|
BUILDING- INSPECTOR RECORD
<br />SITE-WORK
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Sublloor/Vent/l nsu lation I
<br />Roof Shealhing 3 2-518 -ld4r-,r^.{2' )
<br />Shear Wall t,,0\
<br />Framing
<br />lnsulation/Enerqy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lvlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />I ,'t-^\
<br />FINAL ,I/'vj/
<br />Certilicate ol Occupancy I
<br />Notes Remarks, Etc
<br />OWN}:R BTIII,DIiR DI]!-CARATI{)N
<br />I hcr.hy dfii,nr uMc. lrnrlry ol |crjury rh I n cxcninr rn,m rhc cotuntktra t.i.ctrr l-i$ lnr lhc ri,llo$ina rc"v)n lsN ?0.11 5
<br />Buslnc\\ rfll tlolcssion C&tc) Any Cily rr Connry shich rcqur$ r pcnir l() condrucr- rlrcr i'nprcv., dcm)li{[ .r rc|ut My
<br />nturrur.. |ninb ir\ i\n]arcc. nho rcquin\ rhd lPllicxfi fi, such |{nnirk) lllc r \igncd n icnrnt rhrrh. or shc n liccned fur\uMr
<br />k, rhc porisiotrs ollhc Conl!.clors l-iccnscd Lrv (chilcr 9 aommcNin8 wirh Scdiotr ?(x)0 of l)ivision:l orrhc Busi'rcs rM
<br />PnEs n\Codc)orrh3rhc nr \hc iscxcnU rhcrefnnrnd rhc hi\l\ lirrrh.rllc8cdcrcnlprion Aiyvi()Lrn .lSc.rtnr70]1.5hyrny
<br />dptliorfddp.nnnsubjc.rrrhcdppli.rtrrk'r.ivilrcfulryofnor xitorhnnlrv.hu.drcddoll[rlJ5Urr
<br />1.tr\osocrolrhcPropcny,.rtrlvc'nplt)rrcswirhwiscs!slhcirs'lccon,ltn m.$illd.lhcx(rkmdrhc(ructurctnol
<br />i.nldl or ofl$.d lor srlc ( SN 70.!l. Busilrcs Md Pnna*iod\ Codr Thc Grnticrr\ Li..ne Lrtr d.cs nor {nply n, rn ow..r oi
<br />rhcpn,ncny sho tuilJs or inpn)vcs rh.ron.,rxl who dms such sod( hnnsclror hcrqlfor rfin)ulh hil or hcr.wn cnul')y.cs.
<br />provirhdrhlrsuchin$DrcnrfhrcmrinrcnJd.ll*\lforsLlah.sckr.rh.htrildinBoriqnrcnrnrhhU$ithirtonc)ci!
<br />ol conrdd ion. ll[ owmr auiklcr willhr\r rhchrddol |, vinglhdhcorshcdidtrorhuildorinDrxtrhclmFlyrorrhf,pu'r,rcor
<br />-1.
<br />!s.sncrol rhcropcny. rmcxclurivclycanra.tnC wirh liccn\cd c.Mrc,or r{, cotrnfld nr pmFd (S.c 7(I1-il,8unml\
<br />aid llr,tusi.h Corlc: ThcCotrrir or's Liccn\c Lawdocs norrmlyro af.vnfofJ)lorc y who huilds .r irnfmrc\ rhcron,
<br />ud wh. conrrllhlor such t8rj.cts ! irh a Ornttutu(sr liccrscd lusurnrhrhcO)ntr.kr's t-ic.n\d lnw).
<br />-l
<br />umcxempl undcr Sccliotr . A. & P.C. lor rhn rc!\on
<br />Dll€ Onmr
<br />rvonxtns' coniPn.s,rlrtr
<br />IIiILISAIIAN
<br />I hcrchy atfirnr undcr rcnihyolrErjuryo.c olrhc lollosirs dccli..!i.ns:
<br />-l
<br />hrv. ud will nuirrain r (tn ilicrrc ol (.onur h Sclf lnsurc tur qo.kcn $nwhsxrtun. r\ lnovid.d f.r by scdio. llltr oi rhc
<br />hh, (odc.Ior rhc rcrfoirumc ofrhc *ork rbr whth th. Fnnir is n!,qi
<br />i\ i\\ud I\tv$1trkcra conrnr ri{D i',\rr crcrric, md ,li.y nu ftcr rc
<br />tZ
<br />I?n,,r,., "",,,*,
<br />/l-f 22 5'7
<br />-lccnilyrhrr
<br />inrhcpc ornrn.c ofrh. rork ior whrhrhnl)cnnir ir i\{,cn.Ishrllnor ctrDloyan,pcrwn inrntnrnntr
<br />v' ^ t, hLom snjccr t, rhl workcrs con,pcn\a|ion hws ofCrlihrnir rnd rgrc rh.r if I sh)lld hcdrtE rrhicd t) rh.
<br />$orkc corprn\nrn)n F)!kion\ ofSedn,n:17(nofrhc Lfir Codc.l rhdl nnlhwirh conrdy wirh rhos Drovisions
<br />W RNING: F.ihtrc ro sccurc sortcrs conlEn$rion covdB8c is un htrlnl. rnd null n'hjc.( u lli\., n).ri,ntrirl t rlrf,\ rtul
<br />(s'l nn.\ uf r" rir hurd.'J rh.u\.rJ J','lJh '!lr{"{*r rn ?)n. drrr!$ ss In,vidtd for rhr
<br />"r)*,2=L l-\\
<br />DEII,IIIAIION
<br />ol rh.llurircsrnn Prcicsnnx Codc. rnt ry E?#:,::q7#/b
<br />,^r@
<br />toxualJcuqxl.ENlrDc-alj.ENg
<br />I h.rbt amrnt und& F.dry or p.rjury rhd rrErc h a .oNrfl.ri lcndinB iecncy lor lhc pcrfornuncc ot rhc wolk for $hich rhn Fndr is
<br />hsocn lsec lm7, Cie C.).
<br />A.ETLICANLDECI.Af,AUA!
<br />I h.nlrt rllnn u cr NMI y ol E.jury onc oi thc iollor inS d.clnrur i,ff
<br />Dcn,lirion PErnrir\ Ash.nos N.rili.dbn lrcdcral Rclxhrn,n\ (Tirlc.l0. Pad6)
<br />RL\tuncd lI cr of llorifi.drrn
<br />I.drifyrhrr ih. f..l.ra I dtr lrr ions ftlrilnrg rsb.n.\ rcnblrlrr. nor.tfli.$lc Io rht fm,cci
<br />I.dilirhm l hrvc rcrdihis q'f lrari,rrtrJ {dcrhnrrhcrh,!c i rl io. h rorccr I .rra b onrln, wnh ill city ond Coutrr,
<br />rizc rcpresc arnrs ofrhh Ciryrnd Counry lo c $ ulotr rhconlifxtr!r\ rM Shrc l.rrsrchri'rEri huiklir!
<br />rhiivc ,rfrn,nc{l f()Nny f{tr ir
<br />/\pDli(nnl or 8enl Si8nr
<br />l-r\&+. ;,.2-2.,t-tg,,\)ru?.,-Z
<br />COMMENTSDATE TIDEIGJ
<br />--T_------
<br />I
|