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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS oWNl,lt B Ull,l)llla DllLcAl{ ATIoN
<br />I h.reby !fiirn, und.r p.rrlry of p.rjury rhar I m.r.npt rom rh. abddto^ l-ien!. ljw lor rh. ,ollo*ing r.aen {Sd.7011.5
<br />Uusincs ,nd Pro|*nu C.dc): Any Ciry or Cou.ry whi.h rcqoins ! IErmn h.oinncr, llrcr, impr.vc, dtmlish .r RPan any
<br />srdcrur., prnr ro irs asu.M. aho r.quiEs rh. aplrlica lor $ch lcmnl b fk I si8n.d srar.rnr itur tE or sh. i lic.&rl ptr$a,r
<br />rn rh. pmvision\ olrhc Contrroii t-iccn\cd lrB (ChaFd.9, C.m'..rcin8 wirh Sc.rion TOiD oI Oivision I olrhe Busirc$ and
<br />Pnr'.rlions Corle) orrhir tt or sh. is er.mprrhcrctroh d rh. bdir lar dr llL8cd *nl|r iDn nyviobrionofs(rio!70]15briny
<br />dppli.rnrlo'r,.flnnsubj.cNrh.oprlicMrroici!ilp.nhyofnor,mr.rhitrfiv.hundr.ddollo^1J5r[).
<br />l. .\ olncr ol lhc pmFny. or myenpLv..s wnh w!9.. as rh.n \oh c.'n!.ns ion, wiildo rh. wo* ard Ih. sdure t n.r
<br />i' .'xlal or .lT.ftd Ir sL (S&.7O41, ausiksl dnd P'o|sbns Cod.r Tlc C.ntnct}', I-f,.ls ljq docs .ol ll)Ily b 0. owr of
<br />r[. pxpcdy wlll hoilds or iryows rheE,( ,]rl wtx) &,u! snch trt* hinx.lf or l*rslt or rhrDulh hi\ or h.r own.mplotEr,
<br />providcd rha( such imp.okdnk r. mi ink .d orofi.rd Ior sL ll. h.vcv!a, (h. bdldin3 or ntpsrcmDr d$ldw{hinonc }ed
<br />ol rorplcrioq ii Ow*r BoilLr will Mv. rh. hrd.n of prcvirg rh, lr o. shc diJ tror boirl ot itr{,Nvc r& pmp.(y f.r rh. purp.s ol
<br />-l,
<br />orow!.rotricpopcny, !m exclusnlly conrding wnh li.!tr€J.onkrroR t, onnrucr rtE poj.sr rS...701,1, Busi*$
<br />a,rl l\l iisiDCod. Th€Conklctr'rLi..ns.ljqdoe\nDrltnlyroanowndolpoFnywhoburldsorimprovcsrh.ftotr.
<br />.id whd c.ntacrs Ior slch projccrs lirh ! Codc.kn(s) licensd puhuad r. rh. C.nrrt.ls l.i.cBd kw)
<br />-l
<br />r .r.m under Sdn'r-. B & P C. for rhii rda$n
<br />!o4f,!8a.c0!!rE!,t4f!9!
<br />DECLAMIA!
<br />I h.rb, afilrnundo p.Mli,ofr..j!ryoft ofrhc folowinB dc.l arhrs:
<br />-I
<br />h.v. ond will minroir r C.nifut ot Cons ro Sc[-nEUE fo. wo.tm on]rnsation, is pdvid.d for lry s.diotr 37m of lh.
<br />Latu Codc, toi ib. t dforl1gE or ih. *orl Id which rh. p.rmir is i$ucd.
<br />I [1l h.vc ind w,ll nud n m*.6 loNn trcanon insurm.., .s BquiEd hy S..rion 3700 of rh. L,hor cod., t6r rlE pdfoIl:m. or
<br />I}, n s n\k1l MYworkcA (onrrnsnru,insDrmc Mfi urr! Brky nunlE e:
<br />t^-'t W::r.ricAn Zlrlc
<br />\lt l1 /t/zn/ 1r
<br />I c.diti rlur inrh. lcriornuncc of rhc work for whichrhis Ocrmrr t $ued, I shrllrct.rDloy ri, p.r$n in ay mdnf
<br />s s!. bcom uhjcd hrhc mrkc* @nlpc.sdiotr l{wrolC.lifornit, md N8d rhd irl sthuld b.6E sbjc.r ro rh.
<br />work.B $nrt ns!.Dn tovisrens of S.dior lT0o of fi. llbor C.n.. l $all, fo.th*irh.lmply wnh $de pmviriJn*
<br />WARNING: r lurc h kcuc *ortc6 mn{x.sdion .orcEs. ! uola,tul md shrll Nbj.cr M .htlorlt ro aimal r.Mlras md
<br />crvil litr.s uO t. onc hundrsl rhousotrd d.llns (tl rxnr. r idd i,)n h rhe ..n ol.onlP.ns ion. d tu!.s A prov]rl.! f.r rh.
<br />S{iidn 1076 of(lr.lit-r C.d.. d.!.{.nd
<br />a r(
<br />pE!Ld8A!!2!
<br />I h.Eby !0nb under pculy of Frjury $.r I !m lie&d undcr pnrvi\i.n dI Chaprcr 9 (ommncinS wirh S.cthn 7000) ol Division 3
<br />or ,h. au\ms.id Ptuhsiuns CoJc, nl n,! lr..( B m tull luc and cfLcr.
<br />)
<br />[ [o cl?n )-r€
<br />^El,a -<o ..riv i +
<br />I heEby alIm rndq peulry or p.rjory rhai iheE ir r oD,nd io. lc'dlrs ry.ry rd rh. p.nom,E. ol rh. M.k to, *,tu.h r his p.mr is
<br />irsucd (Sc. :1097, Civ. C ).
<br />AIIUCNNLDECLAEAIIAB
<br />I nd$y drm un,ic' p.nalry of p.rjtrry on. or rhc folhwnr! dtrlddiions
<br />D.tulirion P.mJb-Alb.ior Notilicarion F.d.rdl R.3ul[n'ns (Tnl..l0, Pan6)
<br />Rcauiral 1.n., of Norit€ri..
<br />_l .dily rhat ttE tbd.rsl..!uLrio6 E! ding rsb.ios r.muval aE nor qrplic.bl. ro rhis pot.I.
<br />_11cdir) rhd I h,r. @J rhh dllpltrrion 6it n.r. rhirrh. ibov. inlomrioo n.adr.l ag@tocomplywirh allChyand County
<br />onli,Brr.s a'd Si{k txws ahiing ro boildi'u coddcrion, dd h.r.by trurhoriz. aDcsdoriv.. ofrhnCnyardCou y ro.nr.r rpoD rlE
<br />trh,vc nrnri,ncd ftuncny tu insrcri.n
<br />,rI!li.!nt 0r.tgcnr sisntrr Lt-? o
<br />w
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Sublloor/VenVlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framinq
<br />lnsulation/Eneroy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lrilason ry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enoineer Final Report
<br />Flood Zone Certil
<br />FINAL z-l'LtYt^)Qtyt\lt 'LtrYl
<br />Certificate ol Occupancy lr
<br />Notes, Remarks, Etc.
<br />Bev.08-07-2015
<br />lr.rr_
<br />LcrJq ! AddB\
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