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BUiLDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />UFER Ground
<br />SLAB Floor
<br />Sublloor/Vent/l nsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framino
<br />lnsulalion/Energy
<br />D rywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />I I
<br />FINAL tlrt ts /</4C /t
<br />Certif icale of Occupanc v
<br />Notes Remarks , E1c.
<br />OWNTR BUIt,DER DEI-CARATION
<br />, hercby 0mrm utrdcr pcMlly oI pcrjury lhai I on .xc'nfl lom rh. C.nta.io6 Licns ke aor rhc IolloriB rca$tr (S(.r011.5
<br />Businc$ ad Prolt$ion Code): AnyCnyor County whkh rcquns I Imir ro mnsrrucr. .r, nnpror, dcnmlish or rc|tr dny
<br />$ncrurc, f,rior io irr hsu!(e. lko rcquircs rhc lpplicmr tu such ncrmir ro filc0 si-qncn sraIcmnr rhd hcorshc ii li.Tnscd rlriurnr
<br />ro rh. poiilions oi rhc Conrrocrtr s Liccnscd riw (Chaptcr 9. connncmir8 wilh Sccriotr 7(x[ oi Divhiotr 3 ofrh. ausinc$ onn
<br />Pmfcssionscodc)orrh,r lrorshc tcxcq,r
<br />'hcrtrron,nd
<br />rhc hasis lorrheallcacdc&mprio.. Anyviolari.norSftlhnToll.5byd,
<br />!ff,licanl l r pcrmir subjcchrhc applicatrllo i.ivilrcnrlryofnor fr,rcrhd fivc hundr.d dollrslS500)
<br />I. ,s owncr or I hc pmpcny, ot nry cmplolecs sil h w0Acs as Ihcir solc comp€nsll ion, will do lhc *trk !r'd rhc sltrrft h mr
<br />inlcndcd .! oficr.d for mL l Sa.?044. Busincs n.d Prorcsions Codc Thc Coirr(ois Liei* llw dftr nor ,ptly r. nn ow.cr or
<br />rhc psFd, $ho build!o. itrllmrcs rhcNn. n wln drcs {ch slk himsllf or hcFclf or r hnnr3h his or hcr oBtr cnulorcs,
<br />pr.vidcd rhsr such inrDD(nEnk N mi inrcnd.d or ulIchd fo. salc. lL l{,wclci rhc l,xiuin! or niprcvcft.r ir a,ld wirhin onc Ftr
<br />ol cornJ'htiotr, ttE O*trd Buildr will luvc rhc burdcn oal,tr,lina rhr hc or shc did nor hild or i'q,mk rlr lmldy f.r rtr purrn$ oa
<br />l. as ownq oI rhc F)t'cny. rm cxclusircly .ontm.hA wirh licctr\td .. rrb^ ro cotr{nr.r rlr [o]c.r ( Sc. 70,11. &nmc\r
<br />rnd Pruf.$t Codc ThcC()nhcntr sLiccnsc I-r* doc\ nol ryIlyh rtro*ncrofrn)pcny$ho brildsor improvs rhcrcon.
<br />rnJ $ho conlrrhlnr suchI,l).crs wirh r Co nracrn l, liccnicd nu^urtrr rorh.C.Dtri.(tr \Liccn{ Irw)
<br />I nructrr Ln,l.r S..ril
<br />lrsner:
<br />.EOXtr[8S:lO]tf]iNJ rtoN
<br />IECL!aAII9!
<br />I hcrcbyrfft'nundrr lErllry.incrlryone oillEioll,isin8 d(hnrlions
<br />I hrvc d'd sill roinrain aCcnificareolCnnscnr roSclilnsurc hr worken compctrstinn. !s pmvidcd r'or t y Ss-rion 1700.lrnc
<br />khor Code. ror lhc pcrrornEncc of lhc wort lor shich rhc Ir rnn n h\ucd.
<br />Ihvcrtrdtrill ri' .in *ork.ra.onprn\rrnni in\urrn... as r.qtircdhySr.ri{,n.lTmofrhrllhorCotk.rorrhcprrfo rn.rof
<br />ih. qork lnr shi.h rhi\r.nnir r\ Nkd Myuorlc* rotr,p.flrlri, in\umn.c.rni.r xl B)li.ynrn,hrrrrr
<br />l.cdili rhar in rhcFrri,rorn.cotIhc,o hr whichrhn pcirnit h hsucd.l shlll nor cn[loyaoyl.r{'n in snynwncr
<br />so s lo nccom shjcctlo lhc worlsC mmF.ldion lrw\ of Califonid, und a8e. rhar if I sh.u ld btronr subj.cl ro th.
<br />*orkcis' ..mpcnsdi()npmvishtr!olS(riotr3700orr UtxtrC.dc.l\hnll, n)nhsirhmmdrsnhrhorpmlhion\
<br />WARNIN(: lixilr. r, {.urc \orl.* (mruflxr co\crirc i\ unhstul. r \hall \uhjccr m cnrnhycr ro ai'ninrl pcrolrics nnd
<br />cilil lnr\ !0 n,.nc htr ton rhou\Jnd
<br />sNri{m.10?6 0trhc li&tr codc. inrcr.(
<br />)). ir tliri, r ro rhc .o{ of..nI,.trsrri{)n. drn,rgcs J\ tn,vnl.J lar rh.
<br />1//t,//(
<br />lhcrcbynllir ru ild lf,nrlryol l{rjury rhar I prcviioi ofChrprd 9 (onrmn.in8 sih Seri'n rulr)oIDivisi(fl ]
<br />of rh. Businc\\ md Porclsionscndc. ald mr liccn\c n in tulllbr.c ma cli\-r
<br />o lC-r<-, tfY3
<br />*,.,'y'ril-1
<br />I hcrchr rllm undcr [Enillyofp.4urylhoI I
<br />hsucd (Sc..3097.Civ. C )
<br />hr.onnru.rionl.tulin8.Bcn.yturrh.lcrliirnmnccolrhcworkrirwhichrhi\p(nnilis
<br />A.TILII;ANLDECI,ABAIIAN
<br />I hcE'by flninn u Md lcnalty ol|.rjry onc.l rhc r.lbwin! dcclrarion\:
<br />D.nbliliotr Pcnnils- shcllos No(in.arion Fcdfirl Rcguh bnr ( Tirlc 40. Pda,
<br />_Rcquircd trttcrof No ficdion
<br />Erection Pads
<br />T-Bar
<br />Flood Zone Certif .
<br />(-xrnr
<br />4?-
<br />lcno.r , AJ.lrcs
<br />7/,tL r
<br />-,..,'/n, '* *r.r'"r,hrinn. rscd.rs ashc{", rtr.o\.,rrrc mr,mrrJhrc rn,hF 1n,F!,
<br />z-,\",'f, , "'. *t ,n'. spnr'..Jh',n rnr Jdh ,h,h( ft'\c Inrn,,n 'on
<br />* cMn, r re'N,o mmnr)
<br />.rJ'nJnil:h,ls'nrcrj,w.rcht'ipr,,hu'U'nB,rnrru-nn.andhcrch),'urho'i/.,c,,c.enrJtrr.n,rhnCr)
<br />Elnrc n{nlirncd prnncny ln in
<br />^,,,t,J-;;;,.- <z-.--- o.,e:
<br />"""'1."
<br />*,/rn,,, 3 &,re- B, +-o"t-l--_
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