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BUILDING- INSPECTOR RECORD
<br />SITE-WORK COMMENTS
<br />Sel Backs
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subfloor/VenUl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Fram i ng
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handica p Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />FINAL 7 @T
<br />Certificate of Occu nc
<br />Notes, Remarks, Etc )
<br />O\INEtr BUII.Dt]R DEI,CARATION
<br />I td(ry.- rfim u.d6 psulry .a p6lor) rhd t m .r.n'pt 6.n rh. (n.rmdo6 Licd* l is (n rh. follo{ lns r.asn ( s< 701 1 .5
<br />BEin6s rrd Proldion (d.) An, City., Counrt $hkh rqrir6 a tEnn ro cotrnrucr, all(, impro\c. dc 'lshorry.ruiirucruq Frn ro its su4., .lo r.qun6lh. +plket for surh p.m ro 6L. li8ncd ndEm! rtra lE or.h. . I'tdkrl puJsEt
<br />to rhc F.vilioro ofrlE conreb.r l-i.d.d lr* (ch.prr e, (omm.ncin| trnh Scrn,n TCxx).r Diririon I ollhc Bur.B dd
<br />Pmfsion! ( o&) or lh.t lE or iE t dmpr lh6.iiom ud rn lEiB for
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<br />llks.d crorii{,n An)_ rioldi'n .f s<1an Tnl l ! 6,.n}
<br />ip?l'.ur to, . Fd( iubjer rh. .pplicer r{' . civ'l pcuhy of d'r nn. rhe lir. hutot.n J.Um (lt0o)
<br />l, 6 .*ffi of rh. FoFn), or my mplolc sith *^*6 a rh.r $1. NmFMiotr $nl dr dr *rI an rtE sul,tr. E B!
<br />idd.d o.or6.d for $1.{Sa.?01,1. Busind &d ProfsioN ( od.: In Co Eiois l-ic@ l,r d,6 mr q,Il\ n,tno\ndof
<br />rh. pmldiy *ho ttril& or inrrmv6 rlEoa Md *ho d{6 !u.h srr* himrclfor h.F.lfor rhnugh hil or h6 oNn.mpk,r.6,
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<br />of.ompkbtr fi. o".a Aoildd $ill h.r. dE hfilo of F.\ trB rhi lE or !E dn nn hriu or 'trF..rr llE FlFrl lor rrr FtrFt of
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<br />&d PInbiFn Cod. 'I h. Conrraclor'! t-icd!. I -rw dod nor irrly lo rn ownr o I rop.n' wh. bu ild! or inrprorcr lh((n.
<br />a.d *ho olifu. for 3u.h F.tti snh. ( oMo(r) lkmEn Fmd io lh. ('od.&1o.! l.tre l.\ |
<br />ldncr.nu u.dd S€ nnr
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<br />DECIJAAIIA!
<br />I hdrur{ a min u.dd lEn lr} of tFjur_ d.. of rh. follo{ m8 d.(hidb6
<br />I hry. rn u'ill m'nr.in ! ( srifrli. orcotrGn ro s.ltitrru,. t r snrltd comFM rd. 6 For irdl ro. b! sdr i'n ]7lx) o I ttr
<br />LltFr Cod.. aorlh. n-fommc oflh. tro* ltr qnich lh. pcm i isu.d
<br />, hrv. rnd \rill m,'nrrin \ ork6' con,IEnsar nn Nur,rcc. 6 ,.lun.rl h\ Sdr [n .r 7(xr o f ih. I ]trr G)t!., for r h. tE l.nMcc of
<br />rh. sL[I rt trhih rhBIETir 6 i(u.!l V\ r ld'-rnlEsnrn 'Eu'an..L 'c d*lnltr\ nu'nb.r e.
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<br />p.rlorMccorrhcqort tur'hrchrhis Fht B isu.d- l3h!llml dplo j" lny F$n i...y,nrnffi
<br />$ ab b..om. slrdt lo rh. *oitn .omF$rion ldM olcrlifomia. md +16 rhd ifI lhould i'.(om. shjd rolh.
<br />\od6 comFerion ForilioN of Sdbn l T0o of lh. L,tor (-o(h l sltrll, fonhl
<br />'lh
<br />comply *ilh rho- rr.r Brc
<br />w]tRNlNG [ailuE lo <m {orld' .onpqadion cov@sc a unldstul and lrdl .uhr<r tu @pl6Jd ro omindl FMIIB ed
<br />.ivil lind up lo on. hun&.d thoMnd doud (1100.(Xr). in lddition lo rh. con of.omr.ernr. drm86.r frovid.d aor th.
<br />s<ri'. .1076 df rh. ljbor co&. inrsd rnd dkr6 i
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<br />DECIIAAIIO!
<br />I hd.by rm.m ond( p.nrlty oa Fjury rhar I m li.dr.d udd Frlisi.n of (1lapt6 9lcommm.in! wilh Sdi'n 70(x))orl)iriFn 1
<br />ot rh. BBuB lrd PtufshE Cod.. rn m) lic ir in tull tora ,rl.lt<l
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<br />f.,.14.1-?
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<br />X"-"*YA1s4
<br />310ts1t
<br />fOupgtca 1t(2ftLfH
<br />gNqlatqralrDxDlNclcEticJ
<br />I ffi, !,tunu L. FElrr ot Flo,y tld lhc. L. odrudion ladni* rsd' aor rh. Ffffi. oflh. son tri \hrh rh. Fda i!
<br />L$u.d tsd t097, civ c)
<br />lAdf '( Narn.
<br />AIITIIANIDECIASAIIO!
<br />I ha!a, atrm u.d6 ,.nalry ot Fjuy on. olrh. aollowins dcclair ioos
<br />Dcmhbn Pmng^rb.sor f+orificdbn F.rLr.l R.3uhlbN (Tnl. .l0, P!n6)
<br />R.qut.d L.lr6 of Norifiorio.
<br />- I cdlify lhn thc f.dd.l tsuLlirB rt8tdin3 ct6tor rdm\ !l u. no' 4plic.bk to lhn proj.(
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<br />1!lJcd,ryrh,Ihe.ddrhBrpplr.rD.ddrn.rh,rh.!bo,.into8 rioni!orcrIre.6roonplrenhlllcnt. (oury
<br />-oidla6 ud Srrrc Lls ELr 6s ro hildiis coaruclKn. rd h(.ty rulhon& .clr6dran 6 ol rhi Cny &d couni, ro mrd ipon tlE
<br />abo\. mmri...n pmF.n) for itripfg.In purpor.A ^(,*., - n,-,,n-e"'Vu-tQXbw'-
<br />$.-rr*n...rpano, VA14L ( t-,ee I A.,.1-J- t1
<br />7rr--z
<br />DATE ID/SIG.
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<br />Forms/Steel/Holdowns I
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<br />Flood Zone Certif .
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