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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNDR EUILDER DE'TAR TION
<br />t i6cby r,Itrm u.dd Fdr, of p<rlury lnd I m .r.mF 6sm th. Conlrxlou l-i.w L{* fo. lh. follovinr ,!&n (Se 701 I 5
<br />BEi.6s drri Prcfsion (od.): Ary Cny or Co! y which r.qut6 r Fni lo @ri{tu(. .lrq. impm\q da.oli5fi or rlpan uy
<br />strucruc, r,rr lo its isuMc., Als r.!un6 $. applicd lb, such dnir kr il. ! sisnaj lratnnl lhll h. or rhc i! lico*d pcuMl
<br />lorn Fori.ioB of fi. Contr.cror's Licmra] L5* (Ch.prs 9, Conmcn.ing wirh Salion 7000 of Divhion 1 olrh. Bain.s ed
<br />Pmfsions Cod.) or lhar L d rh. b ddpr rh6.nom dnd rh. bara for $.611.8.n .rdFio. Any lioldiotr of Sdio. 7011.5 by Ey
<br />Effi f*:"-:-ffiffiffiil;#*-i*******.,
<br />rhc
<br />',$psry
<br />{ho hril& or m!,!!€ lh6oG Md wral drE $.h mn [nB.lf or h6daor lhrcush hi! or hd om dplor.6
<br />prord.d lhat such iEFoffilJ e nol i,toxLd or oftsqj lor sL. lt ho*dd, $. buibor or mFov.lMt ir bld *nnin onc t@
<br />ofconpLrbl! rrE ('rr( Bu da will h.E 6c hlda ofF!$g tla h. or rh. did ml hild or imFrw th. FoFry for ll* l! Fe ot
<br />l. c o$nd olrh. FoFrr, e crclBn.ll conrd'ns slh licuE d conranos ro cone{d rh. Fo)cl (Sd 7or4, t}Brn6
<br />drj ltllko Codc: Th. ConrGr.. s Li..G. li* do6 frn apply to m o{na of prcpdy sho builds o. mp,o!6 rt6@q
<br />rnd sl$ contds for s!.h rmj(ts Rnh a Conr6.lo(s) lrcos.d psudr Io rhr Contacloi! l,i.@ L.w).
<br />I dnRcnr!! und6 Sdion-
<br />(D.8 3p:'2-L oy,
<br />DI]CJ.IAATO!
<br />, hsch),llir tr.de Faht of lEju,r_ onc.frhc foll('\'n3 dNl,arD.s
<br />I hav. dd will @'nt!in r Ccnifiotc ot Co.gl lo sclt-16urc lor sor td conp.Brrion, s Eovided to, byS4lion 1700 oIrh.
<br />lib.r ( od., for rh. FfolrM.. o f rh. woll fo' whi.h rh. pdmir i! ireu.d
<br />I h&. .nd *ill h.im6in wod6 comFMrion 'N!rffi.. s r.+ncd by Sclion 1700 ohh. lrbr Cod.. lot $. psfolrla. of
<br />rhc *o.l for *hi.h lhie p.nir ir ie.d My *0116 omFMion iNuroc. 6iE sd Dolicy numbd r.:
<br />Ekoln\ td n ttt pctlomtu. or (h. wort rur s h tr h rh'r psnir
<br />'r isu.d. I lrulhor dploy .ny FM. ir s., mM6r*-* n t .".. -q-i r. rh. rolld @tr Fuarhn h$s of Crlir6mi,. m.t .sG rhn irl n; haore subirt ro rlr
<br />slrrd.onFMi.nFoGio6ofsdion1700ofth.l:huCodeIshrll.,onhq'ilhcoDply$ilh0h*Foririo6.
<br />$aRNlNC [ailw ro suc rortd' @mFailion or'6rs. a dla$ful. Md dEll subjd M aploF lo sininol p.ulE ud
<br />civil fin* up to on. hundr.d rhousnd doll6 (1100,000), i. rddnio. ro !h. cd of comFn$lion. {h,.as6 G prclid.d fo.lh.
<br />DECIJAAIION
<br />I hd$, .ffm undE pa,ny oaFrury fid I m ncosl urdd Forirbi otchlptg 9 (@M*ins snh s..lb. 7000) of Dili.ion l
<br />of lnc BGhB @d Potdoa Cod., rd my li.ce 6 D tull aoN &rl.lIcl.
<br />CAIIIIIJCIIO!.LIIDIIS.&qENCI
<br />I hdb, lmm od6 Fnalry ot pdjury lhd rho. s ! conrdrlion kodins i{dcy for lh. FforM(. of rhc *o* for "tr.h $i! Fnn is
<br />issu.d (Sr.1097, Civ C ).
<br />L..doi N!D.:
<br />AIIIfCAIILDECI.{8AITO!
<br />I hqlt y dfiim undd F.ax, of pEjury on. ol th. follo*rng ddhrslions:
<br />D€rolirion Pd,nn! sb6ror Nolifi.alion F.dGal R.golalions (TitL40, Pint)
<br />R.qun.{t lard.lNdifi .rmn
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erectron Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subfloor/VenVlnsulation
<br />Roof Sheathing I ?+t-zt :hatfi
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<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 kpzt :rL-.9{s
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc.
<br />f I fq.r-A., J.Ea^ e^.-a-,o* f c 3rn- zr Drlrz-rrr.l AID C,s-
<br />I -:l)
<br />"##idd" "^ ^^IHFrJ.E //,.-rs
<br />/z Llcinst'n (oN r R ( rolt
<br />li rhd rh. f.n6.l rcgul,rnc Esedh! ct sk* r@oval d. nol alrl(.bL b rhir pn,r(l
<br />rlulharcrcalllnsr|]l]h.llum'lsralclh ih.finc
<br />'nn)mriitr)0
<br />hronN Iag&h(!rl)lvn'rhallC()and(qinrt
<br />r.r{rsc hns.lrhtr(' } ntrdCounrrro orr urx)nrhc
<br />ib.\. nE nrcd propdy
<br />\..-
<br />"^n*",,onkQ4ilQ J C-11t c ,Af-= zt
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