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BUILDING. INSPECTOR RECORD <br />SITE.WORK DATE ID/SIG.COMMENTS OWNER BIIILDI:R DE'('AR"A'NoN <br />I hdq rrm !.d.r Fnah) or p<ouo rhd I m clmF 6!n lh. Co'i,rhn l r.G h* for rh. aollo$[3 r@n (Se 70\i 5 <br />Itusin6s r*l Prof*iiotr Cod.) Any Cil, or ( oudy shich rcqu,c 6 Fmn 'o .o.nNd, ah6. imtrov.. &nolnh or rcplt any <br />qrru.iu.. Fxy ro nr (ue.. ak rd]ur6 !h. q,rlkMt 161 3u.h Fni ro 61. . !i8n.d nnm6t thd lE or th. n li..!.d putud <br />ro rk Frtiri.B of tlt Contsloar I 'cos.rl l,r (('lurr( 9. ( {mdtu'ns \nh sdio. 7m0 of Dni,io. r oa $. BwLs ed <br />Pm[6sion.(odc)orrhErh.orrhcie.r.mgrh6.nom d rh. bsir ltn rh. !l!.8.d .\mptnrn AnyvnlalrcndlsdnnT0.ll5bt.ny <br />.Il ncd ao. r Fmn sbjrlr lh. rrrlicdl lo r civ rl ,.ull y of mr mE lhd 6vt hunrlr.d dolla I lsml <br />1.6 o*ncr oarh. Inrrp.nr-, dr n!.,nplor6 wnh wrgd s rh.tr $1. comFddnri. rnl do rhc sorl rd rh. sMw n Rn <br />iddxt d or ofi(cd for $lG (!{. 70rI. AusiB! ind Pmf6rioN ( od. Th. ( onr.dor! Lk.@ l^r (h6 mr q'Flv lo u .r 6 or <br />rh. r'!Ft $ ho t!l& or mFo\ 6 trrrF( rnd tr rn &6,xn *nlt hiN.rf o. hs*ll or llroll8n nit .r hs orr oplorc. <br />povid.d rhd loch nnFovEmt & nol inldd<l or otraq.l fo. eL l( hotr -s- llE trildins dt imgrov.mt t sld N irhin n. tft <br />oltunpldm rh.6n6 arilt uill h.\. rlE trr ld of Fnu\s lh. lE or slE dd mr t ld or iilh\t th. FoF v f.r rlE I!'r{For <br />l. B otrB of th. Fopqr), n cr.lur tr .\ ..nir,.d!s tr''th licdld codrdoBro 6dEd llE Fri.( (Sc 7(x,1, &B16 <br />dr! Ii.ism co& In. Conlkoi! t-i.o3.l,q'&d mr rrpL lo e o*n6 olrroFly trho bu'ldr or iopm!6 rfi(o.. <br />rnd wh. codndr for such Fojdi3 wnh a ( ont6.ro(, licdrd rn6@r ro <br />'h. <br />( odrdoi. Licc* L.w). <br />I ffi.rm ud6 Sdx,o <br />tlof,f,tx5_(o!.t8EstArjox <br />DECI.ASA]IQN <br />I h6.$y aflinn und6 pcn.hy .l pErury onc orlhc tolloshs dcldi' ions <br />lhav.,rlsrllmhlri!!(difioi.ofCoddrros.ltl6u.it*odar'comFrdion.sFo\dcdrort]}sdionr7(x).frh. <br />l,hn Codc. tu th. ,6aomm. of th. so* for *hl.h rhc pann i i*u.d <br />I hav. .nJ tr ,ll mr'nbi. *0116' (omp.N bn rBU.k., 6 r.q!n.d by Sdnn r 7(r0 ol rlE lltxtr cod.. aor rh. p.rfulmm. of <br />rh. *ort for *hi.h rhn pdmn ! isual My $ orld- compdsrion insuoc. clFiE on Dolicy nunbo tu. <br />c-* ?]4lP<--lat$r <br />,",,., ",.0.:g, itl = I1 <br />) ljs Eullci5LL <br />,.rl A 2 Lta <br />I c.niryrh.t h rh. p.rf6rmnc. ofrh. *orl lor whth rhR Fnrn is i$u.t!. I shlll.ol mrloy any r..$n i tnynd6 <br />g' d 16 b..om rubd h tlk r. 6' (omFMion L olcrlifomia lrd !r.r lh,l if I shluld b<om subjd t. rh. <br />so*6 onFldhn Fo$hs ol Sdiod 1700 of tlr ltbor CGL. I tull. lodnsnh onlply sirh rrb* pro\ti'B <br />$aRNtN(: ria,!ur. r, rcu. \r.rla\, comlnsron o.\drr.! unl,\rtuI...d shall subi(r M d.ployq ro Fm'n.l ndqii.*,nd <br />ctr'l fin6 uI ro oE fiund.n lhoand dolld: (tloo,lxxD. i ihr cd ofcomFn$tion. dm.36 a pr.\ id.d ior rh. <br />Sdren 11076 olrh.l.h)rCd.. 'nrdd 'nd(t l-l'/_ <br />DECIJSAIJA! <br />I hRby ailrm und6 podty otrajuD- lh.l I m lrcsE d unds Foviiioo.l( h,prd c (.ommtrirg silfi S.dion 7000).tI)nri.n:l <br />ol lh. BGitE md kolNB Cod., nd nr lr@ . n full forc -d.(lcl <br />\Zol"I <br />C) <br />"I.L <br />(a!flf,lrc[o LEdllx(ilc[ltr <br />I hdd,y .trm und( Fuxy of Fjury rhd tnq. i. . 6dD.rio. kn re lsacy lo. th. pqtonMc. of ll'. mrt Lr <br />" <br />hi(h rhir Fmi' t <br />!!o.d {s6 1007. c'r cl. <br />6IELI(ANLD}:OIf,AIIO! <br />I h.rb, afm uid.r Fndly oa Fqjur] oE of llE lollo*'.3 dchnr F6: <br />Dnoliion Pmil!-ArtBl.! Notiicltion F.ds.l Reuhl bns (1 nL 40. Prn6) <br />R.q!trGj lnro.rftn'turlnn <br />I cdifr rhd rh.ldidd r+uLrio6 r.srdinr 6t6k'Iffi!.1i. not qrlicahl( h lhrs lxoj.Tr <br />lc61,ayrharlh.vcrodrhlrnpfli.arnnmdsr.r.rharrh.atsv.inlomari(ni6cor(l lagrarocomplysithdll('irr and( ounry <br />orJiMft6 Md Srar. tr$i EhnrB ro boildne Ddir! rd lErq\ rdlF u. r.rf,.s(i'l n6ofrhicirrmd('ornrylo6taursnrlr <br />.h!. nmr.ad proFny for <br />I 'li.rnr nr rrmr \ir {rurr <br />wW4 YICr.l,Ytts ^E,zyla <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />Subf loor/VenUl nsulation <br />Roof Sheathing toltolfi vul14 <br />Shear Wall <br />Framing <br />ln sula tio n/E ne rg y <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 />,z'-^ <br />FINAL n/A//- .ffi'A am{ "7d/ <br />Notes, Remarks, Etc <br />(.-' <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />Certificate of Occupancy