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SITE-WORK DATE ID/SIG.COMMENTS oWNEI BUII,DER DEII'ARATION
<br />I lErchy lrtrm unl.r af,Mlry ( n qury rhdr I m .r.ipr ton ih. Codrr.lm t.ieni. ljw lor rh. lottuean8 r.A'n rs.c 7o.tl 5
<br />Burikr\ rid Pioac(li,n c(d.r An, ciry or Cou y shth rauiB r FnDh r. .on{tu.r. !lrs. itr{,.oE- &mlnt or EFr dy
<br />nMtuE, Fn ro ilr nsuN- .ko Equftr tlr lpllrrnr ,or su(h lErmit ro iL u sraEd {ll.m.t rhi lE or rlr ir liansd Frrr.nr
<br />tu rlr lhiri,B of llE Conr&r. Lft.*d ljw lclEpr.r 9. Comrrng *nh Sdi,n 7uD ot Dnilh. .l or rh. 8liircr. rnd
<br />PDr.shn. Cod.r oi rh lE or \h. i\ cr.mpl rh.rcriom rnd rh. h.( for rtE iLscd .rcnt'lion. Atry vbLior or Sdmn 70.1I 5 lry uy
<br />{,pltul lor . Fmi slbFdr th. qflkanr ro r civil n mlr y ot mr frft rh, lir. hundrn dol|[r ( t5(DJ.
<br />_1. $ ouBr ol rlE F,Fnr, !m cr.lGiEly o r..l i.3 wirh lkcn*d .ohrdoB nr 6n(ruc[h. Frrl (s( ,ot l. BunFr
<br />.d Ptltl<irCnJc'rh.Coolr..1or'rLic.ns.lrwd,ritrnr&lyr{'.nor.dof,lloFdr*h,hiHrorimrn*rtrhdon.
<br />! *n' m Nr ftr sn FnjEl\ wirh a conhcnio l..n(d tuF@rbrlt a'lllB-lm r l-](ctrr u{r
<br />I !mcr.npr und.r Smton_
<br />l).1.
<br />lvt)I{(Ftts ( o{PI\s,r f ro\
<br />l2l;grLEIUOl
<br />I h!rrh) rrrrtr)nftlrr tf,nrlr\ nr |r.r,trry ok,'lrlk l,,ll(^\ iIF dL(L,xrrntr
<br />-l
<br />h!\r rid qrllminrin ! (-cniaf,lt. of Coos n! S.liInrurc lor nrksr oqH{thn. $ pn\iidl for h, Serion.t7(X) ofrtE
<br />lrtx, Cod., f{tr rlE lcformB. ol lrE *od. rn *hih rh. Ignit i iskn
<br />I hrvc lnd trillnuiniri'r *orkr( coqr.n\.rr,n 'mxrih:c. !r BtuircJ hysaai{[.17(r).t rhc Iih.r (idc. ntr rh. n itmu .of
<br />rhc lrrk ld shi.h rhnFrn,ir '\ i\sE1t [t) r ortd<' .Dmltns! nn ,n\urrn.r .trtrr a'rl lx,lry trun]hcr uc.
