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BUILDING. INSPECTOR RECORD
<br />DATE ID/SIG.COMMENTS OWNER BUII,DER DEI,CAITATION
<br />I h.tby,rfiih undcr pcnalty oi pcrjury lhor I anr cxcnrpr lonr lnc C.nh.ron Liccnr riP ti,r Ihe follosirrs ftav,n (s.c.7011.5
<br />Businc$ llld Prcfcssion Codc): Ao, Ciry or Couniy which rcquncs a Frmir ro .nnsrrucl. alrcr, ifrProvc, dcnmlish { rcNn ony
<br />sdcrurc. pr roirs h\!!ncc. dso rcquires rh. lptlaaot ror such Frnit to fileasisncd siatcmnr rhd hcor shc h liccnsed lursanr
<br />Io rhc fmvknns oi rhc Conraclor's t,iccnscd Loe (Chaprcr 9. Conntn ing wirh S.ction ?0()() oi Divni{nr .l orthc Businc$ flnd
<br />Profc$ions Codc) or rhar hc.rshe is cr.'npt rh.rrro'nanJ rhc hasix ft, rtu rllcscd crcnrprion Ai, vn,hliotr ol Sdion 7031 5 brlny
<br />applicrnr r.r r lcmir subjc.brlrc upli.ant k, !civilpc.olryofnor nxftihM filc hundEddorlam l$500).
<br />-l-
<br />,s owncr .r rh. p&!.ny. or nry cnlllores wnh Nr-qcs 0s rhct $h on1pcn\.rion, will do rhc s ork ud rh. (dm
<br />'s
<br />mr
<br />idcnd.d oroliir.d for ulc {Se 7t!4. Businc$ and Piotcl\ion\ Codd: Thc Conl,,crols Liccnsc Lrw docs nor arply to rtr osnerol
<br />rhc l,Dpcny wh. itrilds or iqrovcs rh.dn. aJri qho dds ssh w& hinNcllor hcrslfor rhmugh hh u hct owncmployecs.
<br />liovidctl thrr tuch impn,vdmnts r.c ftn inEdcn or ottcrcJ lq eh ll howc\tr. rhc hui[,ir3 or inlnmumnr i sld *irhin onc ]qn
<br />ol.ompLrioi, rhc Owmr Buikl& will hrw lh. htu noltovir3 rhor hcorshcdil n t{ill ur iinpFlc rhc pmpcn, tbr rht lliFJs.f
<br />l. $ orncr ol rhc nmpcnr- ur cklu\n c ! contrring $ irh licci{d .. kren ro .onnrud rhc InoJ.cr (sc. 7(}ll. Ilunncss
<br />nnd th)fla\imCodc: ThcConk&ktr's t-i.ctrsc LrLv docs norq)plyh xno$ncr oftmlc y wh. huilds or iDtri'vcs rh.(o .
<br />,nd who cont.tslorsuchpr)jccls*ilhsGnnrrcr.n,licris.dpur{rrfrrolhcCodtr.roisl-icrrscLrw)
<br />I amcrcnrfr und.r Sc.l
<br />Ort€ Orner
<br />WORXI[s' C()ltiPENSATION
<br />DICLA.BAUAN
<br />I hcrcbt.fllr undn lrn0lryoIlcd!ryonc olrhc toll{,wing dcclffiri.ns:
<br />I havc Md s ill mriNJn a Crcnilifllc ol GnrEnr b Sellr lrsurc f{n w.rkcra conrlx$diotr. os Ptr'vidcd [ir by S..riotr ]7U) ol rhc
<br />Ulx)r Gdc. ror rhc l.rtom ccofthcwoltlorwhichlhcpc.lnil hn\rd
<br />lhivc rnd qilltrhilrlrii *orkcri ronrntiuriotr nrurrirc
<br />l-ht-
<br />Scdior.lT(xrol rh. tf,hor Codc. for rhc Pcnnnuncu ot
<br />catricr md B,licy nun$s arc:thc work ior which Ihn pcr
<br />,"".,-s@
<br />tC@ -o l-zol
<br />I ccnilyrhar i'r rh. n(nnrnEncc.l rhe rvork br *hich rh s ncirnir i\ nnrd.l sl[lltroi.arPlrty rny |xron inrnynr!oncr
<br />$ r\ro 6ccom suhjccr t, rhc {rrlc^ .o'np.i\dti.la*s of Crli(mir, trfJ rgrc rh i il I \hrulil h(on. n'hlccr t, rh.
<br />workcr conrpcnsiion In,vi\ions ofSc.rnr l7U)oirhc trhtr Codc.l\hrll tunhwirh.onrnly wlrh rhos pmvnion\
<br />WARNING: f{ilurc ro {.urc *.rk.r\ d,fipctrsrtidl rolcrd8c is unh*xil. rnd \l,rLl luhrccr a'r cn,/oyc' ro c.irrinal Fmhhs ind
<br />,rrr. T-b'
<br />nc hundr.,Lrhotr\rfd dollr\ r\ (), h nddilidr k) rhc co$ ,io . donEPcs a\ pn,!id8l ,or rhc
<br />hhn Oxlc. id.rrn rnd rrttr-2dL
<br />IIEII,ABAIION
<br />I bcrcby lllirm und.r pcn,lryorp.riury lhat I om lidnrn undc! pi{,vilion9!9DCt'd s(tunmncina *irh skti Too0) .r Diri\io. l
<br />or lhe Burircs md lroltssions Codc. dnd n1yli.ctra is in lull tnrcc onlcltccr
<br />g-o\(
<br />Af.&LANLDECLAf,AIION
<br />I h.n:by amnn undcr pcull y of Frjory orc orrhc rolhwnrg d.cl0rtrions:
<br />D.rmlirnrn Pcflnih.Arhc(os Norificdn,n F.d nl R.guhrnN (Tirlc 40. Pnn6)
<br />-Rcquncd
<br />tlllcr ot Nolifrdion
<br />I rcnityrhrr dL rc cirlrcgul i(nN estrdln! $bcsros rcN)vnl xrc durnmlicihlc ro rhis Pojccl
<br />l.cnilv rhrr lhn\c rcrd rhi\lE.riqr rtul{!r.rhrr rh. 160rc inf{flulotr i\.d Dlysirh trllCiryand Counr,
<br />ordiunccs dd Srrrc l-r!'\ rcl(i {niriv.\ ofrh,\ CirJ_ uid Counry lo cnrcr trE n rlr
<br />hxr Drtrrirnrtl pn,pd'ryn{
<br />a Ca stvr-llar..=.-
<br />B-L -2,ot4
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsu lation
<br />Roof Sheathinq R /iltt{1)*1l/)
<br />Shear Wall
<br />Framino
<br />lnsulation/Eneroy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif
<br />FINAL Wo,il t).a blnvlY hfr -/
<br />Certiticate of Occupancy -L I
<br />Notes, Remarks, Etc.
<br />SITE-WORK
<br />ffi5iztz
<br />CoNSTRUCNON I ENNIN(i A(:FN(:Y
<br />I hcrch$ilifln undf t trdxyofFiuryihal lhcrc is a construdtun lcndi.S dg.n.y for rhc lerlbrmoncc orrhc work ror which lhis ncnnil is
<br />i$ucd(sc :r09r.cir c )
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