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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE tD/stG.COMMENTS OWNER BUILDER DELCAXATION
<br />I hcr.by nlfl.n u.d.r ,..rhy.f Frjxry rhd I m.r.lPr li..r lhd Contn t,N l-i.cnrc trw rd rhc k,win! rcob. (Scc.7oll 5
<br />Busincs nnd Prctsiotr Codc) Any Cily or Connty whi.h rcquncs a Fnnil ro conslruct. altcr. imF)vc- dcmolilh or q€t my
<br />itu.rlrc. prio. t, irr is\utrdc. aho rcqriE* rhcapplic(nr l, such lcrnlir r{, llle a sisncd {arcmnr rhrr h.or\hc is licciscd lt xmr
<br />ro rhc provtiotr\ ofltr Conl!rclo.s Lic.nscn tjw (Chll,lcr 9. ConmEn.in8 qilh Sccrion 7Om of Dilnion I oa rhc Busincs lnd
<br />Pmrc\\n,nsCodc)orrhel hcor\hc ncrcmfl lhcrctunr0nd rhc hasis l'orrhcallc8cdcxcnDrion. Anyliol ioooasccri,nr0.ll5 hyany
<br />aftli.mrrnapfiniliuhjcc*thc,pplic{nrbrcivilpcnrlryotnoimrcrhninv.huDdi.ddoll,r!($500).
<br />-1..wrrollhcpr.If,ny-,,nryc'nplores*ilnsarcsasttuninc.onDcn\atnnr.*illdortLw{nklndrlEdtuhRisfrniud&l orolTcrcdf.rsrb(Ss.7()4.l.Busilrcss d Protusnns Codc Th. Coiha.ttr's Licc \c hw d.es mr npply,o !tr owtrct of
<br />rhc pmFny wh huildsor inpnrws thcrcn, rnd {ho dm\ sch soA hin\cll or hc^c lf or rhiouSh his.r hcr own cnllloyccs.
<br />prcvidcd rlN su.h (nt(Nlmns:ft trn irtc trdcd or o llcrcd tur *L.ll ho*cvcr. thc luillin8 or iq,mwEnr k {,ki sirhin, rc }ir
<br />of.rnflcri(m.rhcO*crAuiucrNillhavcrhchlrdcnotl]nlin8rlllrh€or\hcdid.urbuildori'q,mvcrhcpn,Fnyrorrhcptrqx,soi
<br />I. asoBnforrhc pmpcdr,.mcx.lunvcly conrm.ng wnh licciscd conri.b^ ro con{flcr rhc projst (Scc 704,{. Bu!rc$
<br />and hii\shn Codc: 'l tc Conrrrrors t,iccn\c Lnw docs nor lpply ro on o*ncr orrropcny sh{, huildr or impbv.\ rh.rcon,
<br />and wlb .ontr.B hr su.h t)ojcch wilh r co.rrkdn licc'r{d pnFU {brhccontacrols LiccDsc ltr'w).
<br />ld cxcnu und$S(ri(,n .B &PC turrhl\rcJrn
<br />Dst€ Own.rl
<br />w()Rxrrr\- i:i)niPE]\\arr()N
<br />D[CtLEAr]ON
<br />I lrrchy rffiirn uidrr p.nrlry ol p.rjury oft ofrhc f.lloairg J&lrrrrn,ns
<br />Ihr!.and*ill.r infuirLC.nifi.nrcbfG)n{nrk,Sclfln\urc trwork.^.o'nl(nsnri(in.N pturidcdlorhyScdior37q)ollhc
<br />lltrr C{)dc, fttr rhc pcrroruk{ of rhc *.rk for uhich rh. ,.nnir is is cd
<br />I havc a d will nrrnrain vorkcrC c.mr.nsdtn,. insuirn c. r\ rrqund hySc.rnr ITLUorrh. hbor Codc. hr rnc pcrfonnoncc ol
<br />rhd work tor shi.h rhtr.rnrir is issurt Myworkcn conp.n$rn,n insun,m.rnicr lnd lolicy nn rn rm:
<br />I ccnili rhar i'r rhc pc.fornEkof rhc worL tu which rhis pcnrir h i\\u.d.I shilltror c lroy.., Pc $n inrny,n.nnrr
<br />so rs b hc.otrE rbjccl to lhc wortcn compcnsd ion laqs ol C,lifonrii. md ogrcc lhar ii I should tEom suhJccr b rh.
