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BUILDING. INSPECTOR RECORD SITE-WORK DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION I h6.tt .Itrn utrda Fuh, or F'Jur rh!. I o d@F from th. CoturtoB' I a(e lre for rrE follotrnt rNn lla 111 t BBinB rd Piof6ion (sj.): Any (-iry or (-oul!y $hrn r.qutr6 i pdni ro .oeM. dia. in ro\e d.mlBn , EFn u\ slrucror( Fior h ils isoec., sllo t.qniG rh. 6ppli.d for so.h tEnn to 61. ! signcd sldlmdt I hd h. or 3h. i! licd*I tuRUMr ro th. FovilioN of$. c6nrrr.roi3 l-i..ru.d h* ((-lu[,l6 9- Cdh'nfti.s rirh sdion 7000 ol l)ivlion I of lh. trunns rnd Prcf*rm(-od.lorlhdlEornEua. 9l thd.6om sd !h. b6ir lor th..lh.d (@Fni tuy \rLtior ors.cliJ. r0:rMt in) tpphcanl tor d p<n suhjelr rhc ippl'cul lo r.ivilpâ‚¬nlhyoftu mor.thd fiv. hu.&.<, dnll$ (S500) l. s o$c offi. FotEly, d n) cnplorc a hn f,.s6 E drn $L onFEercn, * &llEsql.dlltttidci! n id.rri.d q oltnd for .,& (Sc.70.14. &BilB od PinfBirB Cod.: 'I'lr Codraroi! LkdB tiw dE b' .p?ly b u oun6 o f lh. rirpdq who ttril& or trnFoE rtEbE !.d sho do6 i6h h,l hinrlf or hca.lf or lhrou3h hit or hB oM snploy.6, pfuv,&rl thri ruch imFrEdr ft mr iddn d o' ofiEci fq st l( hsE. rlE hlildu!. or ingbrtu ii a,ld *ithin M.,6 orNtrDLrior rlE ()$G t\ilb *ill r.r! tlE h&16 ofForfu $r lE or J. drl ml hnx d EFor. dE FoFry li, rlE lr,rre of I.6o*E orrh.FFiy. @.rctundy.o 6.rrs \nh hc.rql cDflrdoB ro codtud ilr F.jcl lS( 71x.1, &!N ,'d h!ftse (od.: Tn. ( onldor't l,kdc lr*' &c mt drplr to e own6 of FDp.ny *ho b{ild! o, idpto!6 rnqon. ud *ho coirr.cl3 for !u.h p..j<li*irnr ( onldo(r) !ic<*aj pun@r !orhc Contud.c! Lic* ku) I d.xdFt undd S<ron D.l. O*ndl woru(rlts. c(ritPi_rt.sA n(rN D}:SJAAIIAI I h6.lr rrm u.&r Fdrt of Flur_ om oI fi. follo*rs drl,rdrkJ6 Ih.!retwillroi.teiCdrif..ofcon5tloS.lf'lnMtGs.rtdsf,Fldirn.aFviictlorbyScrbnl7(x)ot$. L,tor Code tu rlE FIM. oI thc *!rl fc *tich rh. Fnn i s*{ I hre. ard will mai"t.in world .omFMhn iBu.itu., s rqun d by Srt ion 1700 of th. t bor Cod., lor I h. psfi,muc. of lh. *MI fo. whth tnn Fmn 6 eEI My sr.t6- .o,rFdion iBurM..eE ad Flrl. numb.r &: l.c.tily thst in rh. pdnrnecc ot th. worl lM which rhispsmir is bu.d.I Ell nolonploy&y F$. inlnymannd e 3lo b<!tr $b6l to rh. E,t6 &nFsnhn h*! of Cllifomn. ud trd lha if I 3h\uld h..om *qdt r. 'lEuo'16' orFBrion ForirEG ol sl<1n. r7m of$c l.hr c.d.. Ldl. lonh*nh.orpry vnh r WA|NINC l6nur. ro sr. $oil6 comrasr6n N!dg. ir trnlasful. Dd shlll 3uhrcl u ciril fin6 ur ro o.. hun&al lhouetrd &116 (1100.$0). in addnion ro lh..o( ofc n. ds${.s a provid.n lor rh. Sdrru 1016 olrh. tjEtr (i,$. hlad ad dklq--t A- L8. Z."l ptllttSArlo! I hcby .mm !.dd p6.lty o t Fjur' rhd I m ncoEol und6 FDrsion orclilprs I ((omn@iry wnh sdhn 7(lo0) oa Dtr ision I of lh. Bcirs md ProlsioE Cod., ad my lkcM it in aull lo!c. Erd cr6l 3 - ZS^2,.'\.?,,-*.\ calsralcll0dtEuDtNril{iElt] I [ddy .fm undd Fuxy ol Frury thi rhs! ii . @dndio. ladina rSdy for $. Ffollrl4. of lh. uo* flr *tich rhb pdtnn ir isu.rl (se 1097. civ. c ) afftl(aNfD[cl.Sarlll! I hddr .trm ui&r F.!tl ol Frur) oE of rh. Iollo* irs &.L,, irns Dcmolnion Pamnl^sbdos Notiliftlon Fcdaal RqluldioN (TnL40, Pdo) Lcquitui tdr(otl$tifi.dnn lcdifrrhsr rh. fdl.ril r.suld it,N EBedrns sh6nx rdnoval d. nor appl(ihl. Io rhisuoj6l I cdi& $d I h.r. rat rhir .DrltdFn !n i!'. 'ht !h. rbr. in n !r cord I alra r..!art\ s'rhnll(-'r! aRl(tu.i! ordinrn(BMd sr . tjssGldiu r. t{ildirr condrudirn. oxl horiz. r.Ftgna '16 o f lhn (.n'} dd ( ou.r! ro nr6 ul[. rlE rlx\r nnin[rtllI.Nnr ntr nlc.rifn ^ppli.tnl or,riol stnrirr. b o-:D T S.\..-.o.,..r-- g-eg ccrl Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Subf loor/VenVlnsulation Roof Sheathing Shear Wall Framing lns u lation/Energ y Drywall Ext./lnt. Lath Brown Coat Masonry Pool Fence T-Bar Handicap Req. Deputy Final Report Engineer Final Report Flood Zone Certif FINAL 6-2ts -t7.)"Uth ,fvv) Certificate of Occupancy Notes, Remarks, Etc. I I I l I I I