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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS oruiB Bt tLDEa Diul^r rtoN
<br />I ltrt', lnim !d.r ,.Mhy or Frjury rhd I m .r.rpl flm
<br />'lE
<br />Codnclou Ltn$ L., for rll tolL*ry 6$n (S<.70J 1 ,
<br />susinc$ rfil Pmlerion C.d.) Any Cny or (\unty whrh E.tuiEr r tEdir to .ornn(, iXd, mPmw. rhmliih or r.Fn.hy
<br />srtErE. rirfi, ill trucc. \o rquir. rrE rppli..d lor su.hF nil !o lil. EisEn $dcnEl tlbr lt.r rlt ir limed Inrulu
<br />rd ih. Imvisions 6f r,i Cmr(ror'l La.n-d Ls (Ch.pla 9. Comrmi.a rnh Sarhn 70@ of Divhi'n I of rlE aunr$ .nd
<br />Pmli$,.r Cd.) c rld lE d tE n rr.q{ lnRf,m rn tu hGir fot rlt rlLg.d crcqrr-. Ary vbhlbr orsciion'70:] L by uy
<br />lmlkr,l n, r Fm' $bFNrE rptlkrr ro . ovrl p.Ehy ol ftx mrE ih.n fitc hodrn dolB {$m,
<br />l..r owmr olrh. FoFny, m my.n{lo}r.t wirh *a86 &r rh.ir sk omFndion, willd., tlr wdt rd llE fir1E is ml
<br />intoxLd or o,IcEn lor .b {Se.7044. Bu.irE$ .nd ProfdsioB Con : Th€ C.nlrdroir Ltcrs Lre drr d .!tly ro owM ol
<br />rlE FoFny vho hil&.r nTnB U.m( !d *ho dd sh hrt hirulf or t**lf or rh^,uth hit 6 lEr own.nphys,
<br />pmvij.d rlll tuli lqecEn! e ld hdddotrold ftr sh Il lrffi. dEtuiElt nFlwd ! Dld r$nrw F.
<br />ol oq'trin tlE ol]d BoBd *i! hk dE hrLn or FovilE lnr rE r tE dil ml 1!i! r ,p.re ltE F{Ery frr dt Ftrr of
<br />-r,
<br />\rwmolrhc pmn ny..mcrclu\ivcly lonl,Nirr *irh lic.osd contrdoN h !\,nnrud rh. !mj.! (S( lo+4. BurE$
<br />rd lh'li\sir Codc:1'h. Conreloas Lic.n$ L,!w des mr lprlyi(, m owmr orlbFrly rho blilds.r
<br />'nnrorcs
<br />thcrsn.
<br />d wtk, o.hds ror qn ImJGns *irh ! C..rs-lo(o lic.sd ruruor tu rlxc(drd(tr 3 taM t *)
<br />I u.E {x u'd.r Setin
<br />WORKERS' COIIIPFAISATI(}N
<br />TIIT!$AION
<br />I tFrchy rrfim!nd.i rEDlry of rErjury orc.lrtr n,[o*ins d6Lrdi(,n\
<br />I h.E rn rill midri. Ccnif*l.ofctu ro S.lfl!l@ td * 16 o"FBra.. a FlriLd fd b, SElir l7m of dt
<br />tftr C.d.. fd tlE Frfru ollrE ,sl lor tiidr tE Fin ir i!qr.d.
<br />_l hIE !.d wilr midrin work.n .ompcn rioo i urrEc, .r rotliEn by Sdio. l7m or tlE L$or Oxl, rn itE FndmE! or
<br />.* q(/1e c0Y\1V lns F\^l^cl 0\ IJo 20./.I
<br />-l
<br />c.nifv rhi in the Frfqmr.oaih.hrl to. shkh
<br />'his
<br />p.rm( ir irs!.n.1rh.llnor cn{,loy.., Frc. in.ny mE
<br />$ i.lr,tx.om bi{r to rtE wkEl omFn!.rion hvs of Cllifomi!, lrl |gE tltrt ilI rh,uld b€.oE ruhr..r lollE
<br />wrl6 orrENlho F vnioB of Sdi.,n l?@ or rlt Lrb6r Cr,&, I .ldl lonhwilh oiqlly Eilh lhs PnvlrhB
<br />I4ARN|NG: Frihrc ro Em nrl.F oqEndbn ovn8c n unl.stul !!n rlrI lnFl u 6,ptF io dini.d FElat.d_
<br />.Nl Iira uf tr, om hoBiGn rhuqrld dolLr. illm.o@,
<br />4
<br />S<rnn t0r6 ol tlE Ltts C&.
<br />,",..4\l,h 14 ON
<br />I ltcny drm u,!d.r Frl,y of Frrry rhi I d liat n uild Frvni,n of Orpls 9 (@lmftbg witn serit. 70@) ol Diririt. l
<br />of rlE AuiEs ltd Pio[6iiE Cod.. rrd ay l..M i h tull tor.,n.rftt.
<br />c-)b b13
<br />- tl llol2Zq.-,*d\
<br />rolrllucllrJ!.l.EuluilcENtt
<br />I lEEby rrrm u,rlr Fuhy ot Frrur, tur rlE ! ir . $trrMirn ktninS .!.Ey f.r llE Ffor,t[re of !,8 ktrl tor *iah ihir lEtu n
<br />tq.d (sd.:1097. civ. c.)
<br />t nd..r Add.s:
<br />-
<br />arlL&Adr.lEqlSAlxl!
<br />I hdrt y rnim und.. Fn.hy or IsJu.y orc of rh. nnhwi4 d(hrlnrn!
<br />D.trrition P.rmih-AstE(oi Nolificrtion lcd60l Rquldions {Tnt 40. Pd6}
<br />-Pstumn Ldra ol ttrirrcnn
<br />a.<l_Eiiry rh{ rlE Lrld.l ESuL&F ESrdhS r.6.rlc rcmvd E bl +9la.bk ro ihir pmF
<br />qC(6ir, rh.r I h.vc Brd !h! .0plirlio. !d ilr€ lhd 0E ltnw innmrlhn i! .otr.d I .rE ro 6npiy *Ih .rl Chy Dd Coutt
<br />ordnurk{\ rkl srlrc L.w\ EhrinA ro huildir3 con\r sc urvr\ ufrhh ('iry rtrll (nunry rr ctrr.r ulrtrrrlr
<br />dbr ft nri,md pmtEny fc nlP.cl 4r.-*l]-t lsae\pplil{ ror \rmrSisD Un.
<br />oL\
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Sublloor/VenUl nsulalion Jl
<br />Roof Sheathinq Zll4"t DTJ}'7
<br />Framing
<br />lnsulationi Energy
<br />Drywall
<br />Brown Coat
<br />Masonry
<br />T-Bar
<br />Handicap Beq
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />FINAL Z/z?/zt D4+34
<br />Certilicate of Occupancy
<br />Notes, Remarks, Etc
<br />Rev. 0B'07.2015
<br />Shear Wall
<br />Ext./lnt. Lath
<br />Pool Fence
<br />a&Af In
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