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BUILDING. INSPECTOR RECORD
<br />SITE.WORK ID/SIG.COMMENTS OWNER BT]ILDER DELCANATloN
<br />I lE q, .rm u*r6 Fally ol Fju,! [', I m datF noE rlE Cmrd6 Li.m L& lor rh. folh*iE ,q,n (Sd 701 I 5
<br />Iturin6s ad Prof6ion Cod.) Aly Cty or Cou y whKh r.qt6 . Fmi' io codM, .h6. ihgmlq .ldmlah or lq.n 6y
<br />srtucruc Fior ro ir3 iste.. .bo Equi6 fic eplicar for such Fn to nE ! sisn.d ndoor rh.t h. or lhc b licda.d p@!,
<br />lo lh. FlltioB oalh. Co,rlxld! l.r(t d r,* (CtrF6 9. (-6nn'd'.8 wnh Sdio. 70m ol Dirnio. I of rlE Buir -d
<br />Prcldbc Cod.) d rhll lE or JE B crdpr tlE.non dd rlr h6L for rhc dLAGd adFion. Any violdio. of Sdln 70.1 I 5 by 6y
<br />ltplicst for ! Fn't 3ubj<t] tn. .ppli.or io . civil p@lty of rcl oor. tha iv. hu.<tr.d dollsi (t500)
<br />_1, a oeG of rh. F!F(r.6 oy opbra *nh *i*6 6 rh.n -E otrrFlnio( r'U rb tl! *6t rtl rlE rndG. mr
<br />hlaxLd or ofid.d for sl. (Sr 7044. ANind 6i1 Pma*ioN Cod. Thc Conlhctor'r l-ic@ L* d6d noi .pply to !n o*n6 oa
<br />E FtFry slb tlild or urFrB lhds( !d *lE dE Mt $o* hin&lf or lE*lf or !,ro!3t hir mha o*n dn h)6.
<br />Forlr.d rtd ruch imFololfu e mt -rdi.d...&rd tu $l. l( t {6€. rlE hrildilB o. inFl)\61d. ild *ih6 m )d
<br />ofompldion. tlE owns Buitla wil! h!v. E hd.n ofF.lins tl6 lE or 3IE drl mi toild or ii!.rv. fi. FiFt, 6r llE Fq.6. ol
<br />_I, a o*c of 0E Flpdry, d 6.lN'vcly codr!.rins silh licos.d conrr.loR r. oilrrucr rlE Fj..r (Sa 704r, &!iB
<br />lvl PmGaiD Cod. Th. Conl.rcro.r l-ic.M l-.* &'6 not
<br />'pply
<br />N m o$hd o f piopdy *lE boild! or intmvd fison,
<br />ed rho co'nr*rfd kt Flj.llt wilh r Colnr-lo(!) licduol r{l'd lo rh.Codr.crr't li@ 1i*)
<br />_ldn.rcmpl und.r S.cr
<br />D.t. Oi.6
<br />ltoRl(}:ls' conr rE sAnoN
<br />llcldaalIa!
<br />I hd*, rmm uid, Fdiy of Fiury oG onlt follor i€ &(ld.tirB
<br />_l hr!. Md will dainlain ! Ccni&alc ofconsr to S.lt-lNur. aor qnlda conrp.n.,dn, s Fovidcd for by Sdron 1700 or lhc
<br />l.tror Cod.. for lh. Ffo|M. otllE wrt for *ntt 1fi. Fmn k isu.d
<br />.-I hav. n,j r ill tr,i'nla'n *o,k.6' cotr[Ensonon rBuraN.. 6 rqu icd b] 56l mn ll7([) o f th. l:$r C.!., hr rh. tan'mM.. ol
<br />I h. s.rl i, s hirh rhis IEmir 's
<br />Bu.d M), wor lda co'ry'olqalion 'Nu. c.(unruifn'c) ntrmhq e.
<br />PolicyNunts Etpird
<br />I cdiayrhd in rh. Frfom.n .oarhc worl ror *hi.hlhir pdDrr ir ilsn d, I lhall n.r mplot.., F$n i. oy mun6
<br />$ 6 lo b..oft 3ubjEl lo th. wrld' NmDqrllir. li*! of Glifomi( .d {rr thal if I tlDuld tE(r sbjrxl lo llE
<br />\sd6 smFa.lhn pmuLsE of S.clbn l?0O orlk L&r Codc l tdl rdh*'ilh of,plr q ii lho* FD6iod
<br />WARIIINC: F ilur. lo cc @r{a .onFurnrn cor6.sc n u.L*tuI, ud ih,ll qbrd 6 mploF ro dimd FDni6 Dd
<br />ciril li.6 up ro o.. hudral ln us.l doud (tlm.om). in .{nrn6. b rh. cor of .onFMion, <l, gd a Fova.d for lh.
<br />sdr6n 1076 .f rll. l rbr (ixla inrdd nl
<br />DECIIAAIIO!
<br />I h@by lmrm u.d6 FElty o f Fjury lhlr I m lic.rE d und6 Flliion of Ch.Fa 9 {coffiin8 *nn S..rion 7000) ol DivrDn I
<br />of rb. nui,B Mn PEldioN Cod., .r'd o, la6e i! in aul fo(..d.ftftr
<br />Li.d& CLs:-Lk@ Numbdl
<br />-",3/zt/ t+"*"',+F'r 6F Y'
<br />COIIIBI]CITABI.IdDIIG.AGEIi(A
<br />I hd.b,.rm undd F ny of {Ejnryrhd the ir. @irntodnn End'ng asc, forih. Ffoffi. of th. * tforshrchrfinFnil it
<br />ilrucd (se 1097. ( iv c).
<br />AIIIJ(AII.TECIJSAIIO!
<br />I lErt'y dnm' u.d6 ,aalty ol pdjury orc of ih. fullo*i.! ddlfd ionr
<br />Dgmlhion Pmhr-Atbdor NorifEd kr F.d.r.lR.guLriJN {Tnt. t0. Pd6)
<br />Rcqut.d tdrd otNoiatr'li'n
<br />I cdrt ihd rh. lcddd r.Buldio6 rterdrg Bbdor rm\ d r. mr .ppl.rbk to rh! poltrl
<br />-l
<br />cslily lhd I h.1c R.d lhir .prltolioo dd x c lhd llE .t v. i.aonmlion ir .oret. l &8re to onndy *nh lll Cn! ind Cour y
<br />ord,ne6 !d Srd. ljuJ rd.i!{ to h,illiu ol*n lioc an hacbr ldlsriz ,.Fsri n 6 of rhu Cny !d Coudt !o 6rd upon d.
<br />^"'-y'l-/re-
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Roof Sheathing
<br />Shear Wall
<br />Frami ng
<br />lnsulation/Energy
<br />Drylvall
<br />Ext./lnt. Lath
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif.
<br />FINAL tlttltaf,llh^rrran-2>)
<br />Certificate of Occu n
<br />Notes Remarks, Etc.
<br />DATE
<br />Set Backs
<br />Subf loor/VenVlnsulation
<br />Brown Coat
<br />!ho\c mtio..d FoFly fd in+.dio. etr-i.")",^,""^,"^W
<br />."^u*-,*n*,, F./i" 6^*+
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