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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subfloor/VenVl nsulation
<br />Roof Sheathing +-t.-/?x,ftaJ\ I
<br />Shear Wall u rlJ
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<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 />rw.fr\FINAL ,/h_-
<br />Certificate of Occu pancy 7a
<br />Noteg, Remarks, Etc A\
<br />ltodL 4.1 \\:7
<br />(
<br />OWNER IIUILDER DELCARATTON
<br />I h6.b, rmm undd po.lly of IEjury rhrl I an 6mp( eom lh. conlr.cloB Lic.n$ La* ior lhc tullowing rcen (56 701.1.5
<br />lJEinB! &d Prol63ion aod.) Ant Cily or County shich rcqrn6 a Fmn lo coNlrucl, rh6. iDprov.. {,.nolGh or r+& dy
<br />rlrucl@, prior ro il! ilsEcc. ltro GqutrB th. lpplter lor surh Fmn b fik a sisncd sralml tha lE o, dr i! lico!.d 0@d
<br />to 'h. F)vi5ioN ofd. Coot,etoit Lrc.ned L!*'(Cl'rpr6 9, Com..cinr $iih Setion 7000 olDivisbn 3 oflh. Buin6 ed
<br />arofsion! ( o.tc) or rhd h. or ih. i! .r.mrl rha.tom ed rh. hsi! for rh. all.r.d crdp(ion Ary violdion ofs.clion 701 I 5 by ay
<br />applicol ao.0 Fmil subj*ls th. lppli..nt lo scivilpcmkyolml n rclho fivc hundEd doUd {lt00l
<br />l.6 owofrn tmp6ry, or mr.nplors *nh wrB6 d fi.n $L.onFsdbr
<br />"iU
<br />(I) rh.sorl sd tE srn-1@ i! rcr
<br />t ord.d or ofr6.d lor sr. (58.7044, B6iIg ud PmfdioE Cod.: Th. ColnD.lorr Lrdg llw &6 @r 'p'lr ro M 0*16 of
<br />rh. FDFry * rb bil<l 6 iigo6 rlE6tr ai *lE rh< i(h 6rI hiNlf or haklaor lhmu8l his or hg ou dtrplolB,
<br />Fovidai llr! iuch i6F!r66r! e @r imdlrLd d ollsld 6r nL l( ho\rtg, $. hlilili,S or inprwaEl ir old witnir oE ,6
<br />ofcorqkio( E O*n6 Buil,a will llw tlE hrh ofFDvilts $r lE or,E dij bl hild o, oFo6 th. FFr, 6r tlE Frpo- of
<br />-1.
<br />B o*E ol $. FlFty. @ d.lBiv.ly .om-1trls wirh licqa.d .otuoB ro ftnfud tlE Foid (56. 70.1.1. ttEirE
<br />lrd hDkih C.&: Thc Cofi.cror'! Lkru L.w do6 mr .pply ro & o*G of p.oFry who b{it6 or inprovd ficdn.
<br />lid *ho od6.]13 fo.3uh tmFrsth i C.nElo(3) ltqa.d pdd b th.Cod6croi! Ltoe Le).
<br />_l m crdpl uidq Scrion_. B & P C for thir la$n.
<br />.ulStrESl:.cqUlEdSAnO!
<br />DECIJAAIIA!
<br />I Hry .rm lnda Fliy of Fjlry oE of llE folhwll8 ddlsrioBl
<br />-l
<br />h.v. !n will minrjn r C6lifrd. of Co.d io S.ll-lM fd wl6 @np.n{lior\ s FoliLd for by SanD. l70O .f E
<br />Ir&, Cdr{q rlE Dafollrla. or rlE sdl f.r *,iEh rh. F 6 B!.d
<br />Zt U,. .oa *itt *n.,n *o*6r' ompqsFn trW.. s rcquiEd by Sdion ITOO otllt t lor Cod., ror lh. FfM. ol
<br />lh. sul for wtth thi! FEil i io.d My 6Ld oEpddion idllfu @ir dd polty sdbd n:
<br />9 7.a f< irr-r--[..,
<br />."-o 7ct -7 =^,/-zo_l .61it rhn 6 {r Fh,lr@. of E*!rIi6trlthOnFrnnilrrd.InE[mraphysyF$nin&yI]{,e
<br />- B lo bdor etiel ro tlE Nn6'o,FErion L$! of Cdifomi{ !d tsr llld rrl $ould bdo4 etirt io E
<br />*0*6 onFEdbn FDvirbE ofs.d6n lr00 oflb. LEn Code I JrlL tdrhsnh o,ely * irh $o* F\i]ioB.\r ENlrc f.ituE lo c@ NrLd' @n{EBrbn or6rs. i unL$tul.rd 3h.I $t*< ! dploF lo aiEin l Fdii lld
<br />.nil fG up ro oc hu,!d.d rlbcad.lolbs (tlm.om), in ndnioo io rlE.or of onFGdion. dsus6 a Fovilcd lor $c
<br />Scrion:1076 ofrh. bbor (o<la i sd edrnorEy t
<br />{, *,3'2<:'/9
<br />I hdrt y .trm uflla FrXy of Fjury rhd I h liE!.d u,rd6 Flvi'br of cluF6 9 (@tl:j,E6e rnn Sdih 7000) of Dnilior l
<br />ol tlE BciB !d PEt6i,B Coda -d hy lic t h tuU for rn cFd.
<br />/-/l*,Y"5- zs--12 ,"",,,,...
<br />I hcrby dtm 6d6 Fsny of Fj6y 61 lta. it . odtu ti6 fndiB .ecy &,. ll. Fhr|Er of lb. wt tu rtih lin Fdi it
<br />i&rd (sd. 109r. civ. c. ).
<br />artttcasl.rggAaara!
<br />I halby rtrm ui& panny of Fia, oE of iE follo* i,e d6hDrio6:
<br />t srclitirn Pa,ny^rt nG tlorifr.ri.o F.(b.l !{.suldbB finb 40. Pm6)
<br />-R.quiEd
<br />L.ll6 of fhi6..rior
<br />I cdr'ry lhi rlE r.<td.l esukrioN cg.dins a$dos r.mlal e nor +plkrbk h rhir F.Fd
<br />-l
<br />csiiry rhd I hr'. rad lht .r,plt ion !d nd. thd lh. .tor. inforndion it co(61. t axE lo @nlply I'ifi .ll cir! .,i counry
<br />ord'@tu6 lii Sln. h*i Ebins ro btrildins .o^rru.riu\,d hd.lly !uir6rn. r.F6dri!6 oathn Cn, dd County lo 6lq uFn llE
<br />ltsrc m6rFn.d p.opsiy for
<br />^,,,3^25^-'t7ipplic t or Atml SIItr{l
<br />r.mllfr n.m.(prlrl,:C az-z
<br />Iv!frAl
<br />Set Backs
<br />Brown Coat
<br />q7/d
<br />. 32 I
<br />f T------
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