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SITE.WORK DATE ID/SIG.COMMENTS OT{NIR BUILDl:R DEI,CANATloN
<br />I h(.try arfum unds pc.lhy of psjw lhd I m .rdpl noh l h. (i',{r.doR Lt.@ l,s lor rh. followin! rs)n ( Sd 701 1 s
<br />tldin6r ad Prcf*ioi co&) A.) Cn) or couniy {hrh r.qu6 . rEni ro ..ddd, rtd, inpr.\., ddmlilh or rqnt ,t)
<br />srrucrurc. Fitr ro ns klumc, .Lr. rc$t6 rh. l'pli(MI lor such F.nir Io fit . sisEd slrmd rha rE o, ihl b li(d<d Neer
<br />'orn Foras6 oa E(-o.rdrmt l-k6*d b$ tcrrFa c, ('offiin3 $nh S<rnn,0m of Di!6hn r of rh( Bsh6 lnC
<br />Ihferiotr! ( odr) or rhar lE or rhc is .rdpr r hsctum ud rn. b6n lor rhc dl.s.d .rdprion A.y viol,iirn ofs..liln 70rl l ht..,
<br />,ppn.rd lor . Fm't sbjdB rlr rrpli.d r. r .r rl pnuht. ol tur mr rhr. fi\. tmL.d Lhuds { l5m,
<br />L n orE of lh. F.Fnr- or ny ophts unh us!6 a rhd rk cooFrxnFn. \iU rh rlr }ort &d llE rd4 6 mr
<br />im6dr.l or o ltdd aor $1. ( 56 7014, tldin* md It fdi,rm (inL Th. Codmdoir l-ic6* ks do6 nol S?l),h M o\ rd of
<br />ih< Flrsry trrn tlil.l or 'rg.rdoEo'url $t &E uh trvi hin!.lf or hF*lror dhu8h hn or hd otrn dngh! c,
<br />n.ordal rh.! .uch mFo!ffi3 m mr darld d ofiEEl for qL l[ h)s6c, rh. hrUinA or mForffi n $l.l sihi. orc tG
<br />oaonpklltn, fi. txe ttu,ktd *ill h.y. rh. hnld of F!in{ rh, h. or :lE drl d tuirl or 'n{ftr I rh. FIHy rr rh. Iilq& ol
<br />l. a osE or
<br />'h. F.Fr), M a(lBrr.b .odi&1trE $ nn lt.Bd c.drk.u ro (oddd rlE
<br />',oj.d
<br />tS(. 704J. tlltrE
<br />,nd Phrfrslm Cod. 'th. ( ontacror\ l-icd& lrv do6 nor applv Io o owno of poFry who builds or imprnvB lh6mn.
<br />.d vho olndr lor st FoFr $nfi r ('odftont) ltdB n orrrid ro rh. CodBro.r liN ll* )
<br />I m.rmrn unld sdron
<br />D.t. O*n.r
<br />\IoRLrRa arrnrPf nsano,\
<br />D[ClJBtrUqI
<br />I hs.tr rmrm!n&r FEnt of Fjur'.k of rh. fou.*i.* &.hi.rrB
<br />In\.nisillmi tnacdifrrr.of(oMihsllf ler. ro *.116-(onFrdion. c F.rdalao.q(s..lion!7u)olth.lltn Co{t . (x rh. FfomM. orl& solt lor sni{h lh. pannil ! isucd
<br />/iU,. "nA "ilt ..,nr"'n "o*6 co,rxBiio. iNm., s Equtrcd t, sdr. r70o or rh.l,h.r (-od.. ror rh. Ffolrr]$c orrhctr,rlt rhrhrhEpnnilnLqad Vy* rka c.mpcnsi.n rbur.E. crE ddpn'c\ nu'nb. oc
<br />trtG
<br />A4:V'tztr +(-t-)[
<br />l..nrt rh,t i. rh. Frfolrle. of rh. *orl ror trhich rh'! Fhd i3 uru.d. I rh.ll m' mplo, !n) F$n in.ny EeE
<br />v! 6 nr b..om. sbi( lo lh. *o 6 conFisrtion l!{sofc.lifomia lrd lsrclnn ifl stould b.comc ot'j<t lotlt \
<br />tr!*a onFs! 6n rrnvilbB oasdin !r0o of 'l: L.t[. Co&. I JdL fdhwnh o'ryly * ilh llrs pFEioB
<br />WARNINC Folur. ro sE sork6' comFMion ovois. ! u.b8t!1. d lhtll rbFr M onploF to aininrl tEinir ed
<br />.nil nr6 up ro .E hundr.d rlhN.d &lIB (t100,000). D &ld(irn ro E.or of .omFN'nn. &ru86 u Fotd.d ,or fi.
<br />sRiri 10?6 0frh.lnhtr ( odt. 'nrfd and d omR c f.s
<br />/,
<br />D&Clla^Ilox
<br />I h@t'yljlum und6 Fnnlyof!€jury lh.l t m licd!.d und6 Fruhion oacn! s 9 (cormdcins n'nh Sdion 7000) of Diviri.n l
<br />of rh. Blffi di [r.f<68 co&, !d n, lk.e i. in tull i)r< rn !fidi
<br />e-1lol
<br />o r(tu.F!F,
<br />'^**s-'/4-
<br />12oy(6t,rl i)
<br />(OISIBIJ(IIOTI.ETDIIG.ACE!(I
<br />I h<$r lrm u(Lr Fulll_ ot Fju'- lhd
<br />'hs.
<br />i3 . Ntdrucrion l6'dnrs rstu! Lr !h. Ffolrl@. of rh. {.* n! \hlh rhir Fnir ir
<br />su.J rS( !0r)7. crr a )
<br />I .nl. i \mc
<br />ATEII(INIAECIAAAIIA!
<br />I hddt rtrnr unda !.nrxt of FJu, r. oG of !h. folh* ine d(I,..r ionr
<br />I)qtulirirn PoTil''Asb6r6 l.Jorrficrm l-.d.r.l R.suhli,n] (1 L t(r. P.n6)
<br />R.quEd Ll|ld olMlifi c6lirn
<br />I cdiry lhal lhr f.d6!l rcsuhtioG rcsadin8 dbelos rdovd e. nol dppli(lblc lo rhn tmi.d
<br />I ccliryrhn I h^. @d rhi!.pllicarion !d n .lh,l lh!,t !. inaorurio. ir.oEd I dgE ro comply wnh .ll ( ily lnd Counly
<br />.rdilw6 di srd.lrq. ELrE !o hlildins gy{sFrF lB! rurthrn. r.t 6driv6 oltnn ( ny od Countylo dla lFn llE
<br />.bc,.'JMhkd F6Fty r cpd^^wffil /'*-*-*-,'@y4'* rh,. /olr>/tz
<br />"^r*- rr',n"U, f&l k
<br />Set Backs
<br />Fo rm s/Stee l/ H o ld own s
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Fra m ing
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Mason ty
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />En gineer Final Report
<br />Flood Zone Certif
<br />tl I
<br />FINAL 7 t1,0tft il{tv
<br />Certificate of Occu pancy T lr
<br />Notes, Remarks Etc
<br />BUILDING. INSPECTOR RECORD
<br />I
<br />I I
<br />L
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