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SITE.WORK DATE ID/SIG.COMMENTS OWNET BIIII.DET DEI]CAX IION
<br />I hs.!, llfm undd F.xy ol Fjq- lh, I h q.flpt ebo rh. CbdEdoE Lic.@ l,w for rh. folLwmS lKn (S*"i&ll5
<br />Bsina rn Pmfsi,n ( od.): Any ( ity or Colnly whi.h r.q!n6 ! Fnrl lo co.nnh. .ha. imFo\q ddtullh or Er.! Df
<br />,nKlue Fbr ro ir! n!ue., lko r.quird lhc .rpticri tor iuch Fon lo 6k . r'8r'.d nrordn lhi ,E or ,E it liG*d F un
<br />ro th. provniod of rh. Conrdd! Lrc4-d L.s ((]rFd e, Coffiins *ih Sclio. 7000 of Dilnbn I of lh. BGilrd ud
<br />PoaBhs cod.) d ifid lE d iE i crdF rhctfion.,i rh. bdir nn lh. tlks.d dsqin. A.y vi.LlionofsErirnT0ll t by.t
<br />.I'glicur tor . Fnn $btr3 E .ftlkol h . cieil pdll' ol ml nor. rhr, fiv. hundt.d dollsr { Ir00). t
<br />l. s ow olrhc propdry, or my ophr6 wth *.8d s lh.r $k snpdlnio.. $ill & llE rst .n ,!. i.(rE ir d
<br />iflsld.d or of6.d for sL {Sc 704,{. Bdl!6 dd PrDtdis Code T& Corftltr 3 Li.ue Lrw dG ,Dl +ply lo o oue of
<br />tlE FFry stD briLld iryolstlEEl\ in$b &<rdrm hiNlf or helf orllrcosh hi! orhq oM dplor6.
<br />Fol iLd thr uh ,!qusEr. & ml nod.d oroff@d 6r rl. li ho*M.lh. hilditE o. n!.otqd ir nB wnhin tr )d
<br />ot conplaior rh. OME Buitac $ill h,r llE hq&r ol Fov,B lhi lE d tE did d hlld q i,FDw dE F!fd!, 6r l,E FrFc oI
<br />l. B orG.f tlE FoFy, m dcluidy.o r..liog vnh li.os.d cofrdoN lo Fnstruct ltt F.jd ISe 7044. E u6
<br />rd h!toiix ( od.r ]'ht Conrdroat Licar Lw dos rcl rr?ly lo e orE of proFly *lr t iliL or irF!6 rh66n
<br />dd wh6 .odrar! fG Mh FoFr wnt r Coffiro(r) lad!.d psr{d h rlE Comxld r l,tdE Lr*)
<br />I m.rml, u*Lr S{tion
<br />()in6
<br />\roi(l'Rsi ( (ir\rPrNsATroN
<br />DICI.ASAUAN
<br />I hdchy amnn trnd6 Fmlr) olFrND okolrh. foll(N'n3 'jchi{i.6
<br />I h.r..n r ill dinrril. CdilEll. of Coltsol lo Sclf-tdlr. lo snrk6 comF.rMio.. B F.\ iiH tot b' sdn. r7mordE
<br />llt , Cod.. lor dE Ffofruc. of rh. eort for whtt rt. pann B isu.d
<br />I hA..nd$ill mi lin woitd' .omr.Mli6n iMr.Nc, s rotuiEd by S<l io. .1700 of lh. L.bor (od., tor lh. Ffolrl@. of
<br />rh. u.rt lor uhxh rhi! Fqn B sxi Mr trrrld' tompsurrcn iNure. .frd ,n FIK' numbd E
<br />(md , gil\zE- ev".D
<br />"^*,*,^n e4fuq7b(q n*,; L1L-42--.
<br />.Ic.ntrythdinrh.Flolrffi.ofth.$orlto.*tahlhiiFmnniru.d.lrh.llmlotptty&yFsni.&vmund$ s ro b.$r rubFr b rlE *vrd' snFld ion lrM of Qlifomia .d lsre lnd if I ihould h{om tubiGt lo llt
<br />mrt6 or{E!.lhn Fovi3ioN ot Selio. lT0o of rlE lltor (-od.. l JDll. fonn* nn snply wnh 'h- Fo\trd
<br />lVARNINC failuE ro Fu. mrln
<br />ciril fin6 ur ro on. hunrr.d rh.uld
<br />is unh*tu!. .,!d .hall obj.n e dphls lo oiniMl Frtis ud
<br />ldinrn !o rh. rd oI comFN.rion. ddux6 a! povid.d ror rnc
<br />l.htr C.d., i.rdd !d dlorE,'
<br />o
<br />L!!r !!t!x,\
<br />I ha.6y .IIrd undq p6!Xy oa lsjury rhd I m ltdE d undd plovuioi ot C}.Ea 9 lsffiitts *nh Scri.n 7000) or Dnuon I
<br />ot th. BuitB ud PNf*ioE Cod.. ri my li..B b in tull lorc id.lr.r
<br />,,-*.,"* d{ E_ev?4r
<br />{a/s1/u
<br />coNsllllralol I rND$lc acFNcY
<br />I lElby .rIm urid Fuhy oaFr{r.v lhr lhdt i! . onstuclion ladirg lefty lot lh. p6l(nll@. of rh< mrt tu $nth lh. Ftri ir
<br />i$.d (56 1097. Civ. C.)
<br />lnda r Nlmc
<br />aftll(AtfDlgaSAlIa!
<br />Ih.S,lfrmuidq pd ty of p.rjury oru of lh. n'lhsirs dc.ldrion.
<br />I).nolnio. PahnealtalN Norificltio. F.dml Rlrllalmtu (TnG40. Pd6l
<br />Rqun.d I dtd of lidi6.rioo
<br />I .sr ily rtd rh. f.dd,t r.eul.tioN r.!{dms stElot rtu\ !l & ar !pf'l(.bL ro lhi! F.i$
<br />I cdrft lhd I hr\. r..d rhn trd dd. lh, tn. .t !. infondnrn it sret I !st- ro .omply wnh all Cn, md Coui,
<br />ordiMftB.d sht. lr$ rcldinr iotr ..d t6.b, rdlx'rn. EFei'r!6 n f this ( hy rd Coutry lo di6 '9of,
<br />dE
<br />ilt\. nrnr(nrd In,|tlr!
<br />,\ppllc.nt or Atdl Sltnrl *t++e-^,,, io/:.</r7
<br />Set Backs
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />SubfloorA/enUlnsulation
<br />Roof Sheathino
<br />Shear Wall
<br />Framinq
<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 Report
<br />Engineer Final Report
<br />Flood Zone Certif.
<br />lt I
<br />.,/ t,-) xc-/
<br />FINAL tl/t?//7 *)Ol,t(6 <roo
<br />Certificate of Occu n
<br />Notes, Remarks, Etc
<br />rl 1 (Ctn /,{ Brrrrll^{3 aa-
<br />k ,L. * gi
<br />BUILDING. INSPECTOR RECORD
<br />Forms/Steel/Holdowns
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