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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNEI BT,;II-DER DEII.AR TION
<br />I ha.hy.frm und6 p. n,of Fju.y thd I es6F n!6ih. Co.Llcro6 L,EGB trw for rh. following l@n (Sd 7oll.5
<br />Buina sd Pmlcio Cod.)r Any Cny or Coudy whth ..q!i6 ! Fni lo .olrtud. dlq, ihFov.. <belirh or re.! 6y
<br />rrucruq Frr b nr !sl6.. rLo ..ql16 rh. +did ror rkh FDn 'o
<br />6L . 3r3i.d ndaEn ltr lE or dE i lrclcd An6r
<br />lo rh. FDviriod of dE Conhdois Lic.ns.d Llw (Cni,ld 9, Conm..cinS wirh SElion 7000 of Diviion I of tlE BurB ed
<br />PofBbE Co<h) or rhrr h. d ,lE ! 6arpr tHroo .d lh. b.!i fo. lhc rlLs.d dar$ion. Aty viobrion olsdbt 70] I 5 b, &y
<br />.ppli.dlor.Fmh$bid!rlE.p?liorto.dvilp.tullofturmErbo6vchur&lddolla(1500).
<br />,..l. B o*E of th. FlrErr. d n, a,phrG *nh s!96 6 rtEir ik conFlrion. rd & 0E *qt !d dE rnEE ir d
<br />m6rbt or 6llad tor d.lS< ?0.1t. BcilB ed PEtdioB Co<b TIE Coirdoa! ti.e t* rbd Dl Tp]y lo a orE of
<br />rh. FtrFty who hildr or if,provqthab( dxl who.b6N.hs him.llor hd*lf or lhmuth hn or hd 06 dploy.B.
<br />Fovl,.d rha ut ioFlrqErtc d lnon d uolEld tr sle lr.lbw. tlE tlillirB d ilgs!'d i Dld vihh m )o
<br />of.onpliDl\ tlrO^G Bdtla *in llw r hr&! olFovilB lld Ln3lE di] 6l hrild d irF.oE fi. FoFy 6r dr FlPorof
<br />l, s oed ofrn FoFir. m crcluircly conteDs $nh licqEd codr-ro6 lo @dod rh. FF (Sa 704-r. tl6!r
<br />.nd hli3sbn Cod. Thc Cont&rol! Lic@. ,-rw do6 nor .pply lo e oan6 orpropcly vho brild! or ihprova rhden,
<br />md eho oddr fm $ch aFj.(! $irh a CorrrItnlr lta..d Fraud ro tlE Coffic r Lt@ t *)
<br />I dmqcnP und6 Sclion . ,l & P ( lor rhi! rffih
<br />WORKFRS' ('OMPENS TION
<br />PECI.ABAIIX
<br />I lE.iry .mm lndd Fuhy of Ftur-.m oa lh. Lllosllr ddLr io6:
<br />I t !c.rn will ri, rh r Calift'r. of Co6ar lo SdflM. h. *!.t6 6bt.di'r ! FuiLd lor !y Sdion 1700 of th.
<br />t$.r (-od.. t rlEFfm.of th.m fdsni:lllh.Fnn ! ised
<br />du*-a*itt-*,n"od6 rcdFE rnndlllll8cs r.quiEl h s€rion rToo orrh. L:t ' co<!. fo. dE Ffoil1e. or
<br />lh. wt fDr $r*h rh! FE'r . eld My @rla .o'qsllbn rE yE ffi !d FlEy nmbq d,* . Qa+9 lu5tfind*,,*,' 4E Zi **:12 8-2o
<br />f, .al,ry 'r'" . r* p-r.*. orrh. wo rn rtxh rhir F6n n 4iEd I{!.1!@ranployerFrni'.nyI:.!lE's s !o bdom. sb*l lo lhr sorld @sp6!.lFn LM ol Ctlfdlu .rd lBE rhd rf t nDulC baoh. 3ubldl ro trt
<br />w 6' mFudbn Foribs ofs<lirn l70o of rlE t td code I tdl fonhpnh otrply *irh rlE pro6ioG
<br />WARIIING tdlw lo sa hrtd' ofrFrliJn @ta!a. ir 6l&tu1 .d tlt ll $bjd m 6pbF b aimd Fdb !d
<br />citl n.6 op lo ok hund,.d rhous.l dollq (3100,000), in lddition to rh. con of.ofrp.^lrion. dadgd d providcd for th.
<br />sdin 1076 of6.lrt r C!d4 nrs.i rd dro.ay ! fG
<br />I hd€hy amm undn lohlty o I ti.iury rhir I d trtrdd r,.visionol( hapls ') (com'nocinE $ h sdrtr)n 7ttr0) ol
<br />of rh. BuilB erd ProfdioN Co&, ,rl ny la6e n '. tull tuE ttd.iTd
<br />,"*r"*.:C:lL
<br />",,.
<br />t (/- ttl-/J /Dzo tTcl
<br />,.^,,.",.,1x-- E/ g /.4 Ff -tze/ = h r
<br />cllllrBlJclrad !Etlrlc.Aclla
<br />I ho!b, rlEo urdd Fdty ot FJury rh! th@ n r @nrnElbn lsdins .8fty fo, lh. FfMc of tlE srl tot $tth thit Fnit u
<br />nslcd (S€. 1097. Civ C )
<br />L6Jc ! NM.:
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<br />--
<br />-
<br />AITLII'NLI:CIJSAITA!
<br />t hdrt y dfrf, uidd p@.xy of pqjuy o.. oa rh. aollo*'ing d..l&.rioB:
<br />Damlnion PmireArb6rd NorifK.lDn Fcdd.l R.gul!68 (Ti'1.40. P&6)
<br />R€quird lnl6 of Nolificdion
<br />i)n 6.on61 I 6ara lo onply *nh rll Cny&d Counrt
<br />@ r.FaddilB olrtn Cily an Cou yloo s r4r,0r
<br />,tppll.rflr.r,raor Si*n.rur.
<br />a\!-b4-81--" : 11' 14-/q
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUlnsulation
<br />Roof Sheathino
<br />Shear Wall
<br />Framing
<br />lnsulation/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 />Flood Zone Certif
<br />lt
<br />FIN^L //t{//.0'7,o FU w t t-1,/
<br />Certificat6 o/Occupandy
<br />Notes, Remarks, Etc
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<br />o,,,. . u_(Q _[,r
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