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SITE.WORK DATE ID/SIG.COMMENTS OWNEX iUILDER DELC TATNN
<br />I H'y rltrd !id.. Fnli, or FF , rlll I n cr.ng 6ob rh. Cotu{m Li!.t b* tur rh. iolb*int E&n (S.t 70lt 5
<br />Burir3i .rn hordrirn C!d.,: Any Cily d Cdny $hah EquiB . Fni lo onrnrr. .hd. in+.!E .l.mliih n EFi ry
<br />!lMR. D.ir h irr iisl.E. rl$ Rqui6 rlE $r a..l for Mh Fmi' lo liL r qEd d.r.mnl lll.r lE or iE ir lcrrld Or{d
<br />ro rh. Frirsm ol rE aonrrrG r Lt ncd lr* l(1r| 6 9, CoIftrin! *nh s<rbn ,(rn or Diviri,n ] of rrE Et!ir.. .,td
<br />PmLsrhnr CoLr or rh.r lt d slE Lr .rrpr rrrr.non !n llE ttsi lor rtE .tLg.d .r.qibn Ary viohrbn of sdhn ?01I I l,y.n,
<br />+plicr lor ! Fmir lubFr. rrE .prli.rnt ro r civil F.ullyormr mt rhrn fiv. hundEd dolls! {l$O)
<br />L * nwtrd ol rlE nn)F{ny. or my cn,rlotr.\ s irh sls$ ( hcir wlc onrP.nurii,n, $'ll do rh. sllll o.d lhe ddrun il tur
<br />inrcndrl or .lltrc in *,h (S( 7O4,{. Ausnf,$ rnd lh'lcsii'n{ Gxls Tlk Grr(tn ! I icne l r* &tl nn {ply ro sn owicr ol
<br />rh. fh{iny *tt hriL} or iqm\$ rllfr)( rd sh, ili.( iuh H,t hinMll or hc<lr or rhNuli hi\ or hcr o*n.'Ipk'v..r.
<br />pnnih{ rhd ru.h nltr'Enrft m n inr.flLit oru frln,ab ll lns$s. ilr ttuium3.. nIf,oErd kYrld wnhin'{r v.d
<br />ol.ont)ldr{. rlt ()$N aurt:br u'ill h.r llE h'd.n o, FrinS rlH h. or {E J nn hiUo qn*.0E trotEl! i, rtt F F(uf
<br />I. .r o*r. ol rtr F'lEnt. u ckhsiFly odrdinS *dh li.drd NtirrrrF ro Nddl tlE ImFtl (S< 7044. aBl'B
<br />.rn ffiin Cod.: TrE co dor'3 La.nE L.* dGr mr {,pty ro s .f,E or ltoF.l, wt h{ildt or i,I?mEr rhson.
<br />rld who d,nrrr-li ftr rh FDFr *nh. Conldo(rr lirn€d I'UFMi ro rrE conrdui lift t w)
<br />I rn(rElnnr u lcr \Nri,,n
<br />Dsl. ()rncr
<br />ruxlr:Blluut]:Nrallll!
<br />D!gdAAIIO!
<br />I horh\ irrtr r' utrder r--.'uli!.l F-rturr" f tu ol rlf, lolhN trr* (1.\l.rrri'\
<br />Ih.R!nsillf,i.b.C.nirr.r.6rcm!hS.lf.lNElteqt6c,,lEdbn..rt'oYiLdlortysdi'.l,mol0r
<br />t bn C.rb. r rrE IEfm of llE qri tq *nih rrE Fmi k iied.
<br />I h.v. tnd eill minr.i. hrkdi .odg.ndhn imrrc. B EqoiEd by ssrrr lrm of llt t,l$ C.&.fo. rlr Frftxl]rN o,
<br />rtE wk fnr *lrth rhn Ftu i. k$Ed My *trk6 mnqEndhn i.lnlm ffar .tri Flty dnih.r Gl
<br />-l
<br />aniry rhr in rlE FrrorEr of dE wort ir *tah lhn Frdir ir i{u.d. l .htll mr.nok, r., Fmn in.ny Iud
<br />$ .s ro h.d,m iut*r lo lh nri6 oqrMti,n hlr of C.lifomh. !'d laE rh.' it I .lrurd tRCoE qrbirr lo rrE
<br />m*c' snlE.{lih,,ovirhnrof S4dbn lT()dlrrE I-{n Cd.. l rhll. fonh* hNnl'ryf,nhlhEi' iraoB
<br />WARNINC: F.ihrE ro ffi edl6 d,qEnrdn. NEnIc is hrr$tul .d tldl rut'Fl d -tlphF ro aimiMl Fmli:.id
<br />n' or hn'!fti rlrusf,l d.lli^ Ill(xr(rrrr in ddiir t,.f cotr{rhsrbn. d!m8!r .! Fov-ktl l{n rlt
<br />:: q'rfftrr imcrcr..d omy r 16
<br />DECITEAIION
<br />Ih.Eby,m nu ls Fnllry oa p.rj0ry rhd l.m |i..tr(nun&t lrorhion or (-h{fld 9 (.onrmncin! *irhSdri,n 7ux)InaDi!i\i}n I
<br />ot rh. BuriE$ .nd PFfcsion\ Codc. Erl f,y litnt n in tull lore .!t cffNr
<br />r\D
<br />ltum
<br />q137le
<br />/?t-'-*-;(
<br />l.il]lrgalcuoNrEdDl&cllif.lr;r
<br />I hcFby 'mrn und.r Fn.hy of lErjur, lh.l rtft ir i $n{rucli,n L.din8 lgcrcy fo, rlE FrormR of lh. wrt f.r whi.h rht Frmil k
<br />issucd rScc .1097, Civ C.)
<br />kndci. Nrn(
<br />AITI.II;AELDECI.TBAI]O!
<br />I had')'dfm lnkr Fnrl'y .r Fpry oE ol ilE lollor in! d..hdit.rl
<br />t>mlnion P(mik.A.thor l{oriarri:n tucr.l RcttLrbnrIT LaO. Pd6l
<br />R.qun.d I rn.r nf t{d iff,dirn
<br />I .cnilyrhxr rh.lcJc,rlrsulrri.n( r!ftlrnl r\t!{o\ r.m,!!lr. ior rf'IlrihL li) ihn nfut11
<br />I(niiyrh,rlhvurridrhi\inlrlirrin,n {srcrh rltdhrt in IrNli,n, n co' r.rr l tBr'c.nDlysirhrll('iryun,l(i)!nl)
<br />orilinaRcrand srdc I i*s EhrinS ro bxildint ...
<br />$o!c nhri,md l,n|Edy itr i.(rErrion purB
<br />,\pplion! or \rmlSiCmlufte\clll qJ
<br />,
<br />" r', "'" n
<br />"r
<br />tr ".,'r t:::r.
<br />WjV flT
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathino
<br />Shear Wall
<br />Framinq
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lalh
<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 Certif
<br />FINAL
<br />Certilicate ol Occupancv
<br />Notes, Remarks, Etc
<br />BUILDING. INSPECTOR RECORD
<br />Set Backs
<br />UFER Ground
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