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BUILDING. INSPECTOR RECOHD
<br />SITE.WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns .1,t1
<br />Erection Pads , \[0ll t
<br />UFER Ground 7 ttu ),
<br />SLAB Floor 7 (J
<br />Subf loor/Venl/lnsulation
<br />Roof Sheathinq )Fi nltola
<br />Shear Wall ,<^,rl
<br />Framinq \-
<br />-lnsulationi Ener sv t,l/.tzllx-lv k)
<br />Drywall ts,(trlx 't 4
<br />Ext./lnt. Lath >/
<br />Brown Coal ttldE v 'yb)
<br />IVasonry I I ut (
<br />Pool Fence
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report vLI
<br />l- -,,",1t@V,(aiP Pldt3,D)
<br />tvlblt(/.1 \t/tw/.-otl '2r,/
<br />Certilicate of Occu pancy u I /-
<br />roA<'i\ r-o',rsr -d t.}4 O,^)
<br />o-Z-l
<br />-
<br />O$I\ER BI ILDER IIEI.('AR^TII)\
<br />I h. .hy Jfllrm un,lc' pcnrlry .f [I.rtury rhrr I un' u\rmpr fn,m rhc G,nrracb^ l-ir.nrc lrw r{tr ihc folbwnre r.aon (Sc.70ll 5
<br />Bu.i,r(r\ r Pr,Li(inn C',,1d Atry C y or C',uirJ which rcqunc\ r l.nnir h ..n(flcl, rlr.r, nnrrovc. dcinolish or NFn atry
<br />sru.rurc rfi ln ns nsuaRc. !.n rcqunc\
<br />'hc
<br />nrf icinl ror su.h pcnnir lo lilc a si!rcd srircm rhll tEor shc is licenscd ptnuanr
<br />h rhc E.ti\i.ns "r rtr C.nhlrn.s L'ccnal Lw lchxplcr 9. Co'nh.ncing wirh Sr.!n,n 70m ol Division I of rh. Bnsincs !n,l
<br />nnrrcshns C' c,,rrhlrh.orshtncxcmnrrhcrcfiomatrdlnc$.rnlorrhc{llc8cdcrcfllption.Atryviol.lion.fSNlionT0ll5byDny
<br />qlDli.rd rn' a pc.ntr uhjcc\ rhc rfirl.trn, r.,.{n |cnJlryolrr rnrct\rn l-r\c lLnJre'lJnll,'\{Jlrr)'z'j?
<br />K l. owmr ,,1 thc llnrrny. ry n\ c nrn rorcs wi h wiSc\ ae rhct j,lc ..mpctrs0riotr. will do rlf *nrk rnd lhc (Mlurc n mr
<br />T inr.nlhl or ollcrc,l rnr slc lsr 7lr,14. Burims ,nd Pmic\sions C.de: , he Conrrlcroi s L,i.eose l,w des nor applt, h an o* .r or
<br />lhc pmricny Bho hurlds or h0mrs rh.Nr el wlh es skh m* him(lf or hcnclf or rhmu8h hh or h.r oun cDployccs.
<br />pnwid.d thar skh inroknrnh iE rri inrc lul or ollerd lbr \ah ll io$$ri rhc boilding or iqr.k rnr k mld wirhir rnc )qr
<br />otco.rrhrbn.lhc Owncr Builds will hax rhc hurdcnolproriog rhd tE or shc did mr noiil or inItrov! lhc Dmpcn, tor rrt pxqx,t of
<br />-
<br />l. x\.lr'',l rhc rF.F.r!. r'1r\!hnvc'].,.' r'i nE strh h' i r,.on(rucr rlf, rNlc.! (s( 7(}4,1. llusi'rcs\
<br />rDd Plnlishn Codc: 'rh. Coirrr.kr's Li.ctrs.l-aw ors
<br />xnd $lm ..ftr.r\lor {,.[ tno]..rs\rirh r(innt
<br />x,.,"
<br />|IICITIBA.IION
<br />I hcrcb, a,lirmlndcr pcnllly ol rsju,y orc oarhc tolloqins delirlln,r:
<br />lhrvcoln|willmoinrainaCcrriltarc6fConscnrhSelllnsurctuworksscompcnslrn,n.asrmlidcdforbySccriun:l70oorth.
<br />Lstnr Codc. for lhc F6lormR. oi lnc wort for phich rh. pcrml h Gsu.d.
<br />Ihav.andeillnEinhinrorkcrs.ompensiioninsururcc-a\rcquicdbySNria.1700ofrh.LrborCldc.trrhcpc.forronccof
<br />lhc *ork fd *hich rhh l.mi ir irscd. My w.rkc* onqEnsarion insrrnftc .anid dnd F,licy numh.r a.:
<br />Af-*r,,^ -'* *n"rnnR. n,,hc snrk,nr trh ichrhn n flnil ( i\n'.d.1nnll nor cn,0loyrtrypcnon i', ritnk irr
<br />wr .r Cdlif(rnr. ,nd nAnc r[d irl shonld hcc,
<br />workc^' conEn\alion trovision( oiSccrion 3?urof rhc L$or
<br />\yARNIN(; lxihrc ki v.trr. workcr\ .onrpcr
<br />.i\il fir\ u! ri o c hunJrd rhou\r dolh^ (Sl
<br />x;:ttil;tri
<br />DECI.AEAIION
<br />I hcrchynlttn ukl.r pcnalryorpclurr rhet I trnr li..n{d undcr fn,vnim.f Chryrd 9(.onnm.cing qnh Scrion ?O({)) olDivnion.l
<br />of rhc Bu$ndssnnd Pbfesion\ C{rdc. dd nyli.xn* i\ in fnll f{ncc a d cafccr
<br />TANIIXUCDONIENDINEJCENCI
<br />n\kd lscc lrx)7- ( iv C )
<br />AITIICAILLIII'I:I,J3AIIA!
<br />Ilttubydllmunn.rpcnrlryo,t rjuryoicotrhcfolnrsingdrhnnn,n\:
<br />l)cnnnirion P.flnirs A{tEsros Norili. ion l:cdcr.l Rcgul$iotrs (Tirlc.l0. Pin6)
<br />-Rcqutcd
<br />l-crlcrrl Norii. iur
<br />2k'.nity rl'rr rhc rrd.'rl'oFtrll r\h{o(rd xrrlrrc d xntli.rhlc n, rhisfroJ..r
<br />lxrN ro co.rply qirh,llCiryand ( ootrry
<br />otrlimrccs rfd shrc tiws
<br />rhovc r rn,icd lr,Fny
<br />ivcs ofrhn Ciry lnd Cotrnry b circr uIn)nrh.
<br />Rlprunrorumr
<br />(".'rr* *-.rn;.rr,K €v)a ba-/-:/Ld/rr
<br />ls)AU
<br />'l//.t,*x'
<br />u*\wuy
<br />\**-rJ
<br />[w"t?Q2
<br />dvtrr-.rii
<br />T-Bar
<br />Flood Zone Certif .
<br />ll I
<br />FINAL
<br />Notes, Remarks, Etc.
<br />tJ
<br />t
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