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BUILDING- INSPECTOR RECORD
<br />COMMENTSSITE-WORK DATE
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />Subf loor/VenVl nsu lation
<br />Roof Sheathi
<br />Shear Wall
<br />Framin
<br />allD
<br />Ext./lnt. Lalh
<br />Brown Coat
<br />[/ason
<br />Pool Fence
<br />T-Bar
<br />Handica R
<br />De Ut Final Re ort
<br />ineer Final REn ort
<br />Flood Zone Cefiil
<br />FINAL
<br />Notes Remarks Etc
<br />lllratrElMlolltENsAlloN
<br />DECIAa{IIq!
<br />I lrcrchy sfilm undcr ,€nrhy or rsjury om orrh. rollowirS dcckarnrns
<br />lhrv.andwillminrrinaCcnifrclrcolConsctrrlosclfln\lrcfor{orls{sfrPcnelion.srrmvidcdtubvSNtion]70Ooirh'
<br />hlxr Cddc. lbr lhc re.for@rc oflhc rork for which the pcnir is issucd
<br />lhavcan.tsillnDinlainworkcll,co.Irns0tioninsurdmc.Nrcqutedlyssiion:]T0oollhcuborcodc'follhcP€if6nmn..ol,
<br />$c *ork for *hih rhis Fmir i5 irsx.d. My woAqs comp.ns.lion in\drde.Mier arld polirv nunl'er m:
<br />-lr.nilt
<br />rhrr if rh. p.rl.nrnr.c 'n r[c w.rk nn shi.h r[ \,f,
<br />v, r\tlh.c, nc \uhJr.r t,rhc $orlcr'.. rltf\rlio [8.olCrl]
<br />work.rl ..f,poi\ ror|nnisn,tr\olSc.ridr.r70{rol rhcLrlst(
<br />\YARNIN(; lrilrc t, {. . trnrktr co rlf,rsrri,n (,vcn'8c
<br />rn,ir '\ isrucd.l shrlltrot cnrPlornny FFon banttn{rncr
<br />nnrni!.3nd 4rcc lhrl il I {vJuld t{.otrf, sblcd to l}f,
<br />'r)dc. I \hrll. fod hwir h .omPly snh rh.v tmvhiotr\
<br />k utrhsrrL. and sh0ll subi.rt n cmpbyer h dimiral PcMlric\ ,trdqwbn. dxnirScs as proridcd nn lhc
<br />(
<br />)n olChupro 9 (..mrmmirg wirh Ssti'f, 7000) ofDivi\i(,n.1Ihcrcnyri,l oidur FtrrllyolfcluryrhIlt I !'n licctr*l
<br />ol rh. Ausirc$ rid PtuL$ionsCod.. md nryliccn{ i\ ii tuilliraidcffccr
<br />2U L
<br />L 7t
<br />I turcbyrftirnundcr p.ndhyolpcrturyrhdrrhcrc isa con( crbn lcntjirB rsc rhr F-rlnnnimenf rhlsork lirr shichrhi |t lnil is
<br />nsucdlse 1097, Civ C )
<br />IxnJcr'r N3m.
<br />-
<br />AE$ANLDSCLABAIDN
<br />I lxrhynfinrund.r p..dhyolPcrjur,o d orthc i{,lLwi'rg,lc.l,trxri.n\:
<br />Dcmolilnnr Pcrnrir\-Asticdos Norifi'utirnr ltdczlRcEuldions l-lirlc'l0 l'd6)
<br />_Rrquncd b(cr oI Norili.diotr
<br />-lccnilylhar
<br />rhc Ldcralrcgxlrrk,ns rca ding!\h.{osrcnn)vala{nol{PIicablck,rhn[l,oJc.r
<br />I..nrlythli IhNc rc rlriripPl
<br />.rtl'nr .$ itr Shlr Lis\ rcldilr8 lo huiuir]
<br />rtx,vc nf,nrii cd tr.I'cnyid i'rsPccrionltr
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<br />rh)vc irb'mdli,\ c rrccr I
<br />iJ hcrchyrurh.'nc r.fic\cnrrr ii"'.:lliltTi x"l".ll,:,irxf ;lll *
<br />,,,"flrcp
<br />ID/SIG.
<br />UFER Ground
<br />lnsulation/Enerqy
<br />/'r-
<br />c.2344 4a( 21
<br />Certif icate ol Occupancv
<br />ffilc,rotnol
<br />I ncEby aftr,n u(lcr pcMlry of p€rjury lhlr I M crcmpl tiorn rh. Co.lmcror' Licn* ti* tu $c followins @str (Scc 70:ll 5
<br />Busincs dd Ptofcssn,n Cod.) An! Cirv or Couniv which r.qxncs a ,'snrn ro
<br />'onstrucr-
<br />alr$ impro't de'mlish or rcDrt 'nvjruclure.prhllonsisu!trcc'alsoEquncsth.aPplicanlfolsu.hlErnllofik,si8rcdslilcmlhalhcolshcislicentdPuisanl
<br />l.,lhcflovisioNolltEcontrrlolsLiccnscdrjw(cnlllcr9,co'n,rcncilswilhscdionTfi)ofDivision3.flh.Burinessa.d
<br />Poltssions Code) oi (h,r rEotshe irdxc,n rhcrcIiom ed rhc brsk for lhc trllc8cd cxcmplion A'vvioldio'ors'clionT0ll'5bvanv
<br />oDplicnm for a Frmil slhjccrr rhc {,tlica to s civil l)cnolrv of Bn tuft th!" ivE hundrcd dollors ($5(x})
<br />l. as owocr or rhc rm,'cny. or oy cnrloye\ wnh w,gcs !s rhcn $b ..mpcns ion. *iu do rhe worl a'd lbc nrElm h ml
<br />i,rrcnaea oroncrca ro ic lic.?Or4. Blri.cssnnd ltolcsions G cr The C.nta.roa s LiccnE Li* do's ml 4plv r) 'n 'wn'r or
<br />rhc lmrEny who t{ilds or iq,mwr rrLmn. ond wlF dtB srh R)d( hinsclf or hcrclf nr rhtuu8h hk or hcr own cmllovc$'
<br />pr"via"A rtrar suctr nnlrokftnts m noi inlcnd.n or or.(n for sb If lr,scvcl rfu lDikling or impm'lnEd h eld *irhin onc ,ts
<br />;fmrylclhn. rtf, o{ns Buikcr *ill harc thc tDdcn oa ProvnE rhar lE or shc did ml build or in{'mvc ihe lnFnv ror rlT ,'uqn* or
<br />-1.
<br />!s 6sm ol rhc popcdr. nm cxclusivclr contding wilh liccn*d conkldo^ x'
<br />'onslrucr
<br />rhc lbj"r (Ss 1044 Busine$
<br />","1 n"n*.i,n Cna"' ir,i' cnnrrcroi s Li.cnsc L,* diEs nn rpply ro an oe d ol rrcperlv *ho buildr or inrrrovcs rhcr$n'
<br />lnd who.onrrdsforsu.hfoFcGwilhaConrndodnlicentdlxnu0nrrorhcCo.hdoisLi'cn$L!{)
<br />-t
<br />am.xcrpr utrdcr Sccrion-. B &PC r.rlhhrc6o.
<br />D,l. Orncr
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<br />lriJ.''. A,lJ'r*
<br /> ppli.lnl or At.nl sEn.lurc
<br />P.mile nanr ( Prinl )l
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