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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS O\IiiEI BUII-I)EN DI]L''ARATION
<br />I h6cby linm und6 FMlty ol psjurv lhd I m .rorpl rmn lh. ( olnrelod Lic@ l,* n, 'h. folh$ i,3 tmn (Ji( 70 ! I 5
<br />Burn63 ,ri Preadion C.d.) Ant cny or Co! t *hi<h Equn6 i Fni kr odtu1. drd. inpro\c datuliih or qEr mj
<br />nrudr.. rn, 'o "r
<br />L\3ue., ak' r.qun6 rhc r{pli l for s.h Frnn to fik r ,4n.d stalml thst hc or sh. i licdE n prls@r
<br />b rh. prolisioB of rh. contdors Lrcds.d L.* (Chad6 9. ( onmtr'ns *1h s.clion 70m of lr'ri.t. I ofrh. BGin6! and
<br />PtuGsirB Codc) or rh.t lE or 3h. n.\mF lh6.liom !d lh. hct6 f( th. tlLsni dmFio. An, iohio.ofs..lion?0lll5 hy&!
<br />amlicrnr for r r6nn subje-l! rhc rppli(dr ro . civr! p.ul y o f nor 6orc rhM fiy. hundr.d Joll {t500}.
<br />L s oqF otrh. FoFry. m ny o1110)6 wirh v!s6 6 th.ii sl. odpsqriob. wil d' tlE *orl e'd
<br />'h.
<br />slulw i to'l
<br />i dd.d o, ofidrd tor 51. {sa 7014. BNiK dd PibfdioB Cod. nE ( oddoat Liw l^ &s bt rpply ro u o*E of
<br />rlE F!Fr] r ho hilt or itrsorE llEq!( rd tr'h tt6 sh f,!,l hinElt or lE*lf ot lhhu$h hi! or hd om dploy.6,
<br />providdj rh!' ruch inFoEh$ e n idddai o.ofrE d tu sL l[ rrs66. trE hr dnB or sprodd i $ld *ih, m ]w
<br />ofotrpkb( dE (xE &rBd will h.rr llE hldsr olFoti'u d, lE u tE di, ol hiU or n.FoE t ,. FoFty aor LIE FtrF r or
<br />l. s o*c of lt p.op6ry, o .rclc'v.lt conrding *irh lic.s.d cofua.ro^ h ..drud rtE pmj4l (S(. 70l,l. Il$in65
<br />.[] hrEsm Cod. Th. Cont(u! l,rc6k l.rtr Lk]6 mr .rt,lt to s os n6 oa FoF t) s h. hlildr or inprov6 lhdarn.
<br />d {ho Ndr[ls ror su.n F.j.ts $nh ! (.odEdons) litd.n plFMt to fic (nnt&tr's Liccr l!*)
<br />I an .rftF und6 s<rd.
<br />D.r. ortrr
<br />$ oR(r Rq-( ontPf,\sATIoi!
<br />Dl;gia^]lo!
<br />I h6.6, rmm und6 d.lr, .lFjury on. .f th. fdlowing ddlmtioN:
<br />I hasc sri w'U mi ri. . CorilE r. ol (irnsl ro Sclf-lrolr. for wo,k6 comFMion, 6 t)o!id.d nn b, S6lNn l'r0o o r th.
<br />l.tEr ( odc for rt FfM.of lh. troA fs rtth rlE p6hn a is.d
<br />I h.vc md will m.i.r.i6 *orld' conFB.rion iN!h.c., 6 Eqlrn br Sd ion 1700 oarlE l,hor C.d.. for lh. Ffolllr*. oa
<br />r $.rt fG "h(h th6 Fhn is is.d My $tr16 @mFMion ilus. c'ro td policy nunbo e.:
<br />I c.n,ry rhd 6 rhc Ffor@c. of rh. sorl for "hkh rhk Fnn s isu.d.l sl'lll m' dpt'y.n' Fen i. uy ffi
<br />e s ro tR'm ebj.d ro rlE Ktr6' compqEd ior hws otc.lifomia dd asc rhn ii I rnould bdoh. llhjelo rh.
<br />so 6 comFl-rion provtioB orslclrn 1700 of rh. lihr co<te I d6ll. adhs nh 6mdt snh rh.s ForirhB
<br />WARNINC F jtu( t. 9@ Nrla ompqdio, ornre. n onb$ful &d sl'rll subral & oploF ro oiniml parti6 Md
<br />(ivil nnca uf tu on. htr.dr.d lhoush,l dolles (ll ln .Jdni.n ro rh. cosr ofcomFrx.n. &nurd a provi:l.d tu th.
<br />Sdbn :1076 or rh. rihor Calc inrdd rnd &r.Ey 3
<br />t)tI't-\R.\ I l()\
<br />, hort- .flm un& Fulry of p.tury th, I m lic.{Bl u&tcr Fivi.li.n of ct fl6 I lommo.ins wili S.clion 70{D} oa l)iviiirn l
<br />oa lh. BB'nd md PrcldioN Codc. dd ny lic.e n in full torcc rd.tr<r
<br />B/2-/172 e.N7 ."*..".\-
<br />a
<br />6
<br />CONSTRUCTIOII LtsNDING AGEN(II
<br />I h6rby .llm unds Frty of Fiu.y rli lhd. a i otdru.1io. Enu'g .sd, to. rh. Ffolrlre oltlE "!rl tu *l'tl' lha FDa it
<br />is.d {!i6 1097, Civ C.)
<br />AIIII(bIILDIO.ATAUAT
<br />lhedldlm undd rEnahy ofpsjury orc ofrhc folhwlnB ddlddnns
<br />I).frntrion Pmtrs-Asbdos Norfico'on lj.d.r.l Rquh|ons t lht,r0. P.n6,
<br />R.qurcd ldtsofNd,ficdM
<br />I c61'8 rhRt rh. Ednal r.subx,)n. iqrerlrns ah6G r@o\ rl & a, arthcabL ro
<br />'h6 Fold
<br />I .dil, rh.r I e-. rBl rhi! sppli. ion ad sbr. rhdt th. $or. inn'lmrion n cocl I4raloomplysnhlll(irr d(ou.ry
<br />dJmftd xrr sr.ic ks Eki,E h b(ilding codtudbtr ri E@r.J .dhro. EF6ariir6 o f rhn C'ly u'd ( o@ry ro drn uF. rlf,
<br />alrr. rork,n.i prcpd! ntr iNl8ri,rn
<br />::;::ffi::--fs 2 /<2 9'z-tz
<br />Set Backs
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUl nsulation
<br />Roof Sheathing 7.1- 17 -i),9tf.@ O T- -nvt>c+6)
<br />Shear Wall
<br />Framing
<br />I nsulation/Energy
<br />D rywall
<br />Ext./lnt. Lath
<br />Brown Coat
<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//7/t7 /L/ZS\/1 l
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc.
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<br />I IForms/Steel/Holdowns
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