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BUILDING- INSPECTOR RECORD
<br />COMMENTSSITE-WORK DATE ID/SIG.
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/Vent/lnsu lation
<br />dz\rt2,EVBool Sheathino t-7-th"-
<br />Shear Wall tal'dfrT \Framinq i- ) -rp,lr
<br />lnsulation/Enerqy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />[,4 aso n ry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif .
<br />-\-Ueta{vt ?r')FINAL s-t-/t-
<br />Certificate ol Occupancy
<br />Notes, Remarks, Etc.
<br />()\\\liR rl ILI)th l)l:1.(,\R,\ lll)\
<br />I h.rchy ariinn undc! pcnalr, .r,'.riury rhar I m cr.nrlr riom rh ConracroF l,i..ns tjB lor rh. ftnb*ins ra$n lscc 70ll 5
<br />Busincss .nd Pote*ion Codc): Atry Ciry or Counry shicn rrquircs a Pcrnir ro connrud. alro. improrc d''mlGh or Epan r'v
<br />{ructurc.pri{,roirsisr'!.cd,al\.rcqnircsrheal]nli.!r.rsuchPcnnirrofilcnriSn.dinlcnEnlrhrrheorshctlicen\ctlPusuonr
<br />b rhc pn;viridN Dl rh. conracrois Licentd kN (Chupicr g Commercin! wilh Scclion 7(x[ of Divnion ] olthc Busnr$ and
<br />Pn,f.;i(insCodc)orlhir hcor sh. k cxcnPt llrcrclromand rhc$0sn furhd rllc8cd cxci{'tt'n AnvviolaiionofSccrt'n70ll5$vonv
<br />lonlictrnr rord lrcnnn suhj(hihc rpflicnnr lo a.ivilp.trdliyofno( morclhatr nvc hutrdrd doll$ (S5m)'
<br />L as owncr of rh. poren y. or my cmployccs * irh was.\ as rhct $lc conD.n{ ioo. will do rhc qo* and rh' srtrr!rc k tur
<br />inrcnlL{ or offcrL\t ltr sL l S( T(X,l, Uusines rni PmLssinns CRlc l'hc Conrraci{tr-\ Li.cnsc L!* docs ret a0Ply b rn 'wn'r of
<br />rhdfmJr y !h, ttuikls M imtmts rhcmn. a *ho Jms \kh s.rk hiaNelf ur hc6clf or rhoxeh his ff hs oan cmPlorecs'
<br />p,"ri ri r r rt,n .u"rt improkftnrs nE rn inle.dcd or oficBl lor $k Ii lkNcttr. rh. hoiltlir3 " inlpolcft h sokl *irhi" uic )crr
<br />;lcotr{'Lrri.n. rh. own;r Buikld willhorc lh. hurdm orPmviDa thlr hc or shc did nor hill or i'nprovc rh' pmrcn] lor rh' nxqD* ol
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<br />.nd Pmfssi'n ( odc: Thc Conlrrcttr s Li.cnsc Law dmr mr nprlv lo rno$ncr olpoPcny $ho huilds or i'npnivcr
<br />,nd *ho .nnrnEr\ror {.h nmiccli wirh rCont0dons) lic.n\.d pusuau t, rhc cntrki.ror's t-tctrs tjw)
<br />I rcxcmrrr undcr Sccr
<br />7,f zotr l-*r.
<br />I,&CI.A&IIgN
<br />I lrkhy dfllrn utrdcr p.mlryol pcrinry onc ofrhc tullowinlll(lnntrioDs:
<br />-Iha\r.rnBill'Enai.tCcnifrarcorconsntloscltlnsurcror*ortcFc.mtcnsalion.alroided"rhvSelion]Tmorrl''L.tnr C.d.. f.r rh. Ilcrfolrl@c of lhc{ork lbrwhi.h rhc Frmil is i\suM
<br />Ih,vclndwilldannainrortcrrco'np.ns.rionn$nrrnccdsrcquncdhvs.crion:l?u'orrhctjhorCod'lorthcFrlolfumcof
<br />rhc work rbr *hich rhh!.rmil is nucd Myworkeu d,nlP.trsdion inslmncc.Micr lul Brli'vflumbet sc:
<br />Cmicr:-
<br />Ir0ln v Ntrtrfi.r:
<br />+f(t.n iry rhrr in rh. p.,r.rnunce oI rhe wor* ror which rhi\ ncnnir is i\sucd l ihrll .nr cmplol a'v PcGo! i' anv 'unNr_i*
<br />r. *-* *ti*im,t" *ntkcr (,np.nsarion lau. .r c.lihrnia- and nBrce rh$ ifl sh'xld irccom \rhacr lo rhc
<br />w.rkc6' conpcnsrii.n [ovhio.\ or sc.rion ]7dl or rhc hbr cfrlc. I shall. fonhwirh c'mllv *irh rno* provi\nrn\
<br />WARNINCT itrihrc ro *cud workc c.r.Pcnsart{ covcra8c i\ trnhwful. rnd \hrll suhlccr nn dnplov'r ro 'riniml IEn ts rnd
<br />civil fiNs u|rooN hundtd thous,nd dolhn ($l(xr.(xx)). in addirnnr lo llrc cos or compcosario'' dam'scs ds 'nv cdnrrhc"
<br />S.crion :1076 ol thc tihor Codc, intcrc( md .rft Y s ltes
<br />51, lro,* ^*,iit, 0o,..1 1-oor*-
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<br />IEUI.AXAIIAN
<br />lh.nhylllt[undcrn.nyoipcrjlrylhdl.mli.cn{rlund.rProvisn]nofChaPIcr9(conlmncinswilhsdlboTlxnInfDivtion:]
<br />oi rh. Rusirc$ 0nd PhfcasionsCodc. oJd nyliccne is i', fullforcc lndeffccr'
<br />Li..n\. ( |tr\- l.r.cn\.N! 'lf,r
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<br />CONSTRT](]TIoN LT'NDIN(; AGFN(:Y
<br />I h.rchy xfllrn undcr llci ryofPcrjryrharrhdchacon(rucli.nLndingag.ncyforrhct'cnnrmdccofrhcsorrnrnhi'hrhisFiinirn
<br />t{,.d rsc. 1097. CN. C )
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<br />AIELTCANLI]ECLABA[IIJN
<br />I Myloim uid.r pcnall, of Frjury oR of th. roll,rwine dalrorio.\:
<br />D.mhi.n Pcrmiis Asbc(os Nolifi.arion F.dcml RcsnEin,ns (Tillc4l)- P,r16)
<br />-Rcq!ircd
<br />(rtrcr olNolifrurbn
<br />I cdiylhol lhe r.dcralrcBulorions rsddinS ashc$stcrnovalarc nor aprlic,blc l(,lhn loj'tt
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<br />xhrd ntrtrri(nrd Dn,ncny nr irsnNr i(in pnrpo{!
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<br />l|l|)li. l nr Ag.nl Signslur(
<br />l\'rn,il( n r.rlrinl)i
<br />+€-.0 L{r4){4,;
<br />Eto.l Lo-.,,,o F,",zo\g
<br />Erection Pads
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