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BUILDING. INSPECTOR RECORD
<br />SITE.WORK tD/srG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subfl oorfu enUl nsulation
<br />Roof Sheathi
<br />Shear Wall
<br />Frami
<br />lnsulation/Energy
<br />Drywall
<br />Brown Coat
<br />Mason
<br />Pool Fence
<br />T-Bar
<br />Handicap Requirements
<br />De uty Final Re ort
<br />ineer Final Re
<br />Flood Zone Certificate
<br />FINAL
<br />Certiflcate of Occupancy sAMc s43, 29o, so6
<br />Notes, Remarks, Etc.
<br />Om6-B{ilds D@lr.ii6
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<br />od Pref.srioo Cod.): Any Oty a Coury *bici Equir.r r Frmi b cerflcq .x.r, iDp.!v., .larolith or Ep.j. rIy fis.le.. F* ro ir.
<br />isl@q do 'qsi6 rh.49li.er fdr.n F nn io 61.. risn.d frtdrdr il[r h. r rh. ir lica!.d pofur lo tll. FwilioN of tn.
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<br />rppli$t ro . .ivil pqdty of n r ne $D fiE h6tu dolrt (3500).
<br />_[nomEofdEF!?rt,nntyEnplordrittEs6!Udrtolccoopautioqrill&lh.Etsdrh.nrudurirrori.nd.ddolfti.dfaril.(Se,70+1.BEindltdM.3ioll'Co<lgft.Co.rd.rtLirMlrw<b6ndAply!osomrofrh.,roD.ny
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<br />_!, s olM of lh. F.,pst . 6 a.luiv.ly dlEerhS rir[ lidrcd 6r*roi ro .d!tl scr tt. Fojer ( Se- ,oaa, Bqira &d
<br />Pmf6ioi Codc TI'. Cldrxtcl ljarc L.* &.r no. rpply to D om6 of FDpary r,ho b{il& a i,npbr6 rhr@ , od who
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<br />_I u .r@pt uDd.r Seti6
<br />WOR(IRS COM'TNSATION DTCT.AR TION
<br />I h*by .fiim u.da p.i.lty of Fi!., 6. of r,E aollwi.s d6ldti6*
<br />_I hrv. od,ill n.i.t i. rcd{6dr. of C@mt ro S.lf-IBuc fd wdtd'ffip..{rion, s Flvi.Ld fd t, Sccrio 37oo of fi.
<br />lrbor Cod., for {E p6fcne6 oftheo.t fnrhict ih. pctnir t i!ru.d
<br />_l h.v. &d will minl.tn *d*d' @npd.ti6 in$rda. ! cquiEd by S.cri@370o of th. L.bor Cod., fd lhc Ffmsie of O.E!* fd *hich fik Fnn it ir3u.d M/ rort6' ceFMdo i,lt!a@ ffiicr &d poll., n6br m:
<br />Polic, Nw$e_&piE:
<br />(Thn lddo{r n d not !. dnel.&d lfln. pcnil i, f om hud.d.bllB {tloo) dIa)
<br />_I c.idt d'.r ir ti. doftl,rcc of d. ro* fc ich d t Fmir ir ir!.4 I lhdl nd anploy .n, p.noi i! o, mE e s ro
<br />bG.!,E sbj.ct lo O. *dta ' coip6rr.ti6 l.E ofc.lifo6i., rod .Br!. rhr ifl tholld t coitrG sbi.ct ro thc w6t..!.
<br />cdrpd.li@ Fwid@ ofs.dio. 3?00 offi. trbo. Codq I th.ll, fonlwitt cmdy yirh thsc tiovi!ic{!..
<br />rtrA.RNING: F.lluE ro rC.@ *atd' cornpardoll @v6s. i! 6h*tu} Dd rhdl tubjer D hdoyr ro oiminrl pc.rrri6 ed civit
<br />finq up lo oG lu,&.d lloled dolla (tl00,o0o),i. .ddid6 ro rh. cdl of .nD6l!.ri@, dtmr6 s ,rcvirlcd fd rb. s.dio !016 of
<br />$. trbd Cod., intmt 6.1 . m.rt fcl
<br />LICENSf,N CON?Ttr'i ORq NE.:I,AIT TION
<br />I t+!y .mm 6dd Frlty of Fjtry Orr I 6 li@*d ufiL. p@iri@ of Cl.prd 9 (c.irmcirs ,ilh s&ri@ TOoo) of Divi.id 3 of
<br />U. Buiid rd Prcfai@ Cod., sd nry li€& L la frll fdB ed .rL.r.
<br />U..ecle: U*Numte
<br />o*. , X- -2,,2 f( c^o*r*
<br />CONSTRUCf ION I,TIYDiI\IG AGiNC\,
<br />I h.r.lry dirm m&r p.lrlry of FJE, tha 6@ ir . ortucidr lsdiry raoc, f6 lh. p..fcllleo of ttc rrt fr. whi.h rhir Fmn n
<br />ito.d (56 3097, Civ, C.).
<br />ATPIJCr{NTIS DECI-ARATION
<br />D.mlitid Pcnll}^th.na N.rifcrid Ld.d i..sll.lis GidG rO, Pm 6)
<br />_ liquir..t Lnq ofNoiifc.d@
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<br />_ I 66t ind I hr! Md thb rFliciim 6d tn& d[t dE rt w inf6lrri6 it ff..r I r3l!. r.c@?ly *nn dl Ciry sd cd.r,ddim6 ed Sla. kE Elnina io luildina c@m.iid, od h@by dlh6ir ..lraafiit6
<br />.bov! n rnUolllrl Fo!.rV f6 hrp..d6 pirpdd.
<br />orti, ciry .nd Cosrr, ro 6lr upor rh.
<br />^a-)-4r
<br />IT
<br />-LEJiEIII
<br />DATE
<br />Ext./lnt. Lath
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