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SITE.WORK DATE ID/SIG.COMMENTS OWNE BUILDEN DEL(]ARAATON
<br />I Hy tffm urrLr Fnd, ot Firy dul I D.&n$ nqtr Ur Cdrtdm tiw Ls for tlE follo*il! la$n(Sd?0]l t
<br />Auir* !d Piol6rhn C.dcl. Ary Cty 6r Crdy whih 'qri6 . Frn b M{rEl. d. ingioE. ilmlilh d ,t .i xy
<br />tr*ruc lru |o ir! ntumc, al& rq!6 0t +pli..ln for rEh Fmi l. lik . si8rFd r.ffil ln l lr or ti i liet*d Fts&l
<br />ro rlE FovnbB of ft Conr.rdar Ltc.!.d Uw louptr 9, C.llErini silh Salbn lm of DililiJn I ot rlE alriEs d
<br />Plbbsirnr c.<L)d tlll lE rlE tcHpr rffiui.,n 0Et.ri fq rlr dLrd.rn$rin. Ary rirhlir of Sdbn ,oJ L! b, sy
<br />.Fplic. n .Fnn {hjcu rlr q?th. ro..ivil Funyof.or mE du fiv. hundr.d&llar (3J@).
<br />nL s olr. orrlr FDFnt, d my.rpb)G *trhr.86clh.nrLof,Fn lior siu&,0Ekrt trn t,!Ets!.dturad.d ofi.rrd fr .k (Sc ,{X4 Bui,B.d ProldbB Ct'&: IrE Co'w-rd r Lirc L.e d,.r rEr rtlclr ro 6 ffi ot
<br />rrE lr.Fny sls tlildt m irymB llEs4 .,rd *tD &E *h s hiMlf or ltslrd thmugh hi, n lIr om cnpk'y.6.
<br />rovid.d rh.r *h imFovftnlt E d nsi.d nolfml forql.ll hokE, dE t,ildiis or iqEcrd !' sU wrhnr * Fr
<br />orotrt Lrntr rlr o'rE Buildd wiu lN dE hrdaroftBir* d. h. d iE di! ld hrB ( n!.w E FtFr,6r d! Flro:of
<br />-1.
<br />s o*E oa ln. FlEnr. .d.rlusiKly .onrd1an8 *irn le.En .mMoF lo oBnu<l llE ,llitt (S.{. 7oa,l. BNiBr
<br />!n Mnb Cod. TIE ConrElois LtrnE Lrw dE n, +ply ro s o*E orFoFny who h'ldr or in+reE3llEoc
<br />.d qho omrlll *h,mrds wirh r C.fdcro(r li.Nd p! llr to rLcofixtar t!.m t *)
<br />lul I
<br />I n rl,y.rm uihr F,riy ofFp.y.*.r,l. r.u..igm
<br />I hrw si will minriD . C.niaEorc ofcotrE.t lo Sclf-lnsm Itr *rk6J coqnd ion. as F.tihd lor by Sethn l70o of rh!
<br />Ler Cdq for ltE Ffffi ol E mlt lG shi:h tlE p6Eir i. isrd
<br />A'lhrElnd*ill fl.inwLB €trrpcB.rEn 'trlunft.. d G|trir.d by sdti,.l?m ol Et td Co&, to lh. Frfc!ffiol\h. $ort lor shrhrhnp.mi ir B!.d M, *dksa onp.MFnNul.NcMs !d JblEy nunhd G
<br />V.
<br />_l dirt rhcr in rrE F mB.rdr hrl td whih ftn Fima 'i L!,r{ I 3hll ml .'q,lor.ny Ftr a, d, mnE
<br />$ as ro h.rim $6F ro rlE wkd on{Enr.rion hw! ot C,lifomi!. !n .gE dur ir I rthuld tErm sbFl lo rlE
<br />erl6 orqErri,n FdirioB of S..tion lT@ of tlr l,tu C.d., l .hrlL rdhvirh cnplr wirh llnr pnvirbns
<br />WAnNltc FrihE ro s *rt6 onp..dnn 6rEra. it o rtul .tn tlrl qbFl d alPbF b dinid FEras.d.Ml liEt ur ro oft hudEd ttnusd dollm (tlm.(u)). i,ro rL .d or.on!.mri,L d.f,!.r a Fovil€d for rlr
<br />S.crion 1076 ot dE Lin Cod., inr@n !d,,,-LM-^
<br />I }ftb,.rlim uds F lyof F!r, rh.r I d lia!.n otxls FDvi(i,n of Ch.pt6 9 (6ffii.! wih sdlio.70@) of DUsi'n l
<br />or 6. BrriB !d ProtsirN C.d.. rn oy lirE n h tull foN !n.lT6r
<br />R C,,{O qZLNb
<br />,.rr,aLW
<br />SIIEIAXSUIIU.EDI$IjAAIICI
<br />I rEmby lrnm udcr pMlry of Frrury rh. hft n r .otrrnrrhtr Lndins lscEy for rhc F.fo,r1e. ol ih. w.rt lor stth ths JEmd 6
<br />ns.d (sf.1097, civ c.)
<br />AEt ls/rNLIIoJBAIlll
<br />I holtry lliEn undcr pc"ch y of FJlry otu oI rlE folt winA dslIurbns:
<br />txmliri)n ftmir$ rlEsrfi Norirtrlrion lsl€fll R4!L,bn! lTirL 40. P.d6)
<br />R.rturEd tru6 ol ttrif.{ion
<br />_l ..d ify rh! rlE rdLnl E8uh
<br />\A&d'ry rh.r I ,'w E.d,hB.n rbi,rsca.id s'n. ll*r rcl,rtrrs k)
<br />rioB E!.dinB .6cno. Emvrl e mr {rli.5h ro rhn toid
<br />i-tto. .rrj nrk rh.r tE rh,v. hromnion ri ce.d t !!E lo .n,nl, wnh rlt Cty lrt Coury
<br />hri& ..prcsnrlriv.\ ofrhir Cnylnd Cou.tyto cor.r utbn lh.
<br />invc E Frn tl! Ffl, f(zhrl,\pflir'sl or A*61 sknrluE n Wk4u\
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Ereclion Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framino
<br />lnsulation/Enerqy
<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 />Enoineer Final Report
<br />Flood Zone Certil
<br />I
<br />FINAL 1r\ l.l0\Xl I,FVYT
<br />Certiticate ol Occupancy I
<br />Notes, Remarks, Etc.
<br />Bev. 08 07-2015
<br />BUILDING. INSPECTOR HECORD
<br />II
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