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BUILDING- INSPECTOR RECORD
<br />SITE-WOBK DATE ID/SIG.OWNER BUtI,DER DELCARATION
<br />I hc..by rinn u.dcr ,).nrlry of Fr.,ury rhdr I dn cx. lnr fi.'n rhc C. ka.rtra Li..hsc liw ror rlr blk,wilS rcrsoD (S(.l0.ll 5
<br />BtrsiIc\s a*l Prof.ssn,n CGlc)r Any Ciry or Couir) trhich equircs r pcnnir ro con(rucr. alrcr. irnprovc. dcmolish or Dplir 3sy .
<br />drucrurc- rior to ns istuMcc. alio rcqui$ th. rrpli.d.r for \u.h Fnnir tu nLa siSn d { c rnr rhd h.or shc i( liccn{il pursu,l,t
<br />lo rhc fmvisn r ofrh. C.nracrols l-i.en*d lr* lclrprcr 9. Coumcncins wirh Sccrion 7fiX) ol Dilhn,n .t ofrhc Bu\in.\s aid
<br />Pmlc$innsCodc)orrhrrlforshciscxcmpirhcr.filhii,lrhchisirnrrh.rllcgcdcrcll,i. A rvn,htnrolsNrionT0:ll5b!rtry
<br />aprlicanr f{n a p€milru}'jccls rhc lprlicanr lo o.ivilpc.rttyoinor n!,c rhi" fivc hundrcddollarc(3500)
<br />-1.0sowtrcrolthcl,otrrty.ornrycnDloyccswirh*J8c\Nrhcnn,bconrp.n\arion.siuilorhrwolk
<br />rlIhcsfl.tm^tur
<br />i'n.*lul orolI.rcd itr sl. (S( 70l.r- Businc$ and ltolcssions C.nc Thc Conrrecrois ljceNc Lis docs nor aprly n] rno{ncr.l
<br />rhcpmFny who builds or irnpors rh.Nn. od slr, dtr\ uh *orl hiD\clfor hc^rifor rhnrgh hir.r h.r oencilnl.ycc\,
<br />piolidcJ rhar \uch improv.nEnh uE mr n cfilcd d ofld.i f(tr slc Il h)srvcr, rh. hu ildi,r8 or i'npnruf,nr i{ $kl Rirhin onc ,td
<br />ofconrrhrion. rIr. Osncr Build$ willha\r rhr briLn of pnNing rhnr lt or sh! dA mr build or nnpn'w $c lrn)Idy ftx rtr purl[r ol
<br />_1. n\owncr.irh. |Toltrny. nn.x.lurivcly..nrdin[ wirh lic|i\cd conrn.rtrs b.onirucr rh. ftutci (Scc. 7044. Suii,rusr
<br />r Pmlisrbn Codc: Thc C.nt ctn s t-i.cns liw do.s nor lpply nr rtr owmr ofproFny wh() build\ or inpruvcs rh.rcon.
<br />rnd who conrturx nn \uch pntcch wirh ! Conrncro( 9 li.cnscd ,r,su.llo rhc (inrrlcrolr l-ic.n\c l-rw).
<br />I .trrcxc r0r und.r Sccr
<br />uaatr[&t:l0MtENta.rl0N
<br />DECIII.BA.IION
<br />I hcrcby,iltnxndcr pcnrlryorF,uryom orrhc roll,,wns Jccbrli,n\
<br />-lhlvcrRlwillnninrtuaCcnili.arcolC'.n\cnrr)S.lfINur.fitruorkrrr..V.nsariotr,rsrtulid.dfDrhySccrionlTO0ofrh.bh.r Codc. n, rhc l.rrbrmmc dfrh. wort rd *hi.h rh. pcrmit i\ nlucd
<br />74rc an,l wltt molnhln wo*cm conlpctrsa( i.n in$r.nQ, dl r$u ncd by s..non :lr(D or rh. Lrb.r Codc. for r hc lcrloflrurcc or
<br />u)z._
<br />L ccfliltlhrrhrhc l,crln uncc olrhe*ork tlrshichlhnpcnni i\ n{icd.l\hilltrol cnrploy rny pcron ir rny mrnmr
<br />s is l. h(onr sublt.r tu iltr su*crJ .unrl)C.srrnnr hqr ol Crlifornir. rnd 4ftr thrr if I sbuld hcconf, srhj.( tu rhc
<br />sorkcr( dnpctrqli.n pnivhi(,ns .l Sc.ldr l7O0 ofrhc Ldlrtr Codc,I \hrll. ronhsfh.otrDly wirh rhr* fhvilotrs
<br />WARNIN(;: Fdilu'! t) sc.urc wo'kcr\ coDlxnsrri{in..vrrrg. i\ utrhw,nl. a \hrll srhjrcr Jr cnrdoy.r ti .rnninrl tr rhis rn
<br />civil lirc(t|lt'otchu dd rhot\r J dolln^ (5llx).(Xxr)- in rndiri,ni n) rhc co{ of..mFi\rrnnr. driu8.\ x! nrov'd.d lo. rhc::;:ru?;:
<br />![!LA8A.u!]B
<br />under pmvi\ion olChlr,rer q (commrciry *ilh Sccri,n ?flio) orDivi\n,n:lI hflchy rllnm un'lrr J[nr ryol pcrtur' I
<br />ol rhd lll\mr\rf,l Proltsi, sC.l.. d nr! l(cnr i\ fi ll lli,rcc rnl.lllrr
<br />3 Li.r,\cNun,rf,r: to 3.€ 3 7 /
<br />"",", 1/<a/4 ..^,^". (Y."njIalrJtue-
<br />IOIEI TJI:IION.LENIIINGIQENCI
<br />I hcrchy rifiirn undcr,f,nrlry.rr*rlury rhd rhcrc is 0 $iirucri.n lc.dirg,Ccn.y ror rhc Fnnnmncc orrhc sork for which rni\ Firni' n
<br />ksucd lsc. .1097. Civ C )
<br />atzurANfDlrcldtrua!
<br />I l..n},ylmmun crncnalryol'pcriuryoncol lhc r'oll{,wirsdcclarllionl
<br />Dcndirion Pcrnrir* s$.sos Norificrlion lrcderil RCSUhriotrs (Tilc.10. Pd6)
<br />-Rcquncd
<br />Lcttcr oi Nolif'cntiotr
<br />l.cnilirhnl !hc lc{lcBl rqulari(,n\ r!&ln,! r\hL{.\ runmvrlrr nor Jrplicrhlc t) rhis pmi..r
<br />,(,rLJirrtr!c. r Srrrr tf,u\rLri"! !thu,l,li"! !,{^rru.',in. r hc(htru{hori/crcprcsr Jrircs(ifrhnC,andCornryt,cnr.rrJimrhr
<br />rh)vr nrnri{,ulf'.Nn! li)' iN 4r/?-
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/Vent/l nsulation
<br />Rool Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Ivlqsonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />En gineer Final Report
<br />F od Zone C f t I
<br />%t'r,,1,07//t
<br />I
<br />/. )\
<br />FINAL Htb ,xu a r4K\
<br />Certificate ot Occu vpancy
<br />Notes, Remarks Etc.
<br />COMMENTS
<br />)
<br />1.tr(lcf\ Ad'lrcs\
<br />-,(ltf,eef27P/-aD/1\g,t 14(6D/
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