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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNER BUIt,DEI DIII,CAR TIoN
<br />I h.lcty rfitar u.dcr p.nslry of pcrjury rh l nm cxcnrr rhm rh. cd rrrnr'Liccnsc Llw lor lhe aolk,*in! rc.$n (s..70115
<br />Bu\in.ss rl Pnrr.\snn Codc) Any Ciry or Counr] which rcqutcs ! r..ir ro con{dcr, rlrcr. inrrovc. dcmlhh nr rcFt xny
<br />slrucrurc, prior to ilr hsurncc..ho.cqutcs lhc rmlicanr for such pcrnirb lilc r signcd ndcnrnt lhd hcor nrc is liccird lt^unr
<br />lo rh. pmvi\ions of rh. Conkr.ttr s Li..nscd tjw (Chsfln 9. (hmnrncins wirh Scclt,n 7lx)0 .r Divkion I of thc gusinc$ lnd
<br />P&re*n,n\ Cod.) oi rh,r trorshc s cxcnDr thc..tu,n 0.d lhcbasis I lhc ollcscd crcnfrion AtrylioltrionoiSccli.nT0.ll5l'yany
<br />.ltli.ariturrp.rni\ubjecnrhc.pnliclnliotrcivil!.nrhyornoimorrhrtrivchuMr.ddollos(3500).
<br />-1.
<br />,r .skr or rh. pmncny, or my cnployes wilh qlscs !s thcir slc compcn\srn,n. s ill du rhc *olk and dc {trturc i\ mr
<br />iricndcd or oftcrcd tu qlc (Sa ?()44. ttusinc$ lnd tlofc$ions Codc:'l'hc C.ntNlor's Liccfl{ tI* docs nolnpply n, ri oakr of
<br />rhcF)pcny sho bildso, iq,oB ihck)6. and wh dml such*,4 hi,nscllor hcNll.r rhrcugh hir or hcr own cnlployccs.
<br />pir,rtdcd rhrr such nnpmrc.rerh @r.r i.rcMc! o..lIcrn n, sh ll h'*cvcr, ih. hxiUin! or nrDrtcmd h skl silhinorc rt
<br />of..'r didr, tlE O*nf Buildcr will harc rhc hrdcn ol pmvnB rhal ht or shc di nor ttuiH or impn,t Ihc ln)Fty lor llE puqr* ot
<br />-l.
<br />rsowNrolthc pDr.ny. !mcxclurivcly.onrrrcrins eirh liccnscd.ontttr\ h) cotrnfld lhc pn'rd (Scc ?(X4. Bunnc*
<br />d E lcsri,nCodc: rhe Conrn tr'sLi.c.scLrwdocsn.rrpplylo owrcrolpn,|rLn,shohuiklsornnnrovcsrhcr.on.
<br />rtrd sho co mcls lbr su.h lrot(h wirhaco rrocro(s) liccnscJ rur\uMr krrhcontucr.is Liccnr lj*)
<br />I.m cxcnrpr trmlcr Sccl
<br />t.1", < E/,222(rt As:z-=
<br />DEgLASAIION
<br />I hcrchy afinn urdcr pcMlryorpcrlury.i. orrhc n)ll.qir! d..ld.rnnNl
<br />L'tu C.dc. io. rhc ncrlomam. of rhc qork itr whirh rhc ,cn ir i\ s{r.d
<br />rl'c *ork lar *hi.h rhn |tnnir'\ n$cd. Niysorkc,{.omfDsdrior iD{rur.c.atricr rxl [nicy unrl).rdc]
<br />PolicyNunrhcr-Lrtnc\
<br />I ccdily rhrr nr rtu pcrloirnrncc ofrhc uork ttr *hich rhi! j--rnrir n i\{cd. I \hnll nor cmploy uny per{,n in !ny nrtri$
<br />n, rs k' s.con,c s.hicr k, rhc workcs c.nDcns bn riwsofa,llonria- rnd lsrc rharirl rh.uld bt(rr suhjcd lorhc
<br />qork.rJ ..mFtrsrr ion p6vi\ioN ol Ssriotr 37(x) of rhc litnr Codc. I shrll. r,rn hsirh .otrPl, uirh thnc pmvisi,'n\
<br />wAlrNlNc l'ailr. h surc *1nlc'! o'nn.ns ii{nr 'r.rsE. i\ u llsrul. nnd shdll suhjcct o cmpk,lcr ti dminrl Frhts and
<br />.Nl fircs u, ro orc hundrcd rhou\an,l .os olcom|En{(iqr. da hlcs,s prorrtcd for rhe
<br />Scdnr 1016.t rltr lnlitrOrt. nttu'( xnd d4/zz /r(T,*<--
<br />I hcrcby.llinu dcr NNlr).ltarluyrhrr Irf,lic.n{du r pmvi\ir .f Ch.frLr9{.. nmncing wirhSccii,n 7000)ol Divisirr :l
<br />ol rhc B sinesr rid Pn,fcs\n)n\ Codc. rM yliccnsc h ir Inlllorccr ,cffccl
<br />Liccnsc Cllssr-Li.cNc Nunrhcr:
<br />CONSIBIJCIIONI.EIiDINIi.&GENII
<br />I h.rhy anjrnr uM$ Fnrlryofnclulyrh rhereG!coo(rucrionlndin!rgcicyf(xrhclrrlormnccofrhcsorkf.rwhl.hthnFirniris
<br />issucd(Scc .109?, Civ C)
<br />AIfI,IIANIDEII,IITAIJ.ON
<br />I M'y rmmundd pctrrlry orncrjury onc oilhe lnlb*ins dc.bnnn)n\:
<br />Drmniri.. Pcrnriri sh.fos Norificrrnrtr rrdcral R.Eul.rions (Tillc 40. Pan6)
<br />_R.qun.d btcr of Noriiicdriotr
<br />I c.nrlyrhnr rhc l'.ddrlr.E l.tions rcEirlin! a\hcdo\rcarnrlnrr iorrt,trli.lhlc ro lht pR+cl
<br />odrnincc\ rnilShrc Lrq! Ehr r. huilding.oDnru.ri(nr. rrklhcrchy ho.iz.rcnr.{nrxr(c\.frhrCiryandCounr,krcntcruBnrrh.
<br />rln^r rcnr,tricd t)r,t(rr\ li,'
<br />L4 ?-L& ,i," llzza?
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />Roof Sheathino
<br />Shear Wall
<br />Framing
<br />lnsulation/Eneroy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lvlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Beport
<br />Engineer Final Report
<br />Flood Zone Certil
<br />FINAL ?/2-r3 bt/ toz Br' JD/QY)
<br />Certif icate of Occupancy
<br />Notes, Remarks, Etc
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