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SITE.WORK DATE ID/SIG COMMENTS <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />SLAB Floor <br />FER Ground <br />Subf loor/VenUlnsulation <br />Roof Sheathing <br />Shear Wall <br />Framing <br />lnsulation/Energy <br />Drywall <br />Ext./lnt. Lath <br />Brown Coat <br />Masonry <br />Pool Fence <br />T-Bar <br />Handicap Req. <br />Deputy Final Repo( <br />Engineer Final Report i <br />Flood Zone Certif <br />l\(t <br />FINAL ,\1:|7 <br />Certificate of Occupancy I <br />Notes, Remarks, Etc <br />I\ <br />7- <br />C*- <br />OWNER AUILDER DEL('ARATION <br />undq FEly of Fjury lhd I a crmln nln rh. Co .doR Lary L.* ror rrE follo*uts '@n ilt6. 70l L5 <br />fBion cod.): Any cn, or Coumy whth Eqund a Fn( ro .odtud, ah6, inpmvq &dbliln or E!6tr uy <br />tu iffie.k F+ri6 th. +plii! lor r.h Fid to 6k! 3iF.d ilad thr h.or tlE i licd!.d Fltd <br />of lh. conr.dd r l,Kd!.d Lr* (ch!pr6 9. comdcds Bnh s..lon 7000 ol Divirio. I of th. Bu,ns ed <br />)orrhr'lEdJEir.rdlP|tffiomrd6cbcisaorrh.dL8.dq@Fion.Aryviolrionofsdb.70!I5b,ey <br />subj€lslnc apphca ro acivilp.Mhyofnol mor.tho Iir. hun&.n.jollm (3500) <br />,lh. proFny, or my flployG rtrh s!s6 a lhcii sk comFel Dn. *nl do ltE *!rt ,ri d! nnrlc ! ft'l <br />for eb (sc 71x4. &BilB od Proi<ioN Cod. Th. codddr'3 Lt.M lrw &6 mr +?ly io u ouM of <br />bil& o. E{rrc 'tEEq !n wb .h6 st \rnt tnElf or lwlr or rtmwh hn or lE oM dphrB, <br />ihpro!ffirs @ ndr iniarLd or .ltaql 6r sL ll, how&6, rh. tlrll$S or irIhffii s sld wnhin on. <br />'*(\E l,urltd *ill h.vc rlE hddr otFo{,B lni lF or {r dd rel h,ild or rsoE dt FFly h. rli Frpo!. of <br />f rh. Fopd,, m .rclciv.ly contrding wth licsal ..nr&bn ro coNtud $c F.Jd (sd. 7044. BBin6 <br />o& Thc Comdroar Licdc L.w &,6 6l +9ly x, u 0*6 otp.opsrr vho buifth or idr.ovd tl'6tn. <br />fu such F.F1! wnh t Co tuo(,lk.B.d <br />'l{6@' <br />rorn Codr&1drln@L!s) <br />ua&iEBl-(autlltarm! <br />DECIAAAIIA! <br />und.r Fahy o, pqjur, on. of rh. iollow'.r d6k !rio6: <br />allmi m. CcritElr. of ColEar to S.lr-lBU. for wtt6 @mFEiioq a FDvil.d ror hy Serhn l70O of rh. <br />th. FaolrM. of lh. Nrl for whicn lh. FEil i! b$.d. <br />Ln.inr.in wodd conp.Narion iB!r!n.c, s rcqurcd bysation1700 oalh. Ubor Codc, for lh. psfonnMcc oa <br />h lhis Fd l 6 isd Mr qotl6 otr'pcdion iBll]tr. cui6 rrd polr} numb6 -.: <br />in fic Ffo@n .6lrhc worl foi whi.h rhis p6nn I asudl. I sl'lll .ol @ploy ey pd$n i. oy m nd <br />rub6l to rlE s 6 otrpdMbn L*. ofc.irfomia.rd .3r rh, ir| JDuld baor $h<l b llE <br />ion p.ovtnB olSalion !700 ofth.llbor ( o{e t nElL fonhvith comnly u,th lhoc provlioB <br />F iluE lo GG rqi6' conpd.rpn orE gl ir 6lrq'tu1. .d.b.ll $bj<r & @phF to ciDirn Fni.. !i <br />u onc hundr.,.l rh.us&d doll6 ($10O.m0), r aldir rhc coi of ..mp.Nrion, &mga 6 provid.,.l tor th. <br />cod4 ddd ed drodEy's a€ <br />7..a <br />utdd Fuhy o f Friury llld I o liGtr d u,'ds FrBirn of (tupta 9 (conr]ffi'is nnn Sd., 7O0O) of D,vaon l <br />Md PNf6io6 Codc. md my lictr ir itr full lorcc ad ciT(l <br />lbj25?1-L <br />rv\ i T-rD\]$'(t.16 t <br />uri( pqrlly ol Nrjry Ihat rlEc's i coNrn,.rtrn' lo!Lns f rh. pGtumdc. of rh. worl 6r *hkh rhir psmn b <br />6fti.l(AllD[O.irtr{UA! <br />unds pqulrt. otFjur oE of rtc follo$i.s &cl-dioB <br />ils-Asb6los Notilication F.d6slR.aul ons(t lcJ0. Pan6l <br />rhc lh. f.d6al rquhlioB ns-diu at6!G rmo\.1 & rcl or td,k to lh6 pqdl <br />I hnr ral thi! lpplacion dn sr . rhi di !ho. 'n6hjlion ir cocl I .src ro @mpb wtrh . Cn, ..d (-ody <br />Srar. L2{s nlatin3 lo buildinS irtr ad hncb,.urhorir. r.F6dtdir6ofrhis Cny dCounryroar6!t nth. <br />?\gdlSrgn.lur <br />.l:,i <br />t--"sJrslu <br />BUILDING- INSPECTOR R ORD <br />) <br />W+r z