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BUILDING- INSPECTOR RECOED
<br />SITE.WOHK DATE ID/SIG.OWNER BUII,DDR DT:LCARA'TION
<br />I hcrcby trfilrnr u.df Fn,hy oi I'crtury rhar I a'n crcm,'r fto,n rhc Contrrct,,r i-i.. st liw lnr rhc r'olbqins !.rn (sN70315
<br />Bu\in.s( Md Pnrlcssion C.de) Any Cir, or Co!trry thich rcqutcs tr Pcmrir tr ..n\1ru.r. ilrcr. imrmvc. d.'nolrh or rcJ'ait rnv
<br />dfl.rxrc, iorlo ns hsulncc. rho t quncsrhc aDplirtrr lbt such lcnnirt) lilc, siSncd (arcmnr lhar h.or shc i\ li.cnscd n!6!iir
<br />nr ihc pmirins of rli Cont rn s Licctrscd trw (ChtPrcr 9. comrNkin8 *irh sccri{r 7{xx} of Divi\io' I or rh' Bxri'r's 'n'l
<br />Ptrrfcssion\ Cod.r.rrhllt hcoishc ircrcqrr rhcrcftnnaM rhc brsir tur rlr trllcscd ctmpr i(in Any viohrtr.fSc.riotr 70ll.5bvlnv
<br />npflicitrr lor . ncrinil subjccb rh. nmlic.nr ro ! civil l)cmlly ol nor 'not rhm fivc hundrcd dolltrB ( S50tr)
<br />I.asoEncrolrhcp&,Itny.urmycmployccsqilhwuscs!srhcn$k.onr!.nsrion-Rilldorh.work xl Ihc (Mtrrk mr
<br />inrcd.J.rorcrudLrsaLlSa.TO44.lrusinc\\trtrdPrta\li.'nsCdc:lncContrttr\Lictr*Liwdocsnorrp/ylomowncro,
<br />rhcnnlcny who tuink or inqJn,vcs rhcN[ and sh. df,s such so* hi'n*lfor h.^cllor rhmuEh his or h.r oqtrcmplovc.\.
<br />pr)vidcd ih,r su.h i'npmrcmnF N ml i endcd or oniNl fd {k It lx,B.Er. rh. huillli'l3 or irprcrtmnr is sB wnhin o'f, ]t3r
<br />ol conplclh[ rll. On ncr Buik]$ will hN. rh. burdcn ol lmlirg rhd h. or sh. dil Bn luild or nryro1c rhc pmpcdv t, rh. I)l{$s ol
<br />-1.
<br />&s oerc. of rhc Frpcny. .o cxclusircly conrra.in[ wirh lic.tr*d .onktrclo^ t, con{fldr lrE lrcjccr (scc 7(M4. B sincs
<br />rl PlD€sir Codc lhe G,ntd.ttr s t-iccns. Lts doc\ r.l llPlyb nnornd ofpn)ncny$h. huildsnr imlrov.s rhd&n
<br />utrd *ho coitr.rsror such pn*cls wirh a Conrrack,n n li.ctr*d pursurd nr $c c.hr,cktr s Licensc liv)
<br />B & PC. (rrhr rca$n
<br />L'^k, -+fiSo+fr
<br />]laX[riBS:lO]UrllrUI0NlJl[Ll&Ill!.lr
<br />I heEb, alfrm undcr p.Mxy oI pc.jur, orc orrhc lollowin8 dNlamlions:
<br />-lh3lc
<br />sJ will rtuinrain a Ctrl iaralc of Consc.r k, s.lr-lnsuE for $ortcr' 6 rr.nslriotr. ns pmvided rd by sdion l7(D ol rhc
<br />Gbor Codc, ,o, rhc pcfoflM.cc of rhe wo,k lor which rhc Frmil n tsucd.
<br />lhrvc0 d willnrainrain s.rkcr\' .omDctrsario. irNurancc. s\ rrqund hySc.rion:lTmofrhc ttrb.r Codc. for rhc p.rfommna oi
<br />th. wolk l.r shi.h rhis pcflnn 1s i$ued. My worlen .oq,cnsnr n,n insur.re caricr u Fli.ynumbcrtrc:
<br />D
<br />l.c i,yrhrr tr rh. p.rlnin n.c(n rhc work hr w[i.[ rl,is n nnir i\ isnNl.l \hrllno{ c idnyinv P.r.f t] ny inla
<br />q,rshb.cor\uhjcdbrhcsork.'\dnnp.trra.,nln\(.lCilitunir.rndr8ftcrh.rilInniul,llf,c.tsuhJcdnrrh:
<br />*ortf\.om|xNdriinpmvi\i,,nsofsrcrio.lT(x)olrhcljlnrL-od..l\hall.r(nrhwilh.otrrplywirhrh.$povi\ior
<br />IV RNINGT F lurc ro sccurc sorlcr .oit|f,hdnnt shall subrcd atr c,nplors k, rinl
<br />civil fitrc\ up tu onc hundrcd rho \ nJ dollls {$ll ol conr|{n\rrioi. drDrrgcs i\?rovi.lcd fd rhc
<br />so.roD 1r)76 ,,1 1h. 1 ,rli, (inl,.iri.'.!rnJ
<br />*ad-tfl
<br />I hcEby rfilnr!ftlcr PcMXy.lrcrlu.y rhar I om lirrn{rl lndcr flovisn'n olCh]prcr 9 (.unntucine wirh S(ri,n 7m0) ol Dirision :l
<br />ol rhc,rusinc$and PErcs\naN crodc. d mylictnsu i\ in lull ror.c u4#tr
<br />>$Q278 ^"
<br />CONS'IRIJCTION I FNDIN(; AGI'N(]Y
<br />I hcrebyar]tottrdcr Fnalry oi lcrlury lh rhclc n !.onsrru.r lcndiraqctrcytnrlhcFrli)rnunccofrh.worknnwhichrhnF-nnin
<br />n.ucd (s(.lo9?, cir c )
<br />tf,rtcr's A.lCrc$
<br />ATIIIIANLDICI.AB TIIIN
<br />I N,y allmr onder p.naxy of!.rj!ry one of rh. finhsing dele.'io.s
<br />Dcnh,irion Pcirnih Aslt(os Norifi.dbn lid€rul Rqllarions (Titlc.l{, Pan6)
<br />*Rcquircd lr[.r or Noritt ion
<br />I ccnilyrhd lhc fcdcra![guhrnn] NatrdilrA lltf,\lo\r. ntrrl rc norifPlicahlc t, rhi\!nijc(r
<br />I .enily rh,r I h!!r rcad rhn lpf
<br />ordiMncc\ lnd Slnrc liw\ rclarine k
<br />licarion ud {nr. rh r rh. finc inlinn(i(n, i\..nNr. lasre r.codply *irh rll CilyanJ Counr,
<br />hcrchyrurho.i.c rcpto{nhrivc\ ollhis CiryrJ Coutrly ro cnicr uB,n rh.
<br />,rlu. nr ro (Lt) trlirirl 1ltr ir
<br />€r?a
<br />,^,", g-;t-/tr
<br />Set Backs
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Sublloor/VenVl nsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq
<br />lnsu lation/Enerqy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />l\4aso n ry
<br />Pool Fence
<br />Handicap Req
<br />Deputy Final Report
<br />Enoineer Final Report
<br />Flood Zone Certil.
<br />FINAL ?-tz- tB ut.l,-lal 'dr)
<br />Certilicate of Occupancy
<br />Notes, Remarks, Etc
<br />COMMENTS
<br />Forms/Sleel/Holdowns
<br />T-Bar
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