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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.^L coUMENTS OwlrER BUILDER DEL('ANANON
<br />I hd.by rlran un<!d p€ulr, ol pajury rhll I m d@p ftom lh. Conlr.dor' l.ic.nE l,w lor rh. folhwiry lq$n (sd 70]l t
<br />AuilB od Proadbn Cod.): An! Cny or Cody whkh Equir6 ! pan n lo ordD.r. !ts, diP.oB damlnh or np.n x}
<br />nru.tEc. Fior lo ft is@c.. .to (quir6 rlE @plk&r for s.h Frir lo fl.. rien d {{omr thr ,E or JE t lkdB<d ptMd
<br />lo lh. F!ir66 ol fi. Corl,&td't l,'enr.d ttw {Cl{{s 9, Comc'n8 *nh Srlren ?00O ol Di$io! I ot 0E BG|'6 6d
<br />Pro[Niorr Cod.l or rhrl tE or rh. i! dmpr rhsctom ed th. t .t fo. lh. .lkscd ddiIlioi Aly rnr,ri.n of Sdin 70!15 hr ey'
<br />.loltur for . Fnn oudi! rL 4rl.!d ro . civil Fufiy of ml mr. rho nr. hu.&.d .10116 (lJoo)
<br />L s NG of rlE FDFry, or my mdo)6 {ilh w.A6 s fitr $k 6np6snion. s 6lh.*rlt &d lrEltntu i! mr
<br />inl6d.d or ofr6d for sl. (Sd 7044, BNins ud Prot<iioN ( o& ]la ao,ir.cld! Lkru tle &6 ml cply ro D o*E or
<br />rh. poF!,v *llr hil(l s ,lsDrq tLd td *tb d6 *h wt hi,elf or hd*lfor 'lr$3n nn r ls ou strloy6,
<br />provid.d dd ruch imF.vdmR @ mr inrci.d or otrald lu xl l[ h*'6q. lh. buildq d in+ordE ir eld within m. !@
<br />ofor+bDl! tli O\c Bdtlr *ill hrE tlr hrdd ofFlqB dt lE d dE dn d boild u itr!.or! tlE FoFry ftn ,'. Fnpo!. ot
<br />_1. s oM6 6rihc propqiy. m.rcluriv.ry.onr.cti.8 wnh li..red .onrretoN ro connrud rlE p.oj.n (Sd.7Gr4. &!iIK
<br />sn hDtu ir (idc: llE(i)nrndor'i l-t.r Lrw (iE tul r09lyto oo*E of FoF, $ho hiE or imp$d l,'6eh.
<br />sd who sdrd3 for s!.h p.oj.crJ *irt. Conlfflo(r licd.d pudwr ro rh.Conr.ctor. Li..e t s)
<br />I e crda, und6 Sdnrn
<br />D.rc (r'ner
<br />woRr(,Rs (-ortrErisi riol
<br />D[CtA8Alto!
<br />I hdcl,y.llrnr und6 p.nahv ofF.ruD otrr olrhe follNiry &(li,!rion\
<br />I h,v. !d will mint.ir . C6r ifEal. olcoMr lo S.lf- lBUc tn srxldr' dFrlidn' d F!\ ilcd for b, Sdii,n l7(xr o t lh.
<br />r,!, C6da f( rhc pofollrac olrlE q ort td *hkh rhc Fmn ! isu.d
<br />I hr\...d wnlminr.in *olldr comFNri'n iBulsc, d r.quncj hr S.drc.l70(,of th. hhr cod., for rh. Ffollrjffi. or
<br />istrcd. My workda (omp..srn'n inJurm. @ns.id polty numb.r t
<br />.)r'o tn(o C-la
<br />1r L,ol g- lo-tl
<br />-l
<br />carillth in rhl Ffom&.c oflh. worl forwhichrhi!Ff,n is aBu.d.I dEllnot mpt'yeyFen ineyoena
<br />$ s !o tEoe $tid ro rlE s!rr6' onFErion Ls of Crlifomi ild *c rhi if I lrhuld h.oc sut+( b tlE
<br />$ 0*6' onFEriotr pmviioE ol S€clion 1700 ol lh. L!}Dr Cod.. I null t ro*nh cohply wnh ih.* proviioB
<br />WARNING F.bc $ Ea {ql6 orq.Mion 6\d.A. i! uLetuL !d tull rutiF o drhF ro (min l Fuli: .Id
<br />cilil ii.d op ro oE hln&aj rhout&d dou6 (t100,000), in lddrion to lhc dI cofrr.nerion. d,mt.s a provnjcd ntr Ihc
<br />Sdn'. 1016 oa'h. Lllrrr ( o<le hrad &d.n,*ry r lG
<br />tz-ro"l6
<br />DECIJBAIIIId
<br />I hd.t) .rm unds Fulry or Fllry lhd I u licEuoj unds FolnFi of Ch.pr6 9 lonmftrns snh Sdhn 7000) of Divisnn l
<br />of rh. BaiB .rd PNiBrbN Co&, id 6y ltoE i1 h tull foR in dld
<br />o/22 q
<br />,rr.lli t
<br />gtlslf,lrcllQBLtlDllclcElct
<br />I hotby .1116 u.& pqd) of FJury rhr fia! L . 6lEtu.ib. bnrs .gtr, for lh. Flffic of lh. Nrt hr {tih rhi. FEi ir
<br />au.d (Sr 1097. Civ. C )
<br />affttcalfDEgJaarltl!
<br />I hqlb, afm udf Fndhy of pajury om of th. follo*in8 ddhr.l i.fls
<br />D.nFhio, Phll}ArlEt6 Ndilicdion f.dqll R.ruh io.! {Ti! E 40. Pd6}
<br />_R.quicd kr6orNdif.rd
<br />-l
<br />cdiry th, tlt f.n r.l ESthioB EB.dirB 6hdN rcmv.l r. ftn +pli.$L lo lhir proj6l.
<br />-l
<br />ccrify rni I h.E 'ud fiit .PPlatrbn !n r.r. rhr rh..boE irfonnn.n n.orEr I ltrc ro @mdy $ nh rll aily ud Cou y
<br />odmffi6 ud Sr.r. L3w! Eldins ro boildiq @iigldrol! md lE by lllltfiiz...F.9ldiv6 of rhi! Cny rd Counly lo drc ulon tL
<br />.hoE ir.dior'.d ro!d! fd iGrcrktnofvE lt
<br />^rn-., - ^.-, "*". L - k ^,,' lz'l-o !&
<br />Pdhnu.(P,t.o:.a - --Zlbr4., J/LIL/
<br />Set Backs
<br />Forms/Steel/Holdowns a
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subfloor/VenUl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall l7l1Jr6 ab tr\
<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 />I
<br />FINAL ,//22//9 -.-H)"t /)
<br />Certificate of Occupancy C
<br />Notes, Remarks, Etc
<br />--,
<br />L
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