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BUILDING. INSPECTOB HECORD
<br />SITE.WORK DATE tD/stG.COMMENTS (}1VNI]R BUII,DEN D -(IARATION
<br />I hcrchy ifltor u.dcr Dcnally ol pcriury rh l dc\ctonr rm rhc cotrtd.hn Li..nsc L.w nn rhc ttllowir! rcrsn (Scc 70lr 5
<br />Bulincs md Profesion C{xlc): Any cn, .r couiry shi.h rcqut \ r Fnnir ro conndd, rlrr. inProvc. dcmlnn nr rcirdt ,ny
<br />nructurc. l]rntrro irs n\dmc.. l$ rcquncs rhc eplicMr tu. su.hlrnnirlo ilca\i8ncd n!r. f, r rhnl rEor shc ir liccnscd pu^uir
<br />lo rhc ,tuvniotrs ol lhc Conrrrcntr x t.iccns.d l-Dw (Ch!prcr 9. C.nnncmirg wilh Scclion 7000 of Divi\ion .1 .l lhc Businc* and
<br />l)roli\si{n,s Cod.) .r rhrr h.or ih. iscxdnDt rhcrclionMd rhc h$t |or rh. allcgcdctnlprn,n Antri(n ionolSccrtnrTll.ll5hydny
<br />iptlic(nrbrnFrnrir subjcchrhc llrlicanr b a cirilpemhy otnor ntr,r rhrn fivc hundtcd dollur (S5m)
<br />Lr\ oqncrolrh.!i()ti.ny..rnrycn oycc{\lrhs(re\arrhct{)lc.otr,p. \di.n,Rilld.rh.$ork xlrhc{Ermnmr
<br />rtu p'or^*ny who htrinh or i'np'ovcs thcto\rn. iDi sM (l({s n'ch sork IiN.lr or hc6cllor rhmulh hii.' hcr.trn crnl.yccs.
<br />|foviJd ttur such i'npmwmfhmfri i'nr*lc{ orontu] tur sk:.11. ho\e.vc'. rlfhu'klingor i'np(M'm hv)dsnhir.n.]t{
<br />l. asostur ofrhc tnll).ny,.nrcxclusivc]yc.ntlcrin! !irh liccns!'d.onrrr.t,nkrc.nntucrrhc pr.]tr (S( 7(l.lt.llu\ims
<br />! t\DtsionCode,-l hc Contacror\ Lic.nsc Las do.s n.r llnrly n, rn oqncr oln.oFny *ln hnilds or inrPn'vcs rhcrcotr.
<br />a J *ho conh.rsr.r such pojc.h *ith r Gtrrlt{.ro(sr liccnsci pu^utrnr ro rhc Coituroi \ Li.cnsc tju)
<br />I rn,dr.n,pr untl.r S..ri,nr . ll & t'( ltn rl' \ kr(nr
<br />Irn. (hntr
<br />lva.8xE8S-.(AUII:liSdrIO!
<br />DES,ANIIION
<br />I h.nhyrlfir rutrddNnrlryol'p.rNrto'f, olrh.knk)qi',!dcclx'inntr
<br />Y-lI'r,c.'dtrrllrLi' Jm,Ccdifi.nci,lC' ^! i'Scll li\urc f(tr sork*L conrFfsrri{nr. r\ p'ov cdfdhySc.rimlTolroflh.
<br />I N1 C.,l..tnrrh.t{ '.rm.,Ncnlhcrill ro' ql-*\rhcrc"ar ts'^urd
<br />rhoworllnrqhichr[nNnniri\rsucdMJ_!orld\'.omnensrrionin\LrrN.crri.rrdr,li.ttrttrrl{r.r.:
<br />I
<br />:1 t-lo -17
<br />-lccniDr1[r
<br />in rhc ncrh'tu'ft.orrhc work li'r qhrhthis ncnnil is ilsucd.I \hrll nor cnrrloyrtrytl.Ntr irr !trym ncr
<br />$ .sro h.\onE suhjcc[o rhc sorkcF comFn\ n,n L,wsorCrlinmir. riir.gnc thar ill dnuld hccom \uhjcd r.rtE
<br />s.rkcr..nr|(treiionfrovnion\otsdion:l7lx)otrhcuhnGrlc,lsh.ll.lanh*irhcon y $ilhlk)s pnivhnnN
<br />WARNINC l.iTurc ro ccurc s.rtcr'contt.n\rrnr.ov.r4c i\ utrl *lul. itrd shrll \uhirl un cDPkr]tr r. crimimlrcnrllics a
<br />civil ftB uI ro onc hnnnrcd thrusand dolhn (Sl00.OlrO). ii t dirn kJ (rE cost ol confcnsnlion- da iagcs rs providen for rhc
<br />SirDi \' acfrheL'hr ridc.inh'.JJnJfi'n-)'.f.r. / tr /
<br />,^,",. 7-z*ty ,,",-^;]36k*lgr'/i f larxS
<br />DECIAAA.I]AN
<br />I hchbydlnnund.i pc.rlr,ol lerjuryrharI rr li.lnEl undcr l)(,vi\n orChrplcr9(connrcrcinE{irhSccri,,n7O([)oiOili\ion]
<br />ol rhc tlulims\rnd Phfd*id$Codc. and nrr lkensc h ir lullfor$ md cff*..l
<br />- t? -,r,.- " cr,* t/ L 7 , t."*" "r.*, ' 2a o>1
<br />7-4: 151,".,,,'".,*4fi1r a'r,/nflo 14;
<br />II)!$IIgIII]NIINIIINCIGINCI
<br />i$ucd (Sr. 109?. Cr! C )
<br />AIP].IEAITI.DEILANAUQN
<br />I turh!nlntr,utrd.r n nrlryor NrjLnyoncol'lhc l;llosinEdcclxrrii{in\
<br />lx'noliri,nr F.rnir\ Asb(i.s Norili. idr I;cicrrl RcgulrtioN r'l i1ld .l). I)rn6)
<br />Rcqxncd Irtrer oi NolifE im
<br />-l
<br />ccnilyrhd rh. rcdc rrl .cgn lar ions rc8irdir8 lstr os rcnmvrllrc nol upplicrbk ro
<br />'hir
<br />poitr
<br />dEccnrryrh.r lhdc rc rhi'.nplcar'nn,n,l {srcrhJr rhc srxrle innnnuriotr tcotrccl.l aErs ro comply enh 0I cily !trd colnry
<br />.idrnJnlc( ui'l srrlc Lrws rclorm rn huitd'ns cannrudn,n. sd h.rby,xrh.rir rcprcscnlolivF oflhn Chy and Cotrntylo ctrlq upon rhe
<br />nhorr nrnri(xrd f'oI.'ry
<br />\!pli."nl or '\xt l Sittrrlurt
<br />t'*-ir"",-." rp;.rr, I 621 ay Y;
<br />.z-2-<-/t-
<br />Set Backs
<br />Forms/31eel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subtloor/Vent/lnsulation
<br />Rool Sheathinq
<br />Shear Wall
<br />Framinq -r/- /IL ,-.'
<br />lnsu lation/Energy -/7/r'4/F/,w7t,
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lvlasonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif
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<br />FINAL ,/Dl o//// z w-24 )
<br />Certificate ol Occupancy 1 ^ ,(-z
<br />Noles, Remarks, Etc.
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<br />P,,,.\Ndn / l7f tc 46
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