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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.OWNET AUILDEI DELCAIATION I
<br />I ltftlry rfim u,*. FMhy ol !'.rjury lh.l I m .r.rpr ln,m tlE Con-km Liuc L.* ror rlE ftnb*ing E.$n I-^L 70.11 t
<br />Eusinc$ sd Pdt$ion Code) Any City or Coudy wh(h r.qun.s u Pcmil lo anlnMi. dlr.r, innrulc, d.frnht I rnan rny
<br />{nrru.. Fitr t, ir! irtl.m. n{ Equi6 rlE +diel ln {Eh Fnn h lik r riSEn {d.B lh3l h ot rlt i\ lkd$d nMr
<br />to rlE lroviionr of E cI,nlrrl{r'r t-k.n<il ll* (ClEItc. 9. Cotlftmin! ,ni S..ri'i 7m) Divirbn :l of rlE Bu\it( .nd
<br />PNfesrion\ G'.L ) or rhar lr d sh. t .r.mpl rh.Elion' .nd lh. hosi\ tn rtc ill.*.d .r.nwion. Any !i.'ld i'n of S(la,n 70:l I 5 by Mv
<br />rmlk.nr ritr r F,mir shFi lh. !!rli.!nr k,. civil pcmhy or a,r,E rh{. fi v. tundtn dolbr Ilt{I),
<br />-1,
<br />u\ owEr orrhc FDFny, or my.mphFr! virh $!s6 r rh.t bk.smFn{rbr wilt &' rll M &nitsMEnmr
<br />id.i&l or ofi.En fd sl. tS6 704.4. Boita. .nd PiDfdi6 C.iL TrE Co.tarm 3 l.i.ttr* Ll* do.r d 4rly l. u orr or
<br />rtt FoFn, BtD hrikk d i,lmB rlsa un *lr' ds *t ro* hin*ror lEmlrot rtuou8h ht d lEr om c.rg'lbtei
<br />I,oviLd rh.r sEh imnmvlftd! c br inBn d d oflctd tor d. l( thw.tr. rlE t{ilinI or inlpo*ftd h sld within onc ,qr
<br />or6,pHm dE owEr Build.r *ill lrt tlr lE(kn.l F$i! r lEd JE dn r{ hrild ( i,tp.t'E tE FtFrt lr E F,FEol
<br />l, .\ ormr orrh. Fsp.nr. m.r.l8iEl, cotualin3 rirh liinsd mrklon lo @rlrucr rlE tmFr (s( ?o{t. BuiEs
<br />Irl h)ls\rhCo,h Th.(in r&kr'\ Lr.n\. tr$ ,l,rl fr rffly
<br />itrd sh(' co.rri.i\fitr $.h pR'1..r\sirhtr (in rmt(\r lrri\.d
<br />)FdyPlxr hrildr o mnmts rh.rd,n,
<br />ttt/tu fr,'""",>
<br />I h.r.hy rnth!.&r rEully oa rsrury Dr orrk ft,lkoir8 dRl'rdbn\
<br />I haR dd*rllnuinlon rCcnific.l.of(ilnsenr k' Srlalnsrrcf.r * dcrs (oryrnlBti'n. as Eoeid.dntrbyScct{'n.l7iDolrhc
<br />l,h, C{k. ro rh( F.lonEm ofrh. q'l ntr *tti l,r p.i'n k nikd
<br />-lh0vcrnd*illnEinrainworkch
<br />cnnr..\!tion in.ur.R.. rr rcqurcd h, s.cr i(,n lTlx) or rh. I rhor O'dc. lor rh. P.rforru cor
<br />tlx so aq*fiitltnFmit ir i!{td My *rrlar' onfEnli{,n inrur0Ecrricr !d rrllty nln*Er s.
<br />l.drrr rh.i i. th. p.lforflr. o(rlE $ork aor *hth $i. Frnir ir ntu.n. I rhrll ml.i{,k,y.nyFen in iny itEr
<br />$ !s ro ttod ilbFr ro rh. Kf,t6 onFndbr LB of C.lifomi- .d rlN rhd it I rtsull lE(or el,ctr k rlE
<br />*o*c6 .oqEns(mn l'n,vtbnr of Sc.liDn l?00 ot rlE ljhor Codc, I trEll. r(,nh*irt s'.r{,l, *irh rhoi nrovisi,onr
<br />xlTll"".',ii'l; T;,'j;lll:;\."-. n,r^ ",,h.1"l'" r'*. .k-"-"''/u/*n
<br />('rFtrdnn (arvftsc n ur
<br />a'lb ll(n(IIn r rndi
<br />€ ro oimiEl FMii\ ,'rd
<br />I h.rcby dfirn unkr p.Dhy of Frrry rhn I u liln<n un&r Fo(iii!. or Ct |'l( 9 I onmdrn! $i'h sdbn ?lm) or
<br />,n rh.ll'Atrr\ rtul Px)|.l\\i(r!(i c. rl my li.er! is ir h,lll,tr( r'r1.fi..r
<br />(I)$UA! TON.LE!D!$G.AGEUII
<br />I h.Eby .lIrm uftLr Fulry of p..Jory ihi rhd. h r .odM-,. htnh! trEfty nn E Frfirl.llEI. of rE wrt for.tih rhk lEna ir
<br />krucdls.c. lg)7.Crv. a )
<br />l.ndfl'\ Nrtr
<br />-
<br />afg.lcaNfDEsl,llarl0!
<br />I hdd,, dinn u.ns FEh y or Friury oft .l rlE lollor in8 d.. [Eli,ns
<br />rXmrlfirn Pdnnri-AstE(or f]ohfrdnn tu al R.8uhrbnr (Tnh.nr.lln6r
<br />-R.qut.n
<br />krrcr o, Niiifrdlm
<br />rh{ rh. lc,lerr! rc8nlri'N rurrklr! n\h\n\ '.nx^nlirr n!r ,'t)t,lrihl! ri rh^ Pn)ir!r
<br />I dily ttd I luv. E d rhn q,Ila{bn.rn (.r.lhd rlr.lrrr in(nrrtirn ii ffi I 6Ee lo mnnly *ar
<br />,'rln,rr.\ xtrllsr r.li$\
<br />'.lnnng
<br />ro hurldi c rcFccnrlrivcs oIrhtr Ciry and
<br />Jhrr nf, nr.rn nnlncry 1,tr'nyntr,n prn'ri
<br />,\fl,lir{trr nr Ag€nr Sign{turx *
<br />/Ho,uif D,ttu
<br />Lc*"vy'-",76,'t
<br />ar2z/r t
<br />Set Backs
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Shealhinq
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />lvlasonry
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certil
<br />FINAL 'J/zK//tr hnutl /h--
<br />Certif icate of Occupancy I t I L
<br />Notes, Remarks, Etc
<br />-t
<br />COMMENTS
<br />Forms/Steel/Holdowns
<br />Pool Fence
<br />l-i.dnsc Nnnt r: _
<br />l,nd.l. Addrc(:
<br />-
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