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BUILDIN INSPECTOR RECORD
<br />SITE-WORK PATE rD/stG.. CCTfiMENTS
<br />Set Backs 3 ,kalr B Jl'z
<br />Forms/Steel/Holdowns 3llblrg ,Yc<tu
<br />Erection Pads I
<br />UFER Ground a t.. ltB \)(r(-''Z-
<br />SLAB Floor :1 \\<*L
<br />Subf loor/VenVl nsulation
<br />Roof Sheathing 3,1A1 LZ DQ*4-
<br />Shear Wall rn .,",vJ o.r(3l2,hS t\-$JL\f*rrA,Framing ,tB
<br />lnsulation/Energy h.w0)
<br />Prywall a J/,>Z
<br />Exl./lnt. Lath '1 IL rB .\(+^25?-
<br />ll{-kJt$-tsiown Coat IB
<br />I\ila so n ry I
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report \
<br />Flood Zone Certif
<br />rl/lMY,FINAL I /tp c
<br />Certificate of Occu pancy
<br />Notes Remarks Etc
<br />IBJ CR Z-
<br />Oot-
<br />Ot{ EI' BU I I-DER DEL('ARATION
<br />I hscby amm unds p.n6hy of p.rjury rhdr I m crcnfl trom rhc ( ontr.doE l.irtu. l.tr f.r rhc lollowing rcen (Sd 701 1 .5
<br />Buns ai Prof*io. ('od.) An) (nIorC!un] shih Eq!'6 r Fmr ro..dtud, rXd, rpr.\i.ldDl.h or rcp.tr l
<br />shrclurc. Irhr ro ir. isue.. !L!. r.qlic lh. i.plicd for !u.h Fnnii to nk a stn.d lrilmd thn lE or shc i licmkJ ,urs,rnol
<br />!o rh. Fn\ nDa of E (nnrndol-r Lico{d lr} (( h.prd 9. Cohnftins r irh s.dFn 70m ol Dir Lii.n ! of rh. I}LrinB !tu1
<br />Prof6iotrt cod.) or thd lE or !h. ir .rmp' rffiom ed !h. tf,ii. rd rh. .ll.X.d .rdFion Any riolarirn of Sdntr'rlrll 5,t inr
<br />alrlicul for . Fmi bj{Brn.p?li..nrroncirilFsh,oamr'nor.rhefir.hun&.ddolldstJ500)
<br />l, a oMa of rh. proFry. or mv obplorG wirh *!s6 a rhcn arl. lamFEd n, wi[ d. th. w.ft and th. rnllrc i frn
<br />i di.d orofra.d fttr sllsc 7014, BBiE ed Prtf<hB (-o& flEcodd tLt.EL.e&6d.pcl!lou."Eof
<br />rh. rhrFry *ho hil{h or rqio!€ dEer &d sho &6 sch slti hi@ll or hd*ltor rharuah hi! or h6 otrr frplord,
<br />ForiH ihd sch ltlFuo'dr i.d do'&l $oir6d ftr d.ll ts*6q, r tlrlliB or iqn.'d isld$i'tooE16
<br />ol mBpkira tll (xE t oitb *i! lE\r tlE hml, ol l,nrt rlli rE or nE did d tio'lt or irtmr. $. FlF y lor ft pll,FE.f
<br />LaosFolrh.Fordy,m.rlu'*lyco,..1m8*irhl!..nBl(onlrdoutocotrnru.lth€F(,J.!tlsc.7N.r.&a'nB
<br />al IT bfrsin cod.: Tn. contaN-r l-i.d. I r* d6 nor 4'9ly t, e or nd of propdr v s h6 brildc or imprord rh6a1n.
<br />ud *ho odds ror rucfi Frj.sudfi a CodBlo(s) ltaed puBd ro rlE condor3l.tre lis)
<br />Iu.roplu sSd'on B &tC ntr rhs r.&,tr
<br />D.r. ortrd
<br />!aa[Eati:(a tElrtrarDlloat rox
<br />I h6.b! .mrm !nd.r Fn lr\ of lErurl on. or r hc follo\ rB d.( l&d r)B:
<br />I h.v. rd uill minl.in a cd ific.l. ol consr ro s.la.In*r. for sdl6- onF6l!.lion. c provid.d for b,y S(rion 1700 of tl'.
