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. . BUILDING- INSPECTOR RECORD SITE.WORK DATE ID/SIG..COMMENTS OWNEtr BIJILDIiN DIII' RATION I hc.tr .ffm u.& Frny or FJ!.y lhd I a a.trEr tren lh. Cotu.doB l.!c l,r lor rh. follo$14 lKn (S( 70] I I BsiB .,n .tofdion Cdc) Aiy firy or (oudy $nkh r.quG . Fmi 16 ..do( .ha, i,pro\e &mlBi or r.Fn x) iicr4. Fq ro tu Butr., &. Equn6 r,E qrplrcst for *h Fnn ro nE r 3qEd nr6El rhi lE o. dE ii licosd FrEld ro rh. EoririoB of dE Conlddtr'r l-i(drd t s tcntFa 9. Cmndn8 *nh kil. 7000 ot DiYinn I .l ilE adin6 .nd PrDt6a'6 Co&) or rhd lE 6r rh. it .rtr l lhs.nom sd lh. tas tor rh..lk!.d adplrn An) liohionof Sdbn 70:r I J .]_ .trv .pplicur for . Fnil sb6lt lt rpplror t. t.irIl pdhy ol mr m.. rho l''r. hunt d rhll6 (1500) l.es o*nqofrh.I'.t d),orm!.nll}k)rcr htr!86NlncnFkn\mFndkrn,{ d,rlEuo*ddrrFrM@imr iddxtr.l or olIr.rl for sl. ( s( 704.1, ll$inB! sd ftnfdioN cod. t h. (-onrrrloar I (d* lr( do6 nor spplt lo u o\rs nr rh. Flldy {ho hiLti or mtn)!6 rh@[ dtd *'h. do6 sch Mrl hinklf or h.*llor rhn'Sh hc or hd o*nmplolc{. lrovid.d lhar sucn inrprovodr! e fr idddal or ofi...d for sL lt lxN os, rh. htrkling or inFor @l is $ld \ ihin on. \cr oa.ompldion, lh. oM6 ltuildg *il hav. rh. hrd.n or ForinS $d h. or $c did nn hlkt or imFo\. fic Pmpcly lo, rh. PtrrIrE or l. s om6 ofrfic propdy. m .r.bn.l, ..nn&1n8 snh li..6al conlrt roR ro .onrrud ltE Fjccl (S( 7014. BBmd .,rl Enf3.nd Cod. Th. co.lElor! l.icmr I !* do6 ml !p?ly lo d o*.n o f FoFny * ho t ,lit or inrmr6 th6Fn. ..d lho.odEr3fNschFqdrwnh.(-odr.do(s)l.os.dp{Burrhlh.(idridor'rtkcett\) le crmpr undd scrtr,n ,B & PC f.rrh6r.6n Dtt. Ornd woRr(F nstotlPE'\sa l l(rl\i IECIdSAIIO! I hd.by lmm und.r FDhyotFJUit dm Dlrt folloqi4 &.le.lhB I h.vc dld u ill nlinrdn . ( d,n..r. of (-o.sr ro s.lf-lBurc lot n o'k6 .onFrdio.. c Fovij.d tot by sdi.n l7{ ofrh. lrbo. Cod.. for th. pdforor. o I lhc trlrt( tor tr hich lh. rrnh i! illucd lhavernd Nill,namrain sorr6 ..hr.nsdtrn insumncc. N r.qut.1j bls<1n)n t7l)0.flh.libo!cod., foi rh. pdfonnin(..f rhc rork lor rhich lhn pqn ir laru.n Mr *orkds compsalion 'nrre-. (mid ,rl Brlicy nuhbs e.: Policy Nuhb.r t'rpi6 I .diry rhd i. rh. Fforllld. oa rl! q ort for u hih |hn Fnh ir isu.d. I nrll ft,! anpl6) tF$ninlnynuF $ s ro bc.m $biNr ro rlr *nnd Nnip6.ir. bs. of Califomi.. .nd .sE Gr if I $ouu b<or sutri.d lo lL ur.ld 6,pdsion pmvirFB of sdEn 1100 of rh. hL( Code I Jull. ronh$ (h omp! *nh thok p.trti'ioB wARNINC Frlm ro su. "dld oDFsion 6r6.s. i! unrNtuL dld rldl ubFl u alphF to aimiMl Frtir ed cri! fin6 up lo oE hundrcd rlt'u$ftj r[.116 (tl(x).000). iI .dd'l b !h. cd ol.omr.Mion- dm+B a I,.\ d.n tor rh. cGl.,mr6d d dt,nx) 3lc o I hmby sfljm ond6 pdahy ofrsjury rhrr I d ltroral undd I'mvilion ol( hopls q (.om,n.trins wirh Sdion 7000).rl)1ni'nr 1 oa rh. B6inB ed P$lNmB Qrd.. ed mt liLaE is in full fo(. di.lT(t C ?1Il\ 3a"\69.tr I tE!t, rlttu udd Futy ot Fjury thr llE t ! dldru.lai bnnB rydy 6r lh. Ff llm. ofrh. $$t 6r un*h lh! Fn. . isu.d (s6 !097. ci!. c I A.TTIICANLDE(I,dAATT,A I halby.fl'm unds p6!hy of FJury on. of lh. followins d(lsdlioN Ddmlhio. Pmne^lb6los Norifirahon f.nd,l R+uhrio.s (Iill.4l). Pin6) R.qun.d L.tl( of N(nifKdFa I .dri! rhi rh. H..d .(8uhhB ..*rdi.E 6tBlo3 rom\ tl r. fr{ +alit.h! ro rhir Fqd I cdittha I har.sd lhB,plli.h$ nn r.!. rhd tlE !tor. 'nrorrnnx'n ir.o]Gl Itsterocomrl)\ htllcn!..d(ounr) ddmaft6.rd S'd. Lq: E]n'nt ro tuildim.odrudFlEd