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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS 01{NER AUILDT]R DELCARAAIoN
<br />I hcrchy afin u cr pcnnlry of l).rjMy lh l in crc.rpr Im,n rhc Conhcrori Li.cn* tiB lor Ihc lollorins rc!$n (lcc ?O:ll 5
<br />Bu\in.s ald lt ltsion Codr)r Any Ciry .r Counly *hich rcquirc\ u Dcnnir n, con{ru.r- ,llcr. i'tpR,vc, ilc di\h ,tr rLnJ r rn,
<br />nfl.tu., |nort) irs is\ur..c, rl$ rcquims rhcnptlica nn skh p.nnir r. filci \igtrcd sarc'hnr rtutr h.or shc h li.cnsL{ tusuunr .
<br />o rhc povi\n)n\ oa rh. Cln rrttr s l-iccn*:l liw (Chaprcr 9. Commcming wirh Sccri,n 70(X) of Divirion I ofrhc Bu\ind\\ Md
<br />Pmltssions Cod. ) .r rhdr hcorshc (.rcnrpr rhcrctomMd rhc brss turih. rllce.d crcnDriofl Atryliol.rionofSclionT0ll5 hyrn,
<br />appli.a turufcirnilsubjc.lsthc rpplic.trr to !civilpctr.hy.rnor.Mcrhnn r'iv. hundrcd dollrs (t500)
<br />L a\ o$icr ol rhc proFny, or eycilpk,y.c\ wilh wlScs N lhcn $b comFnsrnnr. $illd. rh. work mlrh. sndtrrc i\ tur
<br />inrcn+d orolitrcdfor$lc(Sa704,l.Busincs0ndPmfc$iotrsC,icTh.CoM.cror'sl,6cnsctnwdocstrotopplylorio*ncroi
<br />rhc ltupcdy wh, hoild\or i'rlroEr rlrr6n. rxt wt$ d{rs sch enk hin\elfor hfi\clfor rhftu8h h( or h$own cnrpl.y.c\.
<br />B)vidcd rlu sNh i'q'nrknrn( d dn inr.' cd orolleNl lir {h ll k)*cvcr, rhc hdiklins or inpnrhn.nr t sll wirhin.,nc rir
<br />orcor!'Lrrion. rhc O*ncr Buildcr will hlE rhc hordcn ol prein8 rhrll hc or sh. dil nor hUild or improrc rhc ,mFny r(, rhj ,,u4D$ or
<br />I. asosncrolrhc pro!.ny. !n.rclusiv.l, con(rudir8 *irh licensd.onrradosnr condtucr rh. pn,Fr lse.704:r. Busft*
<br />ndt\oLssirc.dcTh.conknror'sLiccnsct-,wdocsnDreplytuanowncrorroprnywhobuildsorinrprovcsrhcrcon.
<br />rnl $ho coorrich li)r \uch prtccls*irh0Coorrrclo(nlicctredNruurti11[Conrrocroisl-ic.n\clr*)i.I rDexcnrJ, rtrJ.r Socii,'
<br />Dur. O*ner
<br />]ta.BriEB.LrauffNlljloN
<br />I)EU.A.B/III!)N
<br />I lrcrchy rlTtrD oitlcr p.nrlrj of r^-'rjuryo cofrhc n)LbqingJ.{larxri,n,s
<br />_l h,vc ond willrBirlaina ccnitu,rc ol (tnrnl los.lilnsuc ror workcs .onllc.srrion, as pmvided lor bySccrionl?00ofrhc
<br />trhtr Codc, aur rh. ,nfonu..c ol rh. *ork for shkh rhc p.rmn i\ i\sucd.
