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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNER BI.III,DER DEI,CARATION
<br />I hdct! .flrd u.dd pd,lry oa Fjuh- rhd I m .r6q, frrm rh. (-odr&r6 l.r@ l,tr for rh. follotrins 6$n rsr 70r I 5
<br />Il6in* ,nd Pmf*ion Cod.) Any Cn, or c.onry *htrh r.rttrnB . Fnil l. NBrrucl, .116. nprore danolirh or r.p.n ur.
<br />lttudu., Fhr lo i'3 isu*., lko r.qrn6 rh. {pl(d for sch Fnil lo lik a 3{n d ddmt rhr lE..3n 6 Ii..!E d I[eIn
<br />l(, rhc FovtoB ofttE Coorricrois l-icor.i lrs (ch+rd 9. (bnm.n.int wirh s.clioo 7(xro of Divirirn I ofrh. a$i.d md
<br />Pr.lsoN Co&) o. rhd lE or rlE ir .rdrlpt rnd.6om ltd th. ber! for lh. .ll.scd crdqnrn Any \mLhnofs.1io.'iolrl5 bliny
<br />ipplicmt ror . Fmir subj(G rh. lpplronr ro . .ivil Fnrhy . a nor mor. rh,n fiv. hlndrcil dollm (tS00)
<br />l. s oM6 oath. FoFny. or my nplorc with w.s6 e $.n eL .omFdhn. *ill & llE sst i'd fi. nn rE ir mr
<br />it drLd qo,Is.d fd r]. ISc 7ol,{. Bdi6 !i Phf6.B co& TIE Codrlcloi. l-rl@ ll*.roB mr .Fpb lo.n otrnr or
<br />th.piaFry rtobild!orinFGthdbll!t*h.dEMh$! himclaor hE*ltot rthush ht o. h.r o{! d9hyc
<br />Fovidal rld s.h imFolarlfue ml h.n dro,Hfttr5t.lL rr,NtE, tll bilditB 6r itrFsqBi a$ld*ithiioic]6
<br />orcorq'Liirn. rrE olrc 8uita6 win hav. rh. hnl' ofF.rin! thi h. ot nE dil ml htild or itrrFoE lhc FDFy ftr E F,Po..of
<br />l, -o*F.rth.F!Fl', dqclllnlN.odr(int $nh |tc.6.n co.nrdc r. Nn!rucl rlE FsJ.d (Sd 7oll. &!md
<br />.nd Pr.ftsid cod. Th. ( onreroi! Li...sc L.w &6 not lpply ro 6 o[n6 6f p6F! y who build! or improvB lhdotr.
<br />rrd El[ onn 13 tN ruch rmi.rr! \nh i Codr-!o(3) lr6u.d Ptcud lo rlE Q'f,rdorr Lt* L$)
<br />I m.1mpr !rj6 SdrFn
<br />-"lo/ru/r T
<br />OECIA8AIq!
<br />I hd.bv rmm und.r r,6rhy ot rgjlry orc of rht ftnbwiu d(ldaxoN:
<br />I h.v. nd * rll ro'n.i. ! cdific.t. oa( onFt to S.lf-lBurc for *orkEs .rnnFMio.. a t'ovi'l.d aor bt sdthn r 7m o r rhc
<br />lr.r cdL. fr ih. Faolrj1ft. of th. s.d fs *hth rh. Fml i! N.d
<br />I hltr.nd $,ll runhin qortd .onrFdhn iMm.. G r.qoif{ t'! Sclion uoo oflh. lrbn, co<t , fot lh. pof.llr:4c of
<br />rh< ErI for whi.h rh6 Fnn a e.d My *0r{6 .onFs.lion iNuMc. .unr alj Fli.y .ombd r.:
<br />l.dif, !h{ h rh. Ffolmnc. of lhc trort tor whi€h ihis psi( B irr'.d, I !h,llnot mploy lny p6$n in uy den.
<br />h d
<br />'o
<br />h(om rubi*t ro rlE trql6 onp.dion l,$: of Crlifoftia drl Br lhi rtl nsuE ticor ebj*' to rtr
<br />s!*6 $nF&tion Forrnrn..asc<lio.lT0oolrh.lrb.r cbdq l stEll.lonhu'ilh comply *ilh llrs poilioB
<br />wAmIxC F.ilG ro c@ r.rte o.pddir cora{r. i! ukqtul- drd .ldl at d 6 artqw lo mtntl FEiE Dd
<br />cMl fD6uptoo nun&.d lhoNnd doll6 {t100.0tu). in ldditnn h rh..ori of conP.Nrion. d!tr46.r p.o!id.d lor !h.
<br />".,.,to/oa/ t> a
<br />Vhqsrxa'()NrR^( r'(,R
<br />TETLI&\IIA.}
<br />I hdcby llrm und6 Fi.n] of Fjury rhd I m lnolal und6 rrovilt n of ( hrliE 9t.on,l@i.u wirh Sdnrn 7(xI))oal)ivirntr l
<br />of th. AuiB ind Ptnt*b6 ( o&. !n ny lt.@ L f, tull aoN in.lTGl
<br />(ollrBl](Irclll.Elptlcacfr(I
<br />I h€dr, rlfm undd FBh'.lFju.r rhd th?. t r codD.tio. Hi.s !8acr td l& paf.mu.. oarhc "ort for $'.h rhrs IErIl n
<br />isu.d (S< 11097, Civ ( )
<br />AIITI(AILDISAAAIAN
<br />I hdrt, !trm un& Fnlny ol pcJu' r- oE of lh. folh\ in8 &.Unr ir.r
<br />I)molirion P.mirs-AltBlo! Notilic.rion Fcdarl R.8uhri.rG Onl. t0. Pd6)
<br />R.quir.{j L.lts of Noificddn
<br />I csliry thll rhc tusal 'csuLirN r.!rd'n! ftEi.r r.tr\ .l e. ml qDlk6hk to lhs Foi.Tr
<br />I .diry rhd I hiv. E d lhir .0plt.r ioo ed r.rc rt{r rh. ltFrc InfotuF. i3 .odd I .*E
<br />'o
<br />comg\ tr nh .ll Cn) rnd ('oud\
<br />odiEM6 sd Sld. l.$! r.hlts ro hild'ns .oldruclFnJrd hs.tt rinrnD. r.Fffids6 of rfin City .nd Counly lo dlE ulnn
<br />'rE8h,v. ndrnrn.ri rn)tdv fur 'Nn dionp rlrls
<br />^pplhiir
<br />or
<br />^smr
<br />siri*rure X *," @10< /i z
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUl nsulation
<br />Roof Sheathing lo t\(1 ,1,Ulq il TDI) k,,n 7,'lo>'t
<br />Shear Wall l.rl n^ -|a,,-al,{o"
<br />Framing lDob.
<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 />FINAL o ttJ.llh r 'fl)
<br />Certificate of 0ccu \:7pancy
<br />Notes, Remarks, Etc
<br />c-1Gz/Ul-
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<br />Flood Zone Certif.
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