnd dollar (Xllx).ltx)). i'r a lirnn 1. thc con ol coDrcnlarnnr, duugc\ is B)vidcd rbt lhc
<br />sccrn 10T6 ofrhc Litxtr Codc, inrcrc( nnd anorrry s lccr
<br />uc}]!sl;Drl.)M&!gila
<br />DliELABilUrN
<br />I h.rchy rlltr undcr lcnrlrtofP$jury rhd l.n li.cn\cd trndcr pmvisi.n.l Chaflcr 9 (conntuncint wirh Sccrion 7l(X)) ofl)ici\nnr.l
<br />or rh. lnrinc* ,nd Pmfcsnnrl Cud.. Md rv lkon\c i\ in full i tr( trRl ciicr
<br />Li..iic ClNs:-Liccnsc Nu'nb.r
<br />t,arE ('onl...lor
<br />qONSIAIJEIIANIT:NDINGiGDITqI
<br />Ihurcbydltmu cr pcnrtry.f!.rjlryrhar ih&t hncon{ru.liotr lcndirglgcq inrhc pc orlrti.c ulrhc work f(n s|ich rhis P.nnir i\
<br />i$u.d (SLr :109r. Civ C )
<br />AITLICANLDIIIAAAIIAN
<br />I hd!'tiy rlln. u ndcr Fnalry olpcrjrryone ofrhc folk,win! d..lrdrnnrs:
<br />Dcn!)liriotr Pc.nirrA\b.stos N.lilication FcdcrrlRCEUlarion\(Tirl..l0. Pan6J
<br />-Rcqtrtcd
<br />Lcllcr of Notiliori,,tr
<br />l..nilirhxr rh.l.tl$rl'rstrhr ',r cgddnA r:h!,'! rcfrvn rr fLi rptl.rhlr ri 1lrtr t)n'lc.r
<br />Ic.nrftrhdIhrvcnddrhislptli.rlbnandslnrcrhxlrh.e}nrritri,tr!in,nn.or(r.Il!.elocomtlysirhallCny.ndCoutrly
<br />orJinr .c! atul srrr. hwsrldinsro huildinEcon(rucrion. d hcr.hl rlxrizc rcprcs.nrdivcsoflhisCilymdGrnryr,.nr$utx)nrht
<br />aklvc nrnrioocd prcI.j, fff in\l.dn plx,scs
<br />'\DDli(rnr or,lA.nr Silnxlurr
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/Vent/lnsu lation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framine
<br />lnsulation/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 />Enqineer Final Report
<br />Flood Zone Certif .
<br />FINAL
<br />Certificate ol Occupancy
<br />Notes, Remarks, Etc
<br />COMMENTS
<br />trid.r-. AJJc\{
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