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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE tD/stG.COMMENTS O*NEN IULDET DELCATATION
<br />I h.,.5y rrTrn uBLr Fmlry or F.|llr, fi:r I m .r.ry* noh llE ConlI&rln Lx.M ll* nn dr folbw S mr,. (S.. m],.,
<br />Eriin !r .d Pn'lcsioo Cftr.): An, Ciry or Counry *hrh 6qocr . Fmr to $nrN.1, .lld, rtr{ror, J.E)lirh or EFr e,
<br />rrtucr@. rr, n, ik i$xuc.. rl-$ Bpnc! rh. rytlicmr f(tr 3uuh F mr h lik r sBrcd sr.rcmnr rh.r h. or c'. B lic.oyd p@.nr
<br />ro rlE FovHnnt ol tE Conrr&nxi LicDsd trv (Chlprcr 9. CotrdB,rs sirh S(rn,. 7(m dr Dirirrn I oI lh. BBnEs .nd
<br />PNfcsrnnr C,i.) G rhar lt u r& ! .r.r+ thdcf!6 !d llE b.!i' fd rrE .lL8.rl .k ryrin ary vioLli" ol Sal Dn '701 I 5 b, .n,
<br />rppl.d tu . Fmir $hrdc rh. .I?h.nl lo t .Nrl FMlly ol Rn 8,. !h$ fivc ho erl tloll,i (ltm).
<br />_1, rs owr of rlE FDp.ny. r m, .nployas wnh w.Bct .r tlEn sk .omF.dEn. *r! &r rlI ,rt lrl rh. sdE s d
<br />mt.dldr rr o,T.rcJ ror sh (Se.r044, Busftss and fmr.sbns clnc: Th. ConlIldoa r Lil..s Lw d*s nor .Fnly lo rn ovmr of
<br />rhc nn,rEry wh' trilts or iryh)B th.s)n. {rl eh' &s tuh wnk him:.lf or h.r*lf or ltmrSh his or hcr ovtr .nployccs,
<br />ttuvital thrr ikh i,lJmwm.h e ft ircnldl orofldr! ft)r sL.lf, h'e, rlEtoil]iry.tr [Imtror i.! $! wnhin om Fr
<br />ofoq'ldD( LIE ol,mr BuN.r * h.w rlr hnLn ol F'y!u tld lrrrlEJd d t illlduqn'EtlrF,EryIlirllFiFxol
<br />_1, .s owkr or rh. InFnr, .nr . k lunv.ly Lo.rkr rnf u h lr.flsd cont&r$ b !-ndtud rlE FDF.-i (Sd 701.4, Bosfts
<br />arl lhJlas)n C'xLr Thc Contr&nr's Lrcnsc ljw n€r dr.tDly t) {no*ncr ofpoFny wlx, bo,lds or ml'n)Es !hd.on,
<br />rnd who (.nrErk lbi surh fn,F(rs wnh . Cltnrbrrln I lknsJ nursMr k' rh. Cintrlcrtr \ l,ijcn{ b* )
<br />_l o .rmF unts S&1r
<br />lr.l.:
<br />}lIBf,EBS-.cqUfIllAIlA!pEq.AEAUq!
<br />I lErchy.litm un,icr tEn.hrntrc4ury.nc olrhc lnlk'w'ns .l(la,!riotr\:
<br />_l h,r !n *ill minru. C.nni..r. oaco.gr ro S.r-l6uE fu sxt6 .lu{E8rirr .t tn,lrrdr for b, Sdsn ]7@ or.tE
<br />L.hr Cal., ld lh Fnru of llE wt fa rtr[ rlE IEht ir it,E,
<br />-l
<br />h.I. . l wrll mrnl.D *oltcB .onp.nrar[n n$rrR.. .s ftrtrr.il h, S(r K'n ]7J0 I rtE l:hr Co&, ntr lh. IEtfi,mftc I
<br />rh. k tu whrh rhjs Fm't N 's$i My*orl.ra (,n{F.sri'n 'nsur!L..sE lrl FrlEy nunh.r rc:
<br />PotryNurnE:-
<br />_l c.n'ly rhrr m th. Frftxtrtuc of rM worl ftf, *hrh rhK lErhll r L1ru.rl, I .lull n)l.rq oy.ny FB'.6 rn, tunEr
<br />$ s to tB.m rubF.l lo llr u'ddi corFnsrbn Ler of Califomi.. !ft1qft rh 'fI rhrxLl tt(om sbj.\l bllE
<br />worl.n'compcni.rionon'ririonstrfS$rionl?Ulorrh.llhrCdd.,l.hlll.li)nhwithohtlyvithlhospmvnnrnr.
<br />WARNING: Frilrrc 6 *oE *,*k.is Ln,p.Mrbn !r'wEB. i3 unh*rul rnd shd rubFl rn .q'L'ycr b l]lrlrwl rErulrix ul
<br />(Ml tfts u0 b or hu.dr.J rh'usnd dolls (tlm.Ur), jn &rltrir ro rlE (!r o, Lrnr{'.trrrion, Jrfl3.r .' Fola.rl fdr rh.
<br />Setnn JO?6 .r rhc trh, CrL, ot.d .rn .rlllmy r ret
<br />LltrNur-coNr&[rats
<br />DECLARATION
<br />Ih.nhyrlltr'nrlcrFnzXyoltr|urrhsrIanl(trsltrndcrFn)v,rNr.l(hl|'nI(onnrn(irg*hSe.rrr?(xxrroll)fatr)nr
<br />ol rh.Ituslr$ rnl lrnL*,,r\ (irlc, dn my l(cnr tr 6lull f!tr(.r{.ll(r
<br />Cotrr
<br />gqliualr.laEJ.lNlali-&GENq
<br />I lEEny nIrE urt r Fr.lry of Frrry rni E a, r $de1.n ldr4 .3my for
<br />'lE F.ft{tllG._-c oI r,E 'dl nr t[+h rhn Fnn !
<br />tssEl lsqi. 1{)97. C'v C.l.
<br />&nla r N.m:-
<br />ATTLICAILD&CIJEAIIq!
<br />I hodry .trm udo Fnniy or Flry or or E rolhwmS 'lel,r.r$nr
<br />o.muxrn P.rmrl^rb.rlor NdrrE lrln F.Lr.l R.xul,i$nr (TnL 40, P.n6)
<br />R.q!rcd L.llcr of ltutitrrlih
<br />l.cnrfy rhrr rlE lcdcrrl r8uLll'n{ rcB,rJrf rtinor rcm)lrl rr n {'llrrhL ro rhr thrFr
<br />_l ..n8 fi.r I h.E rctl rl$ .m[.ri'n !n rhl. rhrr rlr .tnr sfomri'n ! r@er I rE €
<br />'o
<br />(,n!,1, vtrh .ll C y .d Counry
<br />ontiEL!. {d SLr. trs El{n8 b t Llft .o.rrl**rhtr .n lErcb, .urh,r EFrrtr.rir3 of rhir C y rnr Courry k .nrd uF,. ilE
<br />il$w mnrMdl p$F.ly for rrFdrn purF*s.
<br />Applicinl or l\!.nt SisElu(
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulalion
<br />Roof Sheathing
<br />Shear Wall
<br />Framinq
<br />lnsulation/Enerqy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coal
<br />Masonry
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Reporl
<br />FINAL 3-t-Zl Ec t't /4-rrrt taf
<br />Certif icate of Occupancy
<br />Notes, Remarks, Etc.
<br />Erection Pads
<br />Pool Fence
<br />Flood Zone Certil.
<br />Di&:
<br />t nJcrlAddrc(\:
<br />I
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