<br />_l hrrc rnd sillnr0intrin uorkcri com!.nsalion iNu.ih-c.0s rcquncd byScdi lT0Oolrhc L,6or Codc. ror rhcr.dornbn.c.r
<br />rhc work l.r whichthn pcmir is G$.n M, worker' compcnsllion jnsurancc cari.r nd rricy hunficr m:ll€:tC,J
<br />QC Z
<br />I ccnili rhtrr in rhc pcrli)i,n{Nc olrhc work tu whi.h rhs Nnnir rs i\sucd. I slDll noi cmpl(iy unv ncno. in an, 'nrnrr$rsk,hcgnncarnjdronNworlq!co'npcn\rri{nrh*\.iCrliri,rniu.rndlgrccihrrirl\houl.lhcco'ncsuhjccrk,rhc
<br />sork.rr conrp.tr\aliqrpmvist,trrotSc.1n,n:l7l()olrhclnhorCodc.l\ltr 1. tunh*irh cohtl, wirh rho{J)n,vitiors
<br />W/\RNINCT FIhrc k' {.ur. porkch confci\dn,n cok.rgr i\ r lnwlul. ,trd \hrll sublc.r ,r.nlpl(iycr b cririnnl |{mlri.s ud
<br />.ivil 6nc( up b on. hu.di.d thuusrnd dolld ($10O,0O0 add iOn b rhc ..s ol (mrEnerion. dnMscs as
<br />'rro\i{td
<br />n, rhe
<br />Sc.rnD 1076 or rhc trbor
<br />lrl t. \[ I (]\
<br />I hcEby aftn u crpcmllrofpcrlurrlhal I !n liccnatundcr tn,vtion o+€lutrcr 9l.onrmming sirh sccrion 7mo) ofDivision:l
<br />ol thc Busir$sa Pmlcssnrns Codc, t my liccns. i( in6r
<br />7gsos8'74<V ..",
<br />(](INS RUC'IION I FNNTNC A(:FN(:Y
<br />I hcrcby lffirn undf Fnrlry or p.rjury thal rhcn is,coniru.rion Lndingdg.n.yforrhcp.rforimn.coflhc wort lorshi.hrhi\r. rir i\
<br />n\ucd(sft l097.civ c)
<br />AIELI!;ANLITECIA.8AIION
<br />I h.r'by rmnn u nd.r r.naXy offE jury otrc ofrhc follo*ing del.rari(,nsl
<br />D.nolirn,o Pernin Asb. os Norincarion kdcrnl Rcg!larioor llirlc 40. Pd6)
<br />Rcquir.d t-ncr of Norifi crrbi
<br />-l
<br />ccnilithot rhc icdcml rcsu,0rtnN Essdin8,\tr(os rcnDv,lnrc not {pplic!6ki lo rhh pre,ccr
<br />o.ompl, wilhall Cilyrnd Counry
<br />rhis Ciryond Counry ro cnrcr uF)n rtE
<br />I (cdiry(hxrl lr\crc d rhisll)fliurn,n uin nJr. rhrrrhc ahr. ifhnnrri,nr ':.on(r lrgrccr
<br />.'n' f tr',|hil,'l\!.tr 1"in'" .-r1 tr.',1
<br />.,hrr nrn,n,.Lr p. 1*ny 6tr in.n41,. *ri".r--r -:
<br />.rr,,.,.,,,.^-;.,r,-;.,,* J. ( 4
<br />n"^u**^"'on^" y'
<br />'ftatn
<br />b€/v'
<br />Set Backs
<br />Erection Pads
<br />UFER Ground
<br />Subf loor/VenVlnsulation
<br />Rool Sheathinq
<br />Shear Wall
<br />Framing I 5D 9{t
<br />lnsulation/Ene Irrl,,9 t\
<br />D rywall I >Daa\/
<br />€Dtnt. Lath )lo (B *ff{19 at tob bl ,,O,9C
<br />Brown Coat L
<br />lVlason ry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif .
<br />FINAL 4r)(<
<br />Certif icate of Occupancy
<br />Notes, Remarks , Erc
<br />Formsi Steel/Holdowns
<br />SLAB Floor
<br />-,
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