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BUILDING. INSPECTOR REGORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNER AUILDAR DI:II'ARATION
<br />I hd.b! amm u.dd FEI'y of Fjury lhnl I dn .xmrt 6om rn ( onr,rcloR Lrciit. l !* lor rh. lollo*ins ttMn (s.c 701 1 .,
<br />Busins .rd Profdion Cod.): Any Cily or Cou y *fith rcqln6 ! ,6mit lo co(ntu( !h6. improv., {tmolith oi rPlr d}
<br />'lrum& E$ lo irs isllmc. iLo rcquirB th. rpplr l for luch Fri |o fi1. r !i8n d !rdl46' ihd lE or th. n lirdsj Fnua'l
<br />ro rh. ForsioB 6f rlE Conrrrloi! l,iccn*d L3w (ChiFr6 9, (-omh6(ins *ith Scxon ?000 ofDiei.(rn 1 oarnc BBiB &d
<br />Pmf6ioru Cod.) or rhd lE or sh. is .ropr th6.iiom sd rhc tEir tor th. lllqtq, amF$i Any liolllion.fsalion 7n.11 5 by oy
<br />arplicer lor a Fnir subjdrs th. .$lican ro d .ivil p.tuh y o f nor e,. rhd n!. hu.&.n doll6 (ts(x)l
<br />(I&,. * .** .nn. **y. or m, mplo'6 *nh w.N6 B th.n $L NmpcrElix,n. sdr & rh. sdl 'd trE rulE ! d
<br />inrdrd.d orofr6.d lorsk(S6.704a, BBind ud Protsioni Cd. Ih.( onlmn t l-i(@bwdB 'l.9p1,rodo*Mot{h.Fspat} *ho hiki or i,nD.oE rlEEa td}l$ dGuh e. him$ltor ha*lfor rhn u$ hir or lE o$. mphy6.
<br />Fovd.d rhd s"ch imF.\sEt ft mr iddrrdl o,nellor rl. lf. n'q66. rlE hiutr{ or iiqmrffii 6$ld*ihinw}w
<br />ofcorphiotr tlE(\c ttuilda wi[ hlEdt hnlnofFlnt lhi &ordE dil n trild o. nqre!.0E F,IEI,lor E I!'FEot
<br />-1.
<br />s o$E of rhc FlFry. m a(i6n.ly coddin* snh [.s!al omrflo.lo.od(r rlr l,nF1 lsc 7o4,r. 86u6
<br />dd Proksim Co&: Thc Contr(or'3 L'ctu t * rks Nr at?ly r. o ownd olFoFly *ho hsild! or inpro\6 rh66n,
<br />&d *ho o'rr&'t3 for s(h Fids snh . Conlr-lo(r) ltasal polurl lo ltE cod,rd,t s Lk.M tfr)
<br />-lmcr.mF
<br />uftkS<10
<br /><o." /2 - /Z -/6
<br />DECraSArX)!
<br />I Eqa alrm uod6 Fully of pqury oE of rh. aollo$in8 .hcl,.'h6
<br />I h.v. .d will mi, .i. . Cdrif.d. of C6@r b S.lf-l@E for wld cmPiqxon. a Fovd.d for bt Sdbn 1700 otrt
<br />t td Code lor fi. Ffm ofrh. *di tui *t.h ir F6n a isr.d
<br />-l
<br />har. lld Iilt mi.d. mrl6 mtuFB.lion irEurft..6 Glun.d br Salsn t?00 otrh.l.h.r cod.. aor lh. Ff(fu. of
<br />dE srt fo. shih tht Fmir i! ie.d My Bda onFdion rMd. ..id ti polk! .umb.r e
<br />\fu.^i7rto,inrlEE:totffiordruo for snrn rhs Fnn i. iBU.d. I n![ mr aphy rr Fen in .nt trnF
<br />b 6ro b.oe$ti6r lorlr e 6'@6t Mion LBol(.lifomi !drrlhr if I J$!ld tEomrut.d l.llE
<br />*.rt6's'!pddbo FortioB of Serbn 17@ of th. trtor ('od.. I tEl[ ffih$dh @npl, *nh rfiox Fovi]ioE
<br />$AnxNG: F.itm b su. pdt6 orlposrbn orqr*. a uiL{tu1. !d lrEll sbjd e dnphF lo oimnl Fdit ul
<br />.ri fG up lo oE h6&.d llblsd &rlLB (r!00,0(()). D t kinrn lo rh. cor of.nnIEE ln4 d.nus6 B Fovn.d 6t 'h.sdhn 1076oarrr t bo. Cod.. in'6d !d.n@Ey r /.-Zx'.,,, /z-./z-/41 ullill}:uitli.t&llll)trDtrl.t&lltt)t
<br />I haEty .rm unda FEny o f psJury lh! I e lcalcd uidd Fo$aoi of ( hralr 9 (coffiiit wnh Scrbn 7000] ol Divnior I
<br />of rhc &.ilB i.d Pmft3.ioN Cod., ad my la@ ir in tull foN !n cfial
<br />ll]llilalJcllllrJ.lllllllij(il!(I
<br />I hercbyamm undoFnallyoatsJUryrhat rhd.iracoNrtudi,J laldin8 llso.y lot lhc IEronunc. rih.{orI fd trhi([thrFn'l il
<br />hsud(sc l0i)7, ci c ).
<br />APPI I(IANI OT('I.IRA I'I{TN
<br />I hd!!, aJrrn uidd Faxyof pdjury orc ofth. followi.S dcldarbn!:
<br />D€nolirion Pmirs-Asb6r8 Norinclrnrn F.n(al R.lohi b6 (TnE 40, ld6 )
<br />-Rcquncd
<br />Lcrr( of Norifi .dion
<br />I cdi& rha $. f.d6d ..suldioE rtsdins sb6tos mov.l s. nol opplKablc lo I hi. piojar
<br />@.-'ry,hd,*.-Orn!!}pl(rnon,n.!.rh,rhr!h,r.infom.rkrir.or<1 I.$enr comply *ilh.ll( iry.fti ( ounty
<br />-ordj,]m6 6nd srar. LrB Rbrd€ ro burldur co,fudh( !t hd.nt dn ri,. r.rrM{d iv6 of lhn ciry .d ('ounly lo 6la uF).ltr
<br />ab.v. mmtioncd poFn' lor
<br />faappliont or Aser slrnr
<br /><ldire n.ne(prlnt)i
<br />h",,tz-zz'/f
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Roof Sheathinq
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Dryt/vall
<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 />FINAL ;/a//4 "--r///r/*/H-
<br />Certificate of Occupancy I
<br />Notes, Remarks, Etc.
<br />)
<br />Subfloor/VenUl nsulation
<br />l.(.e NumtE
<br />I
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