<br />wolkcrI conrrcnsaridr lmvision( oi sccrion l7{D of Ihc tjhn a)dc. I sholl. lbnhsirh comfly wih rhos t',o!i\ions.$ARNIN(; FriLur r. k.urc surkcr\ .oitl].d{rn cor.rxtc is xihwlul. r d sh.ll subjc0r ,r c {loFr ro oiminll F.alrics lnd
<br />civil finc\ uf kJ otu hutrd8i rhousrtrd dollaN ($1fi).1)O0). nt sldirnrn t .n ol conDcns.ri,nr. dlmucs r\ pnvidrJ n)r rhc
<br />Sorion 1076.f$c titsr Coi.. inrcrcs rtrd doirry s f.cs
<br />5-12. /8
<br />DEIJ,AAAIIAN
<br />IhcEbytrlii.rnund$pctr.ltyofp.rjurylhall.nliccnsdnndcr|n,vrsionolChrprcr9(conrmncingvirhScclion7lx)0)orDivisn.l
<br />ol lhc Busircs rnd Ptuf.sions Codc. ril nry liccnsc is in full for( dd clfLrr.
<br />r iJcnscc,r- uccn,c Nura94,",.<li.Trs ,-*"1UJ
<br />q]NIIAIJEIIONIINDINIICINII
<br />I hcruhy afiln undcr pcnllryofFriurylhrr rherc h a connrucrion hding rgcn.y Iff rhr pcrronufrc olthc s.rk lor which rlri! pcrnril is
<br />n!'.d (scc l0'r7. Civ C ).
<br />l.cniltrhrrrtu lidc' rl rclrhlnnN (!d trU r\hdo\ roDnrrl rR tror xflhrrhl. k) rhN lnrl(r
<br />,v. inforMbn is co,Nl. I trere lo
<br />h.6by auithria nFc$nlalivcs oa l
<br />r r.r,,),h. r r J\, n i,r rh^ rrf ri dtrn i n.,F,rrl.Boh
<br />r',itu r.\ 'nJ srrrc I r(. nlr' E i, hudli ,,."-/rd;i'In. rnJ
<br />Jhrr rrdr r.rtr,,ntnr r,tr in,""l'"*f"Y ./
<br />{ppriunr urAactrr siBmrum tr- l-'o l
<br />remi,e.name,Dnn,,: ?Anl rjlcC*s k%
<br />,comf lywith !ll Cirrund Counry
<br />his Ciry and Grd, lo,cnrcr uFn rhc
<br />,",, s lnzlrt
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />Sublloor/VenVl nsulation
<br />Roof Sheathing
<br />Framing
<br />lns u lation/E nerg y
<br />Drywall
<br />Brown Coat
<br />It/asonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certil
<br />1 I
<br />FINAL -t-,r' l(n ->wh
<br />Certificate ol Occu nc
<br />Notes, Remarks, Etc
<br />Poli.y Numbn:-Expircs:
<br />-
<br />bndcls Addrcs '
<br />afftlcaNflrEct dxAllaN
<br />I lr[]6y atfin undcr pcnalry oallcrjlry onc ollhc lo0own,B dcclararion\:
<br />Demolirion Pcrnrih-Asbc(os Nolilicrtion Fcdcml RcEulltions (l illc 40, Pan6r
<br />-Rcquned
<br />blrcr otNolifEoiion
<br />SLAB Floor
<br />Shear Wall
<br />Ext./lnt. Lath
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