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BUILDING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNI:R BUII,DER DEL('ARAIION
<br />I hdd'y allm und( p.nslry of Fjury rh.i I e .rop! 6sn r h. Codidos Lic* l,w for lh. iouo* in8Q.sn (56 7!:r l 5
<br />ttu$n6s !d ttof6b. ('o&) A.! ('nt or Co!d) $hkh .ator6 a Fni lo conrrud. ,16. idFo\c ddmli.h or qtr M!
<br />srrudu. prir ro its isllmc. .lso r.qutr6 rh. q'plEMr lor turh Fmn ro fiL ! !'rn d !idr16r rhd lE or 3h. 6 nc.ned I'{ead
<br />ro th. F.visiom ofth. conrractois Lic.n*d bv (( h.tr6 0. ('omm.ncin8 Bith S.crion 7000 of l)ivision :l orrh. aNiner .nd
<br />Prcf*hns Cod.) or rlBl tEorshc is clmF lhc.ftom.nd lh.li.ti! for lh. .lks.d 30l{ io. Art ioltrion ofs.dion 70:lI ! dn)
<br />arrliLlhr for !Foi {bjclr rh. q!ili(..! ro ro lFah) olR mcrha nr. hund.n dollB{ttlx))
<br />l. I owr6 ol lh. rmp.nv, o. my cmpn)y6 tril h w.rB 6 lh.n $b conpasition. tr ill do rhc rydrl Md th. slrdu. i! nfr
<br />i sd.d or oafEcd forskls(.?ofi. Buin6 ed Prof$ioc ( odc T1.(b rdoi! I kN ti* rb6 ml qlf,lv r. osn(of
<br />ilE FrF! $ h) t!il& or hqi.r6 rtm, rn ! b &B *h {flt himrlf or h.clf or r tmu3h hR s h6 otrr mnhlc.
<br />Fo\ xH rhar 3uct inl'oloEB e mr dot d or olErql for n]. lt hq-s, rh. hildtrB or mF.rffit n $lt *nhm on. )6
<br />ofc.mrl.1io.. lh. ( Ir n6 a!iu6 will h!v. lhr hr&n oal'orins lhd h. or sl'c did ml hlild or iqrcr. 6c F.pory i)r rh. lDrFe or
<br />l. s osc olrh. Fold\, m.r.lunr.[ .o rdha $nh l'.aE i (onrdo6 ro oNod ttE FFl (56 7ol.l- lrrE61
<br />and ltrtsion ( od. th.Co.[!cro.sLic.nrcLaqdoBnor.prilyro osnd orprotdysho buil&.r inprolBria6n.
<br />nd \h..od6.rrlorru.hF6jd.tr{h.Q)nt&rorls)li.ds.dIUBUdrorh.ConliddoisLicdr.li*l
<br />I m fimpt u.rls Sdnri
<br />D.r. ()nnr:
<br />\T ORl(J RS' ('OTTPENSATION
<br />DICIJiAIIa!
<br />I h(.b) .mnn unJ6 p6ahy olFlu^ on. ofrh. iolkurn| ddl.,.rioni
<br />I hlv. ml rill mi.hi, . cdifEd. of consr ro s.lfiBrr. fm sorl6 NmFs, xrr. s FoId.d fo. b,r scl h. I700 .l rhr
<br />Lrbc ( o&. for tlE Ffollre. olrlr rrrt for *tth rlE Fmn ! &u.d
<br />lhnlcondf,illnminrsin worlm comFnsation rtrntr.ncc. as r.qtrtcdb]s(lionlT(xrollh.t-d$r(.n?,loirh.tafo.non...l
<br />rh. u o' k for uhrn rhir p.r'd n iscd Nly q 0116 .om!6s.1nr iEurec. cdnd d
<br />+.(.".,. ' Ini<p tn c{ra .l-
<br />ib1 ev\I nS" r ancl-
<br />')ci6
<br />(<l
<br />-qP,,Itr] Numb6 'tllatlrT
<br />I.drry rhr' r. rh. Fforuft. ofrh. *.rt for snrh rhir Fmn !r i$u.d. I !n.ll ml dDhyu, p.mn in lny mdF
<br />e a to taom. $br<r to th. $nlo' comrF!.rion hw! of Crlifomi.. dd i*N rhd
<br />'a
<br />I ould hrom. $bjcl blhc
<br />*orld' omFa.lior FlrvnioN of Sdirtr I700 otlh. trt r ('de I shrll. lonh*nn ontl! $ nh rhs Foritions
<br />\lAnNINc: trllu. to su. *dl6 drmpaMio .o\ma. a lnL*tuL Ed null {bj.d 6 6n lorB ro @'d Fun6,d.tril liE up ro oE hu*n.ri rlDugn dollG ttlLn.uxr). h sllhioo ro rh..on of conF@thn, d@!6 B F.\il.{ i,r rh.
<br />Sdf on \r7rr.f rh. I abor (.i..'.rr.sr
<br />It
<br />u(l:\u!!l!)l&!Lltxu("r&ura\
<br />I hq.bv.flim und6 nq.lty of pdjury lhal I dn licmBl undr Foririor of( hdlls 9 (com'ndc,ns sirh s.dion 7([xD olrrn iri.n 1
<br />.f rh. BlsitB 8t Prot6rnN CorL, !d my lic.M B in tull nre dd.,rdl
<br />c-lo loo t?oA
<br />q//k/t /,""rr.".,*AkW
<br />calgaucrQllrllpllqacEl(I
<br />I lE.t'v rrm und.r Frt) of FjuI}- rni rlE. ir i codMio. Ldiry !ad) tor rh. Fro'r!e. otrh. trort fr'r $hrh rhi] IErtrir is
<br />is!.n {sd. loei.civ ( )
<br />atftl(:alf[r(ldtalto!
<br />I ha{t rftn utukr Fnah, of FJu, r. o.. .l ih. lollo*'nE d6l,.r i.,.s
<br />D.frniirn P@irt.A!b6ro! Norrn.nirn t'<j.'.! Rqrul,tio (Ink40. Pd6,
<br />R.rtun n Ldr6of Ndi6..lion
<br />I cqr|ryrhd rn Gd6.lr.8uhrrB r.ardoa atdo3lEmrll&c mr q'clr.hL r. rh. F)j.{
<br />!ac6'fyrhdlh,'.rcilrhi!^ml'(.rFnmJ!rrr.rh 'h.at v. rnlomd ion ir coEd lasretocom y$nhrll(ny.ndCouirv
<br />ordine6 dd Sur. h$i ELliru to boildin3 codru.lion. ad hs.by urhort. r.prsrrh 6 o t rhi! (-iry ud Counr, ro drq uE i rlE
<br />,"b1-
<br />S.(<ftyl r f
<br />.bo\. nHrhn ri nn.n n! for rBFdbn pjlrF,6
<br />ADD,..rr or A.6, sr.rrur. *6 k
<br />*-,,-"...,,,.,, 0(.'ldafdh e'"
<br />ql/ r// 7
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<br />Drywall
<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 />I
<br />FINAL 10,/zlt -tf14z..n
<br />Certificate of Occu nncy 7 7-
<br />Noles, Remarks, Etc
<br />-rl
<br />I I
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