|
SITE.WORK DATE ID/SIG..COMMENTS OWNFI BUILI'EA DEL(',\TATION
<br />I h.aht .rfm nol.r !cn.l, oa ttrj!ry rh.r I M .r.n{ rDm rh. ConrBnr' Ilid* L,* ntr rh. tolk)*o! Ea$n (S- 7011 5
<br />Bunncs rfli Pbtc$lr Cd].) Any a y or clllnty wh(h Eq!ft. . Fnn lo Nnstru.I, rllcr. hl0rcrc. &frnnh or En." y
<br />{tutorc.IrDrro nr ltlldr. '&, Fqurtrh. lPplrrr fitr tNt ltmr k,lik r sl8 J {.r.mnr ihr! trur dE ! lrcn*J ,nBUd
<br />k, rrr FrvFn)B ol llr Con'r-lq i LNnsJ li* (Ct.prs e. (imrEur *irh S<rKr 7fit) ol D'rss. :l .r 'h Busm$ .
<br />Fnf.sln! C'xL) * rhrr ,t d !h. tr .r.nlcr rHhn .il rh. h.rR for rlr rlkl.il cr.n{rsn An, vbLrM ol Sertr 701 L5 hy uy
<br />.fi!. rd.FmnruhFrrllE.t',I'lk.rlk,.('v'lpcmxy"rnnmrcihor'vchudEnJrnbr(!5@).
<br />L $ owmrot rh. ln)Fny, or mt.ntl,'ycct wnh w!8.r 8 rh.( v,lc .l)n!rn.{on, wru rlo rh. wu* ail lh. nBrr s Bn
<br />ur.Blal .r oficEJ ntr d. (Se.?0,4-a. Burfts sd Prnc(linr CirL: TlE ( r)nlr&roi r Lrc.< L.w &xi nd +plr n, & owrr or
<br />th. Fldy vbt! trrthr6rhGn,ul b.lFu[q,th,m{!lorh(rulf Drrlm'!!ihnrh.roh.nt 'yer.t'n)viri ihzr lkh ur{n@nt r * ddlJ nofl.frl l,r el lt h'r{t. r tn xA r lqnrrd r rU *.ha m F,
<br />or (xlPLira rlE (rEr Bulra sdl h.E ilr h$Ln ol In'vsl3 rlEr lr q {r ,lJ ., lllll q uqmr Ur F+dr, rtn lll FIID* ol
<br />_l. Bovxrorr,E F{Ent, rm.r(lu\ikly.odtulh3 * hlEcns!.odnronro@nstddrh.F$j.\r(S.704,1,Bam$.il Pi'l.rrmCdL: Th. Conrdoa. t-k.nr. b*.nB r rfitly ro n owE or rnrFn, *h, burur or mpmv.r rhmn.
<br />uJ whr olrB!. lnr rEh FoFlr r'rh. Gddo(r lroGl pu^d rii rh. Gdrarir'r lre t ,)
<br />_l.hci.rq'r ud.rS(rion_. B. A PC forrhtrEaun
<br />D.r.. orm.
<br />$oR(Fns contPENsarloNIr[gatarM!
<br />I h.r.t y rfitn unJ.r Ii.ih! ol Frurr. or olrh. nnl'*rr &rlx.rnnr
<br />-l
<br />hrh ill*il nultrru r Ccnr'rsrc ol (i'.scnr h S.l!lorurc for worl.n' dn.pcn$hon. rs r.vdcd turbyS.dbn l70O.t rh.
<br />lilrtr (irlc. lmth. pcrrornmcc ol rhc w.rl lti whtrh rhc nqnnl r ssucd.
<br />_lh.wr,rtw l Edro rort.R' ..rlll.nnri'n rurn.. r! Blurtl hy Sdr$. l7U).f rlr tilrr C&1, nn lrE Frflrmr ol
<br />rlE **t for *hrh rhn JEmd r 6ul. My *ort6' oir{rndrn 'dit...mr. l Frl.y numb.r n:
<br />lt/t ltq
<br />-l
<br />..n ny rh.! u r,r rErforllrc ot rh. kr niwhrhlh!Frer N '.!EJ.I rh,ll mr.nr,ht ../.J..,,**
<br />$ r, h--m ruhFr b rh. mddi (lqt.qrbn le*r or ( rl'n,tu. .D.l r3R rh.r ,l I lbuu h...m suhj(r t, t{
<br />*o!kdr' cofrFn\rr i,n ln,vrirns ol Srl k,n t7(f,i .t rha uhtr (irk. I dEll, [f hw(h ompl, wnh rh)( ,Nvr!'nt
<br />WARNINC: F rlur. r,, r.ur. vorkcri L.n{rnsdn}n..rrtr!. r unliwtul, rd ch.ll suhj.rr $ cmpbycr h ohi.rltrMh.r lnd
<br />.ivil likr uI' lrr oE hu. En lh.uqnn Jolla\ (31u).()r.
<br />'n
<br />ldd ir n' rhr (o{ I (nmp.nerk)n. drrutc\ r\ pr^ki.J tur iRr
<br />S(ri'n tO76 ol rlE llhr Orj.. br.rr rn! .rtrey r t /,-fr')Z I t5/tctt1 rrtEffi6 u6&fntrrrFlrr't dlrlTlo|lz
<br />lk.n<.r/d.,,l6"lri,r ( h,flfl a (r mmfr 'nr " rh sd i n 'rrr, ,r lr'r$n \
<br />, ""-,.,,,,,,ti,,,., ",^,,.,,.,,
<br />I h.r.hy rltrm un&r trnlkyn, Ftury rhd I rm
<br />)f rh. Aormr\ dl Pn)i.$r)nsCdL. rn mvl
<br />t (ro L
<br />iltqt-l
<br />I rxEh, rrm ueld Fult, or F iury rhi
<br />'h.k 6 !, tu rlx FrfomB. or rlE Rtrt fir h.Lh rhn Imd n
<br />trurl(S.. 3llr7.C'v ( )
<br />ATPLICATT NECLAIL\lION
<br />I lr.hyrllnnunJ.r p(nrlry ol li.rjury,tr,. or rh.l('lL)*x,g J.LlGr('n!
<br />I).trxn[!r licrnnk-Altino! N,rrr'.rrk,n l'.r.r!l ReeuLr!!F I l lc 41r. I'rni)
<br />-Rcqur.n
<br />lJ(.ror Mrni.rM
<br />I (.ddt rh.[h.lal..rl ktuLtxrr ESuJ'nB ahc{orrn'v d Rn rf'0lf,rhk b rhtr loFd
<br />_lr.n,lvrhxr I l[r. rt')J ih,\ rprlrrr(,,ri darcrtur itr.rli, I rIRit'(,mdywnhlllCnyrftlCounry
<br />ho,Uu,F ! on(turr(,,. , krchyrurhnr.rrl,.<trhLttinlih'\CdyrrJ(i)!nryr)cnt.ruF'nrh.
<br />Set Backs
<br />Formsi Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUlnsulation
<br />Rool Sheathing
<br />Framinq
<br />lnsulationi Energy
<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 />FINAL \H\6I11 1,rt4tl-,
<br />Certilicate ol Occupancy
<br />Notes Remarks, Etc
<br />BUILDING. INSPECTOR RECORD
<br />)
<br />zlnlr.-tlt
<br />Shear Wall
<br />Flood Zone Certif .
|