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BUILDING. INSPECTOR RECORD SITE-WORK DATE ID/SIG.COMMENTS Set Backs Erection Pads UFER Ground SLAB Floor Subf loor/VenVlnsulation Roof Sheathinq tr/ts/t9 Dte/v6r * 6-a Shear Wall Framing lns u latio n/Energy Drywall Brown Coat Masonry Pool Fence T-Bar Handicap Req Deputy Final Report Engineer Final Report I Z' ncCertificate of O ccu N Remarks, Etc FINAL v€{l -t ) OWNER BUILDEF DELCARATION I ho.t, .nm u'xb Fun) of Fjury thd I @ d@fl liod rlE Co rar66' Lt6g lry for rlE follo{t .aD (Se 10! l'5 BGind rd Pr!f6!io. ('6d.): An, Cn, or Coudt xnah ..quira . Fmi ro 6rdM. .lG, imFo\q damlirh or rq.i! sy slNclue Fior lo it! isue., rto c!un6lh. tpplkdl lor 3u.h Fmn lo 6k r rign d nn6dl lhn lE or Jt it licBa.d puJsdl ro rh! Fovtio6 of rE Cofierdt Lico!.d trv ((tu$s 9. Cosm*ins *in Scri.n 7000 of Divitio. I of lh. EBilB lrcr6ilN Co&) d lnr lE c rlE i ddF lhadron d rL b-i! tor 'h nk*.d dapri'n Any vioh6n ofs..lih r0l I t Uy rrplicdl for I FaEi !ub.(r ri. .p9li.an ro . ci\ il p.uty of rcr norc rhd fiv. hun&.d dolld {1100). t' t. o oru orr* popall, or Ey opb'6 $ *186 s rh.ir $k omFsbn. erll tt, lh ust rd lrE rtElr . t'l id.,i,.d q olrcd fG s]. (Sa.I)a4. Aut6 &d EokilB Co<k Th. Co'nr.r( i LitB ts d6 rcr +ply ro d orc ol tt FlFty wh. hrl&6r rp.!60E@n.,n wlr do6$cn m hiN.ll or helf or lhmuan hi! or h6 o$n mphyd. Fovn.d !h.l tu(n in'r.!t6E t n N nrdrd.d o&..1 6r $L lt hocd, da brildtB or i,Fo\d6r i! $ld *ilhin oE 16orotpki4 tlE ()\*E Buil& qi[ lIE E hddr olFDtirt rL lE.r rhc dn d hrilt or inp.oE dE FoFq 6r th. FlFEol :l - l. s ouE of llE FDrElr, e sclBiwly oilrJlh8 rih li..E d.odEim ro 6drud rlE Fijdi lS- 70.l,l. BGi"a dn hDisnoco{b TrE (bddor'. Lto* l.$ do6 br !!pl} ro d o*c olFoFtt *ho hild! inpm\drha6n. ud sho co dr ad !!<h prolxlr sih ! Co konr) lkftal FBU 'o rh. ( onrdm r Lke tt*). . I m.rnF udd Sdon - .B &e{ forrhirr@o,".'\o-zs-tr *". g WQ*L 1*r.. $ oRRrrL(' coltPr\sa I toN o[clJtallo! I hddt .rm un& poulry ofFru., oE ofrlr hlbr ins &clrnioBr ! r r,.'. .,a *,tt *m,n . Cd'lr.l. ot C"Ml to S.lfiEur. ror work6- $mp€B.lion, 6 F!v{t d ror br sdFn 1700 .f lhc L.tor ( ode for ilE Ffo'rre. ot llE rcl 6r sntn EFrn i! i$.n I hi( and will mai.rai. * or\d .odr.(!rion i6uEncr, 6 r.qun.d by Sdr nn lt 7(n or rhc ljtxrr (idc. aor rtu Faom(. ofth.$o aor trhrh rhir p6nn n ie.l lrt $orhd comlEsion iBure..'lffi ald FJIKI numb.r r. l.cdrfyrh.r in rhc F fuffi. orrh. wo lor *hih rhir Fnir i! Gu.d, I ihdl not dploy rny Fsn in .n, mffi 5 a lo bccom $bic.t lo tlE "0116 ..np.ni.lhn los of ( .lifomia &d lCR rnd il I 3hould b..om rubar lo rlE tr *4' @rrEE rion Fo\iioE ot Sdion STO0 olllE hEtr Code l rlrll. fonh$ it on9ry tr nh 0F- po\i!n6 Wi|RNING: tblurc b sE. $vld .onFdb. @!osc n unb*tuL id drll rbF e on loF 'o ainiMl Frti: Md civil nn6 up h.n hu.dral ih.osd dolle! (tllx).ofiJ), in addnion ro rn .oi of conp6{ion. 'lma86 a prorid.J aor Scrion 1076ofrh. Ilbor (i!!, i.rd md db.Et's f6 lw'-n,'l.s,.)-9-14 Df{:BAAIPN I n6!br rrfm !d.r F{n! of Fjury rlu I 6 l4E!.d uids FD\ itim otft4tq 9 (oiffilB *nh Sdn. 70m) of Dtln6n l ot rh. BEins lnd Prct6tio6 Codc. Ed ny licru t i. tull forc. dn dl(t.n COITSTRUCTIOII LFItDINC AG FIICI' ! hott y rffm uid.r Fnrhy of Fiu.y lhd lhs. it r onrrudion knding .ady for lh. Ff(jtMc of it &rt tir *lich $i! Fna a nscd lsd. 1097. Civ. C. ) AIILIIANLDI(IAAAIIA! I hdd') dIm und( p6rh) of Fjur) oE oflhc ldlosins dahrariont rrsml En Psnne^stcr NorifErrk,n Fqkrl RcslldioN (InE {0. P.n6r lrr(ttrftJ I (0.lNdLllrdidr I .gliry lhi lh. H.r.l EsuldioE rBrdins Et nG lcmrd s. d +pla.bk to lti! F!j.(. & .6iry tlln I re. Ed rhn .ppli..tion rd 1r1. thi rh. $.y. inrotuion ir .otu I {re to 6mpry wnh .ll c y .rd counyqdiffiB -d $d. r^! EliiB ro hildia @dnEiio( rn hd.6t dhoriz r.FeriivB olrhn aly od Couny ro dd rfo. dE ff-"::::;-:" ?-witr w {,,n Pm'r..n.rprrn,,: <- Nrla)Gth e eer - oP L511 faa l.i@Numb.r Forms/Steel/Holdowns Ext./lnt. Lath Flood Zone Certif. ll