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BUILDING- INSPECTOR REGORD SITE.WORK DATE ID/SIG.COMMENTS OWNER BI]ILDER DEL(ARATION I hs.try lmrm undd pco.hy of ,rjuD_ lhll I 6 .xmfl fiom lhc ConlEdoc' Lic.nk bs for th. rolbwbg r.en (Sd T()lr I 5 BBin6! a l Ptof*ion cod.): Any cn, or cou y $hi.h r.Iut6 . pdmit ro otrsldcl, rlt6, improve dflolBh ur r.run uy {tudu4 Fetr b ils B!oec., .t r.qriE lh. .ppli.d for soch Fnnir to fik . siBn d srllmnr thlr tE or slE ar hcs.d pNanr (, rhc FovilioN.rthc Conticrd r LE.n*n Lr* (ChsPr6 9. Comftrg rnh sdi.n 7lrco of Divisio. 1 ofth. tturid d Phadlnlm ftrd.) or thar tE or sh. is.rmp! rhqcfron Md rh. barb tor rh. rllcscd .roFion Any vblllio. ofs.dhn 7U:ll 5 bt tny rpplica.t for a p6nil slhjdB llE rpplicml to r civ il p.nalry o f nol mo.. lha fiv. huftt .d dolles { 1500) -1. a osF olrh. Flpdty, or my dploy6 *nh urs6 6 $cn $E co,rF.sdion, sill d. tlE $ril ad dE n iw i! mt idorr.d or .fid.d aor sL (Sc 7Ol-4. BuiB sd PrnasioG Cod. Th. Conlrlcld ! Li# L$ <to6 nor Sply lo e ouffi oa th. FtrFry who bil& or irqevB llicotr ad who &6 si wd fiielt or lE*lf or rhmush hi! M h6 o*r @doyG. p.orid.d lh.huch hForsEr! E hl htdiLd or olH 6. slc l[ ho$6q. dE hrildi4 d in*roigid ! $! sithi. onc ta or mnpktioE rlE O\h6 Buil(b wiu tsr tlE hrtdr ofFoviDs Ulr lE or CE dil ml hild m i@.or. lhc FoFt, for tlE FiIDs ol -1. 6 otrE orrh. F!r,sry. u dctunrD co,nr.crins uirh licds.d co,iI.noE lo oisrucr rtt F.j.tr (sd 7044. BGIB rnd hnism C6d.: Tn. conli.doi ! Li..M ltw d66 mr rpplr ro 6 o$ru oaproFry {ho buildr or iFprcv6 rho6n. ,nd who codd. for 3uch FaFs unh r Co'irado(s) ltqE d pr4@n ro rh. Coilr.dd'r LkG t e ). I er.rmfl und, s&1ion . B & Pc forrhllten }AB5EIII-CgITIINTAIIOI D&gdaarrax I h6.ny rmm u.dd Fuh, olFjurt or. oarh. aollos ine {k ledioc: -l ll.E.tdtritl i.r.i. . Csri6.r. of Co6ar b S.lfiM for *.rldr' 6mF.rlio'\ 6 Fo\it d fot by Salb! 1700 .f iE r.bd Co<lc fr rh. Ffolr!.d o f dE eqt for rtrtcrr rhc Fin a i.u.d lll t.'..ln *itt *in.in *t6- o,F6dior iffiq ! Equind by Sdtioo l?m old. !rbo. Cod., lor tt Ffffi of rh. v t ld whi.h rhir FEn i iE d My eql6- orpdrbn irffi @; rd polat r@bd Gl scat QIL,iPL\c* lrt<l19 _l cdiry rhlt u tL Ffllrre. otrh. *orl f.r $h(h rhis Fmn i! is.4 I ndl mr @plot &y pqen irot mtE s s ro barft sbrd to rlE wl6'omFMbn Lss of C.lifomi{ dd tsr lht ial lrhut b<om sl*{ to rlE u!.t6 on{EMio. ForirbB of Scrih ! 7@ of rlE L.hor Code l JErl fdnsilh 6dr snn thor Fovti,B. \'IARNINC F il@ r. sG,mla 66pddb. 6ra+r ir mt wtul. ild tlEll $bj6l s orploF lo <min l Fdil dd .nrl n.6 up 'o oG hu,!&.d rnourld d.ll,s ltlm.ooo Sdir:1076.f rh. t t r Codq hr.d ud rndrEy'r tc. ), in ddhhn ro rhc cor ol DECIjSAITO! I hdlny ifim u.& Frn, ol Fjury lhn I o liG!.d ur& Flvtior of cluFd 9 (ollljlBme *ih Sdio. ,000) or Dirnion l ol rlE BBnB drd Pr!l6io6 cod.. rd oy lie t h tul! foe rld.ftd. c1L{O bq8 o r-\oL{ I I al CAIIIAUCIIOII.ENIIIGIGIICL I h.Eby lrm unds FEly olFju'y rht rlE a ! o,srucrio. lad$s reat tor rlE Ffo'l:rtr. of lh. *ut 6r r'b.h rnir p<oit i! ist.d (Sa 109?. Civ C). AIIUIAILDICIJEAIIOX I hdrtr afm undd Fuhy of Fjury oc oarlE aollo$ins d..lrdioN Lrsmhion PoTit!-A3b6lor Nolificd6n F.d6d R.rulalioE (TnL {0. Ptn6) -R.quiEd t.16 ot Noti6cdiJ. I .dif} rhd rh. I.nd.l r.8ularioN l.3rdin! ab.rtos rmovrl e. ml applicabL lo th4 p..j..r -l cdiry$d I h!v. rad lhi! lppl,c io. dd srtrclha rh. abov. inlomaio. is cotrd. I .sre to .onply uith dl Cny tnd ( ounr, ord'n!(6 d Srat. I iur chr ins ro bxildins codlrtudion, .tFv. m6li.ncd preFny aor iNpcclion pupo6. rcF6a dn6 of thir Cily ed Corlr b drd upon rlE ,\ooli(rnl or ,{renl skn.nrr€ P.*rR n.n.{prfn,,: fu" "a +<;tl" ,"," dzlty ll.) Set Backs Erection Pads UFER Ground SLAB Floor Subf loor/VenUlnsulation Roof Sheathing Shear Wall Framing ln sulation/E ne rgy Drylvall Ext./lnt. Lath 2-l+-t1 lI.l{&) Brown Coat 3-t3-t"l T-UM *+asonrf- Jct,lrlvtr 2-zl-11 *.t*41 Pool Fence \J T-Bar Handicap Req. Deputy Final Report Engineer Final Report Flood Zone Certif ,t FINAL )/24 ////*nozn-//9 Certi ficate of Occupancy Notes, Remarks, Etc Forms/Steel/Holdowns glovttq B