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BUILDING. INSPECTOR RECORD
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<br />SITE-WORK DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
<br />I hd.br 6ftr,n und6 p6al9 of F.jury lhar I d ci@pr lmm rh. ConlrucloN l.i.cntc li* fo, lh. folhvin! r.e1n (3€.703 1 t
<br />gNins ud Prol*io. Cod.): An, cny o. Counly shich r.qut6 ! P6mit ro conntud. alrd,'inp.ovc dqnolirh or rq{r ry
<br />{qruu.. p.ior o iii ilsMcc. !k Elutrd rhc ippnc t for ru.h Fnir 6 6k.siSncd sldmol lhd lEor !h. ir li(G.d PMI
<br />rrhc rn,\Brtu 6I rh. conr&u'i L'c.n*d ti*' lclEpld 9, Comck'ns whh s*rirn ?000 of trvirion I ofth. BNind Md
<br />lf.fdions ('orL) or rhll h. or ch< 6 d@r,l thetsom &d rh. hsis for rhc ollcs.d .!oFion. Any virhrion of S.dnn 7ol L5 lry u,
<br />. /&f"-r r",
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<br />p-.r *rr*rr th. tppli.dr ro a.i\ilpnalr) oamrnor.rhm fi!c hun.t,6j.lolldirt(0u,tg
<br />llLt. * n"no orr* s',po'). or mr .nplorc ulh qas6 6 rh.r *lc.orFson. q l &r rh. n,{i lri rri rtul@ . mr
<br />U ,r-".; .;;;;;;J;t,t-liiii. ii-*'"i- *i it r*.6 c6d.: ft. (on,r.c,oii r.tre ra* ao< nor ryry ro o o*rotl
<br />rh. Flrsry * h) hil& or inrF.€ rlEE[ ad wh. do6 str$ wl him3.lf or hl*ll.. rhmuah hL or hd o*n dFl. ') 6.
<br />rhd sNt inFotffi e mr i dld.rt troll6d 6r !L ll lE$oE. rlE hriLlil{ o. inpro\gE{ ir $Ll rnhin on. td
<br />lh. O*E Builda win ha\. llE htrd6 ofFow{ rht h. o. slE dil 6r hrld or in!..r. fi. Frpqly ftY rh. FrFe of
<br />B ouE of rh. FoFiy, m d.lNncly o r*lins snh li.asd codrtdo6 b o,gnd llE Frj.(l (Sd 7or,l, Bui6
<br />CDJ. I h€ Conkr.tor's L'ccn* lrtr do6 ton 'I)pl) ro do\.6 olpropql} $ho h{ildr or m0ro\6 rh66rn-
<br />*ho corind3 ltr .ch F!jd! *nh r Coffio(, lt.6.d Flrulr lo llE Conr..id t LkcM L!*)
<br />*-*nJt *."- .B &Pc rorrh!,@n
<br />M*Jg o'n6I q tllt8f,E8l-(olltElsArlolt
<br />DECIJIAIIA!
<br />I h-.lD lmm und( Fat) otFjury om ofth. follos in3 &rlrd bE
<br />I lEv. rd will mid.i!. Cfiird. olcoMl ro S.lf-lEe ln @ld' (mp.nElbn, B Forit d tor b, Scr6n 1,m of lh.
<br />trhx code for rlE Fftu oltlr esrt fr $nih rlE Fnt i! is*d.
<br />-ltu(rndrillmri.inm*m'cotrpdBlrioniMu..6,tquirdbtsdbn1700oflh.IibrCod.,fotfi.p6tol11@.of{E trut ld *hrh iha Fni! ir KEd My wdla' otr9alnio. iBdu. ffit.'d polry numtE r.
<br />Nunbc:-ErPi6
<br />'ft rhat i. tlE Ffoffi. of rh. sorl fu *hah lhB Fnn ar i$u.n. I sh.ll ml 6Phy a! Fen in.n! nEK
<br />; s ro b..o6. etid b rlE *oit6 o,{E6iio, It$. olc.lifomi( {d lsr lhi ,al 3houE b<oft
<br />s!rl6 6nFdb. Fo\iioB ols.<riD 1700 01lh. r,t Co&.I tElL fonn*nh otplt *nh lhor ForirioB
<br />IVAiNINC Fnlu. ro su. nlrkd ort9.Mion cor6de.
<br />chrl ro6 up ro.F hunrncd rhou!.d {k'llB (i1O0.0001. in
<br />sdrirn 1076 of rh. tild coia i.r6d &d !nm'! f6
<br />d ophrs lo .mrol FEiis lrl
<br />datus6 a Forii.d for lh.
<br />I hd!6, .lfrE u.& pa!}y otFriry lhi I D lt q!.d ud. Fpvition of cllpla I l@nltED8 snh SEIbn 7000) 6a Di!,rm r
<br />ol rtE Btl.lB &d Prof<io6 Cod., -d Ey lto& n h tull foE rd.fiGl q
<br />"". LV-22:4
<br />caxslauqllqx]ElDllc.Acf!(I
<br />I ha*y llfm und, Fdty of Fjury lht lh6c a . @'rsto.tbo brl,:e !8dy lor lht l,6folr1s. of $. *sl ft'r "hth rhis Fmir il
<br />su.d (Sa 1097.Civ. C )
<br />AITIJCANLDECIJSAIIA!
<br />I h6d, B]Im und6 pdrh y oa pdjury on. of lhc followiry {kclsdFtu:
<br />Danohnrn Pmirs-Asb6ros Nolificarion F.da.l R.SuldioN ( I nl. 40. Prno)
<br />R.quir.d L.l16 of Nolilicdion
<br />-l
<br />cqliry lhn thc Ldml r.sulalioE rcsodlns 6b6los roo\ al e. nol tppliclbk lo rhi! pmj.<r
<br />I cdifyrhd I hrv. rqd rlG,rpli.arion and nar.lhal th. atorc r B onel l ssre kr comply*irh tll ('ny and (i,unly
<br />or,In.nc6 dsrarc l-a\srh'i.! lo b{ildins codrucrion.
<br />at{vc mdrbned prcp.ny fu
<br />applirNnr or,\Etnl Sign{xrre
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<br />r.F* div6 of$it cny ud couly lo 6rd upon [E
<br />o". rO:22-4
<br />-.4)
<br />Forms/Steel/Holdowns \,lrlta-a,^. ..&r
<br />Erection Pads r'r I r.t 'r
<br />UFER Ground ,--=\
<br />SLAB Floor 4uln N A445/P'
<br />Subf loor/VenUlnsulation
<br />Roof Sheathingy zl- [,o i)
<br />Shear Wall / lan 1.r-1 _^,tA-4L
<br />,/
<br />Framinq TlTbltq -,Urk{,r\
<br />lnsulation/Energy llLiItq ,U4nY
<br />Drywall ttlrt(1 /444fT.
<br />ln n'lDlt') .tt4;16,
<br />Brown eo-6f 't lr\ il u,l1dr
<br />Masonry
<br />3l?,e h s -fldr7D
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif.
<br />FINAL f( /a/
<br />Certificate of 6ccdpdncy
<br />Notes, Remarks, Etc
<br />Tlzt tel ttt (a 4v
<br />la.-work Ira{a
<br />Set Backs
<br />o,.4g:t2:14
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