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BUILDING- INSPECTOB RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNER Dt'II,DER DET,CARATION
<br />I hcrchy afttm un{lcr prixlry of Nrjury rhd I $r cxenDr tnnn rh. Conrncloti I i.drsc Lrw lnr lhc lnlk,si'r8 r.r\ntr 's" 7r}1r r
<br />Susincs !trd Plofcsn n cGlc) Afly Ciry or Co!trry $hich r.quirc( tr ,)cnnir h con{tucr. drcr. iDtln)ve. d. x,li\h or rcFir anv
<br />(rucluE. nriff h ir\ i\\u.n.c. nko rcquirc\ rhc arPlicsnr f(tr {rh t'cfinir ki illc r \i[n d idrcrxrr lhrr h.or \h. i{ li.cnrd PuKurnr
<br />h' rlt ln)vhior ol rhc Cortrtil\ Lrctrscd ljw (Ch!!lcr 9. Connncr$r sirh Sccrt,n ?fin of Divhi.n .l of rhr nu\nn'\\ 'nd
<br />l,olc$ioN Codc)orrhd hcorshc iscxcmfl rhcrclio rndthclu(islhrrh.rllc!.doxctrrtrior Anyvi{nlrn,n.fstcri.tr?oll5nyril
<br />rptlicitu lorr pcnnir ruhjlra rfic aptli.nnrnr !civilnctr{llyol'mr nxn.rhrtr 6rc hudtcd dollrr\ (S5m).
<br />-1.
<br />as o*k! of rhc F utEnr. (tr Dy cmPbr.cs wirh wrlcs ns rhcn srh conllensd irrn. will do lhc 'ork and rhc {trtut i\ nor
<br />i'nundcd oroffci.dlor$lc(Sd7014.Businc$rtrdProicssion\C{xlcThccontroclmil-iccn*l-rwdocstrotopdvr.rnow.crol
<br />rlEtDp.ny whl hilds.r i'npmtr\ lhcEn.0.d who dms su(h su* himsclior hcrscllor rhrouEh hn or h.r nwn cmPlovccs.
<br />fri,,vidd r har such inrpror$.n( m n.r inrcrk\l or ofrcrctl for eh IL hlwcvct. rh. buitl,ng or in9n,E nnt ir v,tl * irhin on !r'r
<br />ot coq,Lrbn, rhc Ovtrd Bniklcr *ill hxk rh. hxidcn of pmvire rhd hc or shc did nor buill ot inDmrt rhc lmJf,try fot lilc purlrrc of
<br />L rsowncr ofrhc |}n|.ny- rncrc]u\iv.ly.onrrocrinE wilI liccnrd conkr.trs ro c.n{rucr ihc rtuj..r (Scc. 7l}r4. B!\'n.s\
<br />rtrd PFli\sirn Cod.: TIE ContNoas l-iccn\c l,!* do.s nor lllly b an o$Nr orptuP.ilt who huilds or in0r.vcs rhcrcon.
<br />trnd who conrra.tsforsichpojcchwnh,G,.trr.io(s) licctrsd p!^u. r ro lhc conrt0cror's t-iccn* hw).
<br />l, cxc rtr undcrSNri,)
<br />I)!(e O*mr
<br />woRxrii-oMPFNsar()N
<br />IE(LAAAUAN
<br />I h.rehy rmrmondr F.rlry otrcrjuronc.rihr rolbRnrg dc.1tr6lions:
<br />-l
<br />lrvcnndwillmri'nrir rCcrtiliculcolConscnr h sclllNUtu for*orkcN co rpcisrriotr.0s Pn,vidcd lnrhvsccliM:l7lx)ofrlt
<br />hli, Co(lc. fitrlhc pcrfontuic. ol rhc wort lor shich rh. r.x ir i\ ssu.d.
<br />rltr qork,(rqhi.ir[il0cnniri\i$ur Nlyw.rkcr{..mncn$rioin\urancc.naicr \llnicynu rhcrirc:
<br />d,.
<br />-ErDrs
<br />j
<br />I.cnifythrrinrhc pcriorronrcorihc sork hr *hichrhi\ Pcimii it i\\ncd- I dull nor c'.p!ov rny Ns.n in riv
<br />'rnncrb rs ro b(conf srhJd fu rhc s. cr'.ompLn\rrid hNsofc0liforia. md alRc rhar1fI slnuld bcconf, suhic.r hrtE
<br />sork.r( ronl)cis rn lr)visior\olS..ri(n] 17(Xr,if rhclrhtr(i]lc.l \
<br />WARNIN(; Iiiilur. k) {ctrro work.ri.on|rtr{[i,r covcfugo n ! lt
<br />hdhqirh comply w irh rlx^c pmvisions
<br />rnd shrll \uhjc.r in cmfloycr lo dini.rl Fnrllics rnd
<br />.i!'l fincr uD k) or. Iundr.d rh.u\rtrd dol!ar\ ($l(X).lXI)). t] rddir
<br />Sturim 1016ol rhc lilq (ixlc. i'ncrcnJid lrionry \ icc\:2":--"""' f,-zt -t f,''''"'-". *
<br />DECI.A.EAIIAN
<br />I hcshyrlfinnu .rNnulryoip.riuryrhi I rft liccn{ u du lYovis i,r of ( )u|ncr 9 (.onrntrcin8 *irh SL{ri(r. r0O r) ol l )i!ni(n :1
<br />of thc llrNiocss md Pofclsi.nsCodc. and nry liccn* i\ i', tllln .c nl.lic.l
<br />r.r-^" r'r*, - 4 6zr s60
<br />6 -z r- /f, ,-*""* /- Ca 1 plsA
<br />,/,ac Yc'c
<br />CONSTRTI(:TI(IN LENDI\C GFN(:Y
<br />I icrchy rlnd u df Fnrllyolpcriulyrhar rhcm is,.onendi(r LindinE +cn.y ror rhc P.rrormancc or rhc *or[ lirr *hkh rhis lErn]ir i\
<br />issul ( Scc. .llD7- Ci! C )
<br />AISIICANLIEEIABAIIA!
<br />I llyct'y dlim under pcnrlry oipcrjuryonc orrnc rollowinr dt.lanrions:
<br />D.trrlirion Pcnnih Ashcios Noliliclrion licdcml Acsuhr n\(Tirl. 40, Pon6)
<br />RcquiHl Lcrlcr or Norifi .ar6tr
<br />-lccnilyrh
<br />hcl.dcrlrcgullrions rcgrrdi'rg nsh.sos rcnn,v(l arc nor nt,flmhlc lo rhh Poj.ci
<br />I .c'r l\ rhrr I h o..rd th'( rt,dl.iim rl .otrrn y 1!irlr rll(-irv rn(l(-,trn !
<br />in(\rl arl(ntrnIyt) cnr(, ol)! rl.
<br />,',," ' 6-izt -/0
<br />onlirrn..\ rnd Srrr.l-n\s i.hrirrt t, hnil,l
<br />o\r.rnri(trEd noprdy tur iNth_ri r
<br />]\Dpli.trnlnriB.nl5i*n trr.
<br />l'cmilft itrnrr(prid):!
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/Ve nl/ ln su lat ion
<br />Roof Sheathinq -7*ty1y k_v{:1d)FEA I-EFJ_
<br />Shear Wall
<br />Framing
<br />lnsulalion/Enerqy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />It/aso n ry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Cefiif .
<br />/,^
<br />FINAL 6'l-lK X)LHE
<br />Certilicate of Occupancy vv
<br />Notes, Remarks, Etc.
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<br />c,r^ /^, / lq
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