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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG,COMMENTS OWNER AUlLDER DDITT'ANATloN
<br />! hsctD i,Im uf,d6 Ffl.ny oa polury rfi6l t m.rcnpl 6on tnc Contraclo6 Licffi li{ forlllc rolbwiry r.&o (5(.70115
<br />8uD* .,1 Profsion Cod.)r Any Ciy or County $hrch r.qun6 a pdnn lo codru.L an6. ibpr6v.. .bnolirh or E an .n,
<br />nM'Ec, Fior h tr3 suac.. ,l5o GNn6 rh. rpplkul aor $.h Frmil b liL r sisn d idoml lha lE or JE it lic6E d nuslr
<br />xi rhc rorirod ofrh. conmcroa! Lic.E d hw (chrprn 9, conmcncinE wirh sdion r00o of Division I ofth. Burins ud
<br />l'rofsions Cod.) c rhal h. or sh. L! .(mF rh6.to'n ed tn. bf,ris for rh. alkgcd .xorltrro. Ant vioblion ols..1bn 70.1 I 5 5, &y
<br />arplicdt fo, , p6n( subjcl' rhc lrolicair ro . civ'l poaty ot.or mr. rhd fir. hundrdl .hlld (lsoo)
<br />L s o*'E ot lh. prop.nr. or n'y .mplo,6 u'ilh wss6 6 lh.ir el. conF,sal6n. qill & dE wrk exl rE {nde it Nl
<br />inrod.d .r orla(l for s.t. (Sd 7014, Bosi6 ed Prnfsioc (-od. Tn Conlr..ioas |.rc@ t $ 1116
<br />"or eply lo o o*nd of
<br />rhc ff,orEry rhdtn &orinFo!6ln@tr, who do6 s!.t tro hnnscla oi h.Mlf or ttmush his or hq o@ dpk'yc,
<br />,rovid.d thar such iuprovdrn s e ml i' dxbl or olTq.d lor sL lt t $is. rlE triEilB or @Fo!.j6r ir $ld sihi. od t@
<br />ot.ohpkiol\ th. ()$c BuiU6 ult hac th. hrd, ofp.lviA rhd hc o, si. dil Nl hild or irp..e t. FrFry tu UIE F,Fre of
<br />l, 6 o$ns of rfic rroFrt, m.r.lGiv.l]- Lonlrdtrs *'llh liGsd Lo'ndoE r. @nslrud tlE Fojd (Se 7(x,r. tt8d<
<br />rnJ hrfBrkr(i r Ih.(inn'..(n's t-rctrsc I-r* tlor\ ior n rl u o$nd.fpro!.ny *ho nuilds or irnprovcs lhdmn
<br />.nd who conlmts for such Fojds eith ! Conlt k'(, li(plrswr ro rh. conracrois l-tce hw)
<br />lan c\.n,pt utrdrSdnn
<br />,,"," s S-z{-?dl-\
<br />Df,q"l&UtoJ
<br />I hEcby amm uadr Futrr of FJuO onc or
<br />I hav. &rl *illmaflain a Cfiincar. orcnnst to s.lfltuurc lor w.r[6 .omFMlnrn. a proldcd tor byS(tior 1700 otth.
<br />l,bor Cod.. lo. llE Frolrle. 6f rh. *qL lor *ith rh. Fh{ a isucn
<br />I havcand*ill linlain workss comp.Nsr nr. iEuru... s r.lutcd hy S(ri{n :1700 of rbc l$or Cod., ior rhc Faalr@c. oa
<br />lhc $orl for $hih lhis p.ml n isol My qorl6 conFtrio. eurac 6i6 &t! pol'., rudbf &.
<br />- lc.nily$ in rh. pqtu@c. otrh. \ ork lo. \,hkh ih,s fEmn 6 su.d. l 3holl mr odol dnr !.r$. ir sy Den6
<br />s 6 lo tl on sobjrt to th. *ort6 comFEdion hs of C.lilomis. ed a{6 ltd il I rhould b<.oe tulicr to llE .
<br />so m (ornpaslnrn prerisioNoiS.clioi llT0Oofrnc llbor (
<br />WARNINC Failurc to s(. *0116 .rnpoen,n (!-+.
<br />r('l nn* up to on. hunJ,<n thou J doll6 (1100.000),
<br />'n\Rr'on rro olrhr lrbu' C dq rnrdd J. r.mo \ {6
<br />conply wirn $os pNvtioN.
<br />l ebjd' n oploF lo aituind Ftrnis.frl
<br />or dnFMion. dm4r6(, FoirH to. th.
<br />I horbr-' amm u.d6 p@l', ol FJury lhal I on l.6!ql F!!t&n ofcn p'6 0lon'nftin! "rh sdnn 70@)olDnBbr l
<br />ot thc lnNinsond PmfRri('6 ft'.ic, ad r, h.sc Ll in tullforcefl clTer
<br />Cq!iIB!Cru!.IEUU!G.AGI!C
<br />t hecb rmrs uid6 FBlr, of Frjury fid rh6c is r .o.arudion kndmg lsocy for rhc D6lolr@.. of rh. wort fo. whi.h rhts IErn i
<br />isu.d (Sd :1007. Civ C).
<br />AITUCANLDICIJAAII!,I!
<br />I hortr 6fli uidd I,.n.hl olFjury orc of lh. followhr ddlelioB:
<br />l).molnirn Pmnr-Ash6h. No'iicdion r.d6rl Rcglhiio$ ( I {lc 40, lu16)
<br />Rqr'tr.J I drsof Noni.aron
<br />I ro1'li rl rih.fuddrlrr!u].rrrrrc8,ud tr!\ale. nor aaplrnblc lo rhG prold
<br />f(1 .-n, ,,', , *," ,-a\" *,"'u- -!bo\.'nfofl'drc. G cor6l I 33re lo cooply snh tU Cnt d Cou.rr
<br />o',1' ftrrcs itrd Srrrc Lrssrclnrirtr,!d ho.by .urhonz! r.p 6oktiv6 o f th6 (ity d Counry ro drs uFtr rh.
<br />.tF\. nori(,o.! prup.ny lor
<br />ADpli.{nt or /\prtrl siEn{l
<br />t mile nrm. (prino:_\.fo/.|
<br />5-4-2{\
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Enerqy
<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 />Engineer Final Report
<br />Flood Zone Certif.
<br />FINAL K -20 -21 y,tll10
<br />Certificate of Occu n
<br />Notes, Remarks, Etc.
<br />""..-fuAnal-
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