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DING- INSPECTOR RECOBD
<br />ID/SIG.COMMENTS
<br />Set Backs
<br />Erection Pads
<br />SLAB Floor
<br />SublloorivenVl nsulation
<br />Roof Sheathino
<br />Shear Wall
<br />Framino
<br />lnsulation/Eneroy
<br />Drywall
<br />Ext./lnl. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certil
<br />rA
<br />\* )S-2 r'hl)d
<br />Certilicate ol Occupancv
<br />Notes, Remarks, Etc
<br />OWNET BUILDAR DET,]CARATION
<br />I h.r.hy .ifrm undcr p.ulry or p.4try rh, I d .r.f,pl 6nnr llr Co r*16 l it€ trw fttr llE follosh3 E$n (Sd 70l l t
<br />Burims .d Pnrfci.n n Codc) Ary Ciry o. Counry whth EquiE\ . pqtit io tur .16. i.9rDE. d.tubh o, ftFir -y
<br />rttEi@. t id h s hsu.mc. llro Equircs rh. lj,plkd tu uch Fmil lo lit. risBn {n.mr rl{ lE or rlE ir lirtrrd Fddr
<br />!. rtE FsvBirns of ttE ContEclorr l,e.ed lre (chq'r.r 9. Cottmrins rirh 56rbn 7s)0 of Divkbr :l of rll BBiEn .d
<br />Pmf.srnni Cod.) q rlEt lt o. rlE F.r.,!, tffii'm. rhc ts\ir forih. dh8.d.r.{plon Ant vblr'irn or sdb. ,0.1I tbruv
<br />rtolaad ntr r Ftur {ttler! rlr +flkrt ro r civn Frllyolmt mc rh fiv. hudiEd dolle! ( lJm)
<br />,-1. ( o*H of E FlFny. r my cirPbrtts wnh h86 s r,Etr $L otr4.Nn.. *i[ iL' ft \rotr !d llE sltElE n Dl
<br />i' dH or oirc*d ror *L rsd 701.a. BurnE!.,n ElrBtioB Cod. TrE Cd ,rfu ! tift tr*.,t{t d rtt'lt ro d owr ol
<br />rrE FrFny *ho hill or hpbE! rlErc rd rrb dc sh k t hie lt o. h.elf or llmoah hi. d ts om.f,9bvB.
<br />Fotit d rhd rwh ihFtr@nlr 6 mr in.nd.d trofstd lor $L ll homE E tlilin8or itrForwi. i! eU wtninft !d
<br />or6rti.ii4 r OpE Builb *ill llE 0i h,r&i olFMn! lhd ,E tr dE dil ml bitd or hp,!w dE Foocry rq dE ,u!FE of
<br />-1,
<br />$owGof trr FoFty, rn.rluriwly.o rdhB Pirh littr:d cddm ro lldr*i rlE Ftin (Se. ?O{4, BBES
<br />rn EdBlir Codc: Thc Co.rslol r Lic.nr L.! dal mr rP?I, lo d tuEr of FoFty *h boildr o, i,llmEr rlw6(
<br />.nd uh s'nE!ct! fry o(h |roFlr wilh r C.nlElollO tiltr d purturn rodE Codraitr. U..M L.*,
<br />_l rm .kmF ur&. scr
<br />Drr..
<br />WORXlRS' CoMPF'{S TION
<br />IECIaSAIT(a
<br />I rEctly rtttrn urhr FMhy of Frur, oE of ilE folk,*rg d..ld ionr.
<br />I h,w drl *ill minlin . Ccditrtr. of C6trcd ro S.tf-ln@ fr qxt6 onErrr ior. 8 F)vitr ln ny SEliotr :!700 ol th.
<br />Ldor Oi., l.r dE p.rforM. o( rlE s for *hi.t rlt paml i nsi.d
<br />&iErnwillNnr.ifl srlra ooFn.rno. rmunE.,8 quircd bySelb.lTOo ot rrE trrrr c'o&. r( llt Fra(Iffi or
<br />r! Et 6. rhin fiir rEmd i\ ii$.d My {.,16 6n!E.r.rhn in$lld cri, .rd pol-y .uhts e'
<br />_l qnr,, d- &' dr Fft.mr ofrlr Et 6. rnrh Oi. Fmn t kE4 I sllll iol.rfLya.y Fen in uv nUE
<br />e N l.r hdrE -l*Er b lt Er6 6.Fdin L- of C.lironi4 '.d ieE rhd rl I tlFuld hccor sobiir to rlE
<br />v kd!.o,pd.ItrFvibrofsdib.ll6otllttartC.&.l,rrrltritsnhontdrrilhrho:Fnvni,nt.
<br />WARNINC: Fsilurc to E3t wl6 dlFiErrh oEra. ! 'd,tu1 .rn !16 tlFr e cnPhF to oinid FEIai u'd
<br />citil fircr up ro orc hrd,.d oDrGnd &lLtt (llmm). h.rldtbo ro UE d o{ mqENdhr drmrsr ( F.viLd f'r tll
<br />r., rnrr rLr;6,n rrf, Lir( (i\lr
<br />,,.," t ls lzo
<br />ih*.r-. rlDr of Dni$i tDEqBIAIEd
<br />I h.Ety dfilm lnlcr Fndiy or Frlry rh{ I rm liqrql urd6 Fovithn oa (trp6 I (odErit rr
<br />of rlE Busircss ud PrnrcsioN Cod., od dt lartr€ i\ h ruu rorc !d .fiel
<br />?31E14It,lt 20 r-r.*.. ha€Q,q !5 0n9(w11wil L)c
<br />IOIIIIEIJCIXEI.EDING.AGEdI]
<br />LrEb, amrn udl( Ftulr, or rsj!ry thr llEE * . mn(Mrir Lndins !s.8, fd rtt Fftffic oi ttE mrt for *tih
<br />'hn
<br />Fnn is
<br />i.n.d {sd 1097, civ c.).
<br />kri.r\ N.m:
<br />-
<br />AIIIII;ANLDECT.Af,AIIO!
<br />I hod,, .trm trnd.r rdal, or ldiu.y oE or rh. ftrtlwine d€Lr.i ion3
<br />DcfrnnFn ftrnnrArlE(G N.rrfrri'n fiddl R.Suldbns (Tnh .l(). Pd6)
<br />Rc!unca lro( ol Nriii.Jliox
<br />_l .cniry Uu rh. IcdcEt Esuhlr'nr r8ddh8 dr{los Rnbvrlrrc ftn rF li.d'L lo rhn tmj.11
<br />diry lhd I h.E Eld rht $pliLnrion rn {r. thd th. .br nn,ftr ion R otr(l I lse ro .o'JPl, *iih .u Cily url Coury
<br />odiotuq rd srrr. tiw. RLikt ro trildh8 on(Mhtr rn h.Eby rllhrn! E?r.*rn.r'Es ot this Ci y $d C.unly lo cnld upon tlE
<br />',lrf .o
<br />Rev 08-07.2015
<br />SITE-WORK DATE
<br />Forms/Steel/Holdowns
<br />UFER Ground
<br />FINAL
<br />(..,.. gtDi t Cri\r?D,rJqf,rro! id su4.*Dr '( i/DD.
<br />Pd,.,!',*,W*r*, I I a I zl
<br />ds\c nEdiNdpnFd) nr insEri,n rrp.6
<br />-^;,...;,:;:,." -t-*6p@r.@rr.i,rr ArUavyfuuns-
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