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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS owNEr UutLDEr DfrC{&rrrutt _
<br />I h.n5y ilrrm uid.r pcMlly or Fry.y lhn I u .r.rr, fNm lh. Cdr..r(6 l-iar bw for rlE folbe& Bsn (S( ?011.5
<br />Businc$ ad Pml$li,n C.dc) Any Cny or Comry whrh r.quiEs r F,n !o .oaiuL aks. 60ow. &mlish or EFir dy
<br />rltrrurc pim io irr kumc. clv' EquiE\ th. aFlicrfl d ru.h Frmir b lil. ! riSn d slelc'El thlr lE or rlE ! liccntd ,uodr
<br />h rlE p.ovtrions of rlr Conrrroir l-i.cn.d L:e (Cnlpr.r 9, comftir8 enh Sarion 70O ol Divni.n I ot ltr Butid!! ed
<br />PrcsbnrGxt)orrh.rlEdslEB.r.np{rrEim.,ntlEh.rirforlh.lLr.n.r.n{rh.4.,vaohri,nofsditn701IJbyx,
<br />.ppli..d fo. r Frdr bFB tlE rptlkdr ro . .ivil p.Ehy of m' nm tn.n firc hutnEd dollrr (t5m)
<br />-1,
<br />$ o*d olrlr FlFny, d ny.nploF! wnh *.,s ri llEn sloqEnqlhc *iU & dE ktl.rn dE !$tu ir rr
<br />mrodd or ofi.Ed for ek (SE.?044. BltiFlr Nd PFfcrioB Ci.l.: TtE q) Edtr'. Li.n* trs dEr ml rl,l,l, ro M o*F or
<br />ih.FDFdy wtti toiik or irprbB ttm( url wtD der rsh sll hitucla or lE*lf or thmu8n hi{ n h.r own.mpLyc6,
<br />ptuld.d dEr ru.h imFowftemli.nd.do.off..!drmaL.lr,rbrtG.dEhlirli.gorinpr.EE.li!eld*thinftrsr
<br />of.drphia llE owE BuiEd wil llt dE hrdo ofFsins ll lE-dt dil n, hi! d it!.wllE FqEly for tlE B,FE of
<br />_1, !\o*EolrM F.IErr. mcrchii*lroddnS qtrh lr.nrd cdrur(m t'.r,trrMr lrx F(!,.d 156.7044. AunlK
<br />dul Pr{ctin ('(xi.: Th. Conk-(r\ I-ien..Ilw drx. R rpFly lo u o*rr .f nmFn, *ho i'oildr or inl,NEs thc6n.
<br />lnd who onruclx lor skh Fsjccrs *irh 6 C. mlonO lirni.d luBulnl lo lh.Codnclo/r LtctrE Lrw).
<br />_I d .kDF un&r serirr- 6 tL P C. f( thil abn
<br />D.r. Oxtr
<br />:llxrur-snMlorarrxils(l48atrQ!
<br />I h.rcby.fl.ror undd Frdlryorr(rxryom of E aolro*rA dclq.lions:
<br />_t hIE nd *ill minr.jr a C.dirr.r. olcoBnr ro S.lf-Iff@ fc Ert6 @rtErqioL ( FDeiLd for by Serbn lrm oallE
<br />l.bor C.d.. fd rlE Fiorrc ofrlE mlt td rtin rFnil i ir$.d.
<br />_l hrE .ri wlll m! .i. mrt B orp.B.rbn il[uE. B ,quir.n by sdir.l7m of rh.lrln C.d., fr llt IEfm of
<br />rrE rcrl tr whih fin Fmn b i$u.d M, *(tds @'rltndtn i.ffi .4ir tn lblty NtrlE E:
<br />Pulk.. Numhr
<br />-linir\
<br />I.d,fyrld i. rlr F lmE orrll hrt fq *hih rhir Frnn ir i$Ed, I rhll d.f,pby.ny rEsn ir by md
<br />s r\ ro benft sbr.r ro rtE {d*6 $qEndrn L$ ol Olifomia !n .td lhd ir I ltnuld b.<.r rubF!
<br />'o
<br />tlE
<br />mdcB or,IEtrqron Fovisbc ol S..1iotr l?m of rh. Lthtr Cqj.. I .hll, ftdhwirh onply qirh tlnr tmythns.
<br />WARNINC Fiilurc ro scB wortch' onwn$rn,n ovft8. k unlt*ful, a thdll .uhj6t on .nrlo,tr lo rimlnil FMlti.s td
<br />.ivil nrcs up ro o,E hufllEd rlFuod doll&s (lloo,ofti). i. {ddili,n to rtE .o( .r com0cnstion. dnm8.3 ( pmvil.d fot rrr
<br />s.dion 1076 or rtE Llrg C6d.. im.E{ rnd ilmyt 16
<br />Drr.: Applor:
<br />r rcr:rsnri trrrrrciorlllllSalrq!
<br />I hcEby afii,m unic. Fnrlty nf 0crprr rhrl l,m liftn*d und.r F)vision of (n0pt€ 9l.omErins *irh Sdrirn 7fiIj) o{lrvnion,1
<br />ur th. Buliks md Pflf.$ionr Co&, itn
<br />'ny
<br />licctre n in rrll tnrc aJd .l1((
<br />qlrJslauijlr0NrBuNq-uiEdcr
<br />I lEEby .mm !nd.r Ftulry ot Frjury rhd rh.E ir r $nrulbn Ltdins rs.rt tu rr. tEfolrr4. (,r llE qorl lor rlr.h rhn tEmi i
<br />ro.d ISN l(l)7.C'v C ).
<br />A.tILIIANLDECIJSAIIO!
<br />I hdlbyafrmun&r F llyolpsJuryom of0E rolhtin! d.clrtrin.rl
<br />Ocmhir. P.rmar.AslBt6 Ndifrdnn &al RquLl$nr (TirL,lO. Pd6r
<br />RcquiFd tdr.r ol Miirdir
<br />Irrni,irl r 0r lrd.tulrcloldhtr\ rrx (lill! rltr {r! nlr,v.rl rrc ar llnll'.trh1. n, rhi\ l)n'l(r
<br />-l
<br />cdrrt thr I llE E d tht +pli.srioi .d crrc lha dE rr,E i.fomi,n ( cftl I l8ld lo N4ry snh dl Cry ud ClMy
<br />ctlin.rE rdSur.t *. rbriB ro boildinS .onfubtr !n h.E6y dhorit EFt.rdi6 or rii! Ci',.,n C.u'ry b ols q-r dE
<br />.trw mrior'.d FrcrEry td ir$6rio. trF6.
<br />Ir)t,!i.,mt nr lArnr sirarture
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Roof Sheathing -7-6-a ,uhi k la /EPT
<br />Shear Wall
<br />Framino
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />[/asonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif .
<br />.h_,4)
<br />FINAL //6/V/C W&
<br />Certif icate ol Occupancy
<br />Notes, Remarks, Etc.
<br />JP\ d" jq,,4t\l ud.c*,r6 x4.-4U JhU)4u"6
<br />Rev. 08-07 2015
<br />CuEr
<br />Subf loor/VenVl nsulation
<br />/J,U//h
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