<br />rrN (-o&, lor rh. Faolrffi. of rh. f,.rt for shkh rh. Fni 6 (rcd
<br />I h.\. !.d * ill E.inrrin $0116 conFarFn iBu.ffi.. s rcqur.d br S.clnn !700 of lh. l.br co&- lor rh. Fn,nI@. ot
<br />rh. *orr for whrh lh6 ldnn i! su.d My eorld smFldFn iBffi. (ri6 tn FNy nuntE a.
<br />PolicyNudhs: Erpir6
<br />-----.-+.dil, thar inth.FaolrM..of lhc wort fo wh(h $ii Fmi n iss!.n,I !h!ll not mploy a., FNnr in ay men.
<br />$ u lo tc!ft .rt*{l lo lh. smr6' omFuFn L$s of( .lifomia .nd *E rhd ir I lhuld b..oE aF to llE
<br />so*6' conFelDn rrcvnio ! ol S.nion l7l9 of th. Libo. ( od.. I nEll. f{nhwirh $ndy s nn rlns lh,vtioN
<br />WARIIINC F.ilu. lo s@ sort6 .omFMion $\a+. ir u.L*tu|. .d rhdl subFl u aplors
<br />'o
<br />oiniMl Frnit ud
<br />cnil nG up ro om hundEn lll.snd &tlG (tloo,ooo), in .d.idtun ro rh. coe oa comFBho.. drh!86 6 Forn.d for rh.
<br />n 1076ofth.llbor(ode inr6.n Md olk,mq. s fc .
<br />^ror-",,
<br />tnr \\Oq\ fr+c(?
<br />DI(IISAIIO!
<br />I hfthytmm und6 rEndly of pojury lhit I d I'ccrcj unds provnn'n ot( h!pr6 9 (con'noc,n! rilh s.cri. ?m0) oll)'visk'n I
<br />or rn B{ruB ..d Pn'ashE ( od.. !n m! lrc.e u h tull foie drd.fid
<br />lcob l+\.y'*-*,*. B\,. p3-ob-\?Dr(!-lc 3 [ l?Rre L
<br />(alsla.uc1[BtlBDrNclcrd(I
<br />I hdrty rmrd und6 Ftrltyolpdjurylrd rh6. i! asn ruclrr l@dos astuy tur rh. pdfome. or rh. Nrl tu (hich rhB F6nir b
<br />isu.rl lsa !09r. ('iv. C )
<br />Artult r-p[(lJaarlltN
<br />I hodry afl'Dn und6 Fulty of FJUry o.. oflh.follo*,ins d(laralion.:
<br />D.,iolnion Pmnr.Asb6iG No' ifi.{hn F.d.r.l R.8uhrions (1iL,10, Pd6)
<br />R.qunal t!r6olf()lrfidb.
<br />I rdl'1\ rlh rhu fed.'3 '.!trhr(,ns '.[ d trr isl*{!sr.m,\il.,u n.r qr|
<br />'.3h1(
<br />rL, rh\ tr,] ecr
<br />I .diry rhd I hrv. ral rhn rppliclii.n &d ndc rha $c rbov. 'nf.mdio. ! .od(t I .!rc io @npl, *{h .ll ( n, rnd cou.ry
<br />odiEnc,rd st.1. t E Ebi.{ to hildry.odtuc1blr !'d hqcb iurhoi@ EFslldn6 offiirCn] Dd Counrylo dra uF). rlE
<br />rbo!. Mri6n d FDpdty fc idpdrFr FqD<
<br />y,pp,r,r or uo, \k..iu,, lrn4n"4u}/ty*
<br />Q.^u*-.",rn,,, r:tty' rt'r '' qn: ( I p Ct q L
<br />,",.o\- ob-,ts
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