<br />-l
<br />. irt rhrr in lL tEforoR ol rh. *r ( ror *hih riir F,mn n nsu.d- I rh.U mt .n{,loy m, txRr in .ry nsFy, s '. tEdrm .ubFr tu rtE s(tsi $ryEnsrri.n l,wr ur Calirornir. *t rsfr rhd ir I ilbuld li.or uhFr to rlEhii(i orqEnnrion pmvti)ni ol Sccr ion .171x) of tlf, trb. Cd.. I {Ett ftnhqirh mrllry *nh rbr FsririnNWARI{INC rntuc lo suE mrt.is NqE.qrbr d,vcnsc h unh*tul. r'n ch.ll rubFd m.rq,hF ro cinind Fmia! &d
<br />civil fimr ut ro oft hunt En thousnd dotts (1100,fi), in.(l(|ithn to ttE drs or oqEnsrion. drror.r !r,,mrt.d to, rh.Sdn. 1076.f rtF I rtq C.d.. irt.En r l!n.my'rtrr \ i .D.,.: reeuor, K l'l\tlann \\ttQ9LI?F\SF! tolYrl f-nrn
<br />DI4IASAIXN
<br />I h.6h, amrm unLr IEErt, rF.jurtrh4I.n ltr.r.d ud.r F)$iin oao!.fl6I (mmfttuin* snh S.clirnT(rrO).fDivirhn l
<br />ol rh Busir\r d Pn,rdrhnr ctn , !t!d my lE..c ir in tull foat ud c,Iccr
<br />"--"..K 0.&c[Uftg
<br />coNsrf,ucTt(N r r{rrrN(: ,r(:rN(Y
<br />I rr..l', rtm und$ Fndry of F.rry lhtr rrFc n . 6.(Blhn Enin8 !8.my lor rrr Frforns. 6r . r6rk tor *hth rht Fni k
<br />hsxn (Sd 1097. Civ. C,
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />44.f1>.ffitl>:
<br />Shear Wall
<br />Fram i
<br />lnsulation/Ene
<br />D all
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Mason
<br />Pool Fence
<br />D eputy Final Report
<br />En ineer Final R ort
<br />Flood Zone Certif .
<br />FINAL 'l-9-I Y"W"r0)
<br />Cerlif icate of Occupancy
<br />Notes Remarks Etc.
<br />BUILDING. INSPECTOR RECORO
<br />_1. rr uwEr ol rlr ImFny. or my.rrl,Fcs *nh srgc\ r. ilri qrt .r'nllxtr$ri'n. wrllto rtE *(rl &d rh. {M@ B mr
<br />inr8rttl or aniEd n, {k (S( 7l}{,1, Bu'iF! .nd Prof6$n! Cdt Tlx ( ., n.Jor'\ Lic.r liw des mt .l)I'ly lo M o}F {f
<br />rhc nn'IEtu *b h{iLlr o.ililr,B rlrrd rd vln drE tuh *r'* h,mrllor tErrlfor lh^'ugh his or h.r o*n.mph!dr,
<br />[ovil.d th.r *h nqm*ftnr & ml n.id.d d of.r.d (, sL lt hnk6. rlE l[iHiq or irr{mEnE n y,U rnhm "r Frorcon{rkria llD ()*ffi Builld qillhrR rtr hhko ol ForinS lhd h. or sh. dil nn tuitt or irts,e E F,IEny tn rtE InrFE ol
<br />appt r(-{uT nfcr ^iJrTr()rtI M,.trmoid.r F hy or Fpy oE ot rlE fnlk *int &chErionr:
<br />Dcmlihr P6mi'r.AstEnor Ndifi..rion F.d.EI RcSuLtir.! (Tirlc ito, Pd6l
<br />-R.auiEd
<br />tdrd ol NdilErirn
<br />_I cdiry
<br />'hd
<br />rh. rcd.d rcllLt h6 ESrnirB .rh.rB cmttl m n't .r'lttrbt to fik |,rF.
<br />-lc.ifyrhdItrv.Edrhi!.pplktbn.rn{.r.thntlr.lbEmtomri,nirctmrt!g@ro..dFlywnh.[Cn,.idCooityordiBmc! 8rd srd. L.vt ELtlt ro hlfiin! Nnn{4rior rn ffiy {,rlFtr. ErnEnrxiri or rtu. City ,Jrd Counir ro .lra upon r
<br />et$rc EnrnEd poFny ft{ inrFciior prFE . I I I .
<br />^ppr(D,q^s6,srdo' *\d'^@"^-L. .,. qlEilll-
<br />P.r,rrn @ rDrlrrr: d U
<br />UFER Ground
<br />Roof Sheathino
<br />T-Bar
<br />Handicap Req.
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