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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNER AUILDER Dl:I,CARATION
<br />I h6rt, .lltrin u.d.r F.ll, of Frjury thd I m .rmfl &oo th. ( onhdon Lic.n* lay nr rh. follosint r*rnls<70ll5
<br />llEin6s !,rl Profdiotr ('o&): Any Cn, or Con , whkh r.qun6 . Fnir ro .odtud. .hd, imror. dimlGh dr rqf,ir et
<br />sltudu.. Fxtr 10 ils isuffie llso GquiE thc Aplicei for iuch Fnn to nl. . ti8..d nd6d rnd l. or rh. ir licfts.d t umd
<br />ro rt fnnnn)N of rh. Conll*ror r l-'c.n&d tis (Ch.tra L Commd.inB rnh sdb. 7(x,0 of Di!i!h. ! of rh. Buind sd
<br />ProfKKB (il(t.l or rhar lE o. $. ! ddpr rhscfros ud rh. b.ra lor lh. dl+dj d@FF. A.y vnldio.ofs(1nn 70ll J by&r
<br />4'rli.. for.,Enn subjds rh. applicd ro . .i\ il p.oxt of @i tuftrhr 6r. hun lrd &1116 (15(x))
<br />l.aosffiofrh.FoF).cm,dpl6r6withrrs6stlrrsLomp6uab[rrll&rlEwd]rdiErtulG.tur
<br />mcrlcd or ollq.d for e]. (S{.7O1.1. BuiB ad arofstrB Cod. TIE codndd r lj.de l,* rt6 d Tglr lo 6 o$E.l
<br />rh. I,oFry s h hlilt or irq!\ 6 rlEq -d *ho dG sh srt hinklf o. haxlf d itunulh hii o. ha oen mpb\6,
<br />Fnld.d rh! r(h iiForlEl! e d dod.d qotuld 6r s]. lt hosqq. dE t!,tlrr or EqsqGr r hld rih @rd
<br />ofcrnpki(a l,E (xE tuiila qrtl IEE dE h,rb! ofFo\ide rlr hc n llE dn d hild G flq.\. dE F!Fr_ fttr llE F,FE ol
<br />_1. a o*G olrhc F.Fry. d dclsivcly.orndi* n nn kqel codrrloE ro o,tiocl rlE p..J.cr (sr ?tr'{,l,llG'B
<br />dtl PrDkinCo&r ThcCorlBddi Lil@ Llw d.6 mr.pplt ro xo*n6.fForEn'$t torld! or inprord rh(o..
<br />rd $h. ofrrr! lor sh Fbt{3*ithr Codrro(r) ltd!.d p{ra{d to ih.( o r.dd'rI(.etr*J
<br />_l m .rmF ur& sction_, B & i C fo. $. r.&n
<br />l).r. Orn.r
<br />]!!8J!!&::(AU[IiJSATATlr};SJSIUq!
<br />I hoch\ llli n trnd6 p.,alr! of Fturt oncofthcfoliotrr! d(l arnri
<br />I ha\ . xxl N' ll maint''n . Csr,ficar. of Congl ro S.lr'lGurc lor rort.d .on,p.nshrn, tr\ F.\ kl.J nr h! S(r nn r?rxi o f rh.
<br />| ,hr ( ,r1.. ftn rhc pqf.muc. of rhc No& for rnich rh. psntr 6 isu.J
<br />I h.r. . j will n.inlain w.rkd! comFcslion i6rm.., a r.qur.d by sd' io. l?00 oarh. l.rtx,r Q'd.. for lh. Ffoll114. of
<br />th. *ork aor $hich lhn Fnil i! is.d My work6! comp.Mion iNrm. trirui F)lk! numh.r r.
<br />(';.i<-W
<br />- WCSocLot>,,rt*,- ty'tfn
<br />I cdify rhrr m rh. lsfoman..ofih. worl lor shrh rht p6m is irsu.d,I.hall60r dtlot.nyFnon in ontnrsnnd
<br />$ ar ro h.comc shjd lo lhc wort6 odpNlion l.$ ofcslifomia. and aBR rh.l if I shuld tr(om. subier nr rtE "
<br />worl6' conrp.Mli.n prolirioB olsalion I700 of lh. hbor ('od( I shlll. fonhsilh conFly tr ilh lkrF nnrlirhnl
<br />WARNINC f_!rlur. lo su. \o*d' comFelion o\@s. is urhslul. d shdl 3uhJal oplolr lo d lihrl Fshi6 and
<br />dvrl nn6 ur to oru hundrcd rhoMd doll6 ($l@.U10). in lddnion r, th. cod of comFNr$n. dEnas6 f,t ,,o d.n ror rh.
<br />S{ron r07() ol rh. I nlrtr ( ird.. mtq.n &d indr
<br />I hd-,r{ dlmn un !d FEh} orFlurr rhn I m I'GE n of ( h,F6 9 (.om,*.-i.g $nh sdhn 7000)of lhi.ion !
<br />oa rh. BciIB ed PrcfBioc cod.. !d ny E6e s u tull fod sd 191
<br />q,7 )1+6
<br />tlzq tr
<br />I Enr* lllm $d.r porxy ot FJury rhe UE i!. @'dru.rb!
<br />isud l!i<. !(Rr. Cit C.)
<br />l 16r rE Fflfu. olrlE \rA lor rnih 'hi Fmi i!
<br />AfrttcANf![clJlallo!
<br />I rEe.+ !flm un& p.nllly or Fjury orc of tlE follo{ing &la.lioB:
<br />D.ml,'Dn P.mn$/\3tBror Norifi.dion F.ddl R.lol'iioN (Ti'l.1r0, Pd6)
<br />R.qutrd tdrd olNo!fic.rDn
<br />I .d'l! rhar rh. redral rqulariodr EBedi.S aslEtn ro.ral .noraIiFI'..b|.hrhi,roFl
<br />-lc6lilylhal
<br />I ha\. rd! lhb oppli.alion dd ststc Ihd rh. atur. infonnari,n it cordl l.$alo comply $ih lll(iry snd ( d'nry
<br />onli@nc6 ud sratc li$s Elaliry lo hildiu consrruclion. ud h(.5r 0urlNri/t rqr.9rari!6 ofrh'i (\ry dd (i)unryn' 6td olnnrh.
<br />,,.,. r/z"f rn
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Roof Sheathing
<br />Shear Wall
<br />flqming
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />FINAL 2- -26 - /'l ^2Q'7 )
<br />Certificate of Occqpancy
<br />Notes, Remarks, Etc
<br />Subfloor/VenUl nsulation
<br />Brown Coal
<br />;:;:);J;*.f,-'"*- /.#-7
<br />"* u," "*"" rl,u",,,/dr, <- 6rrh'2 // 1_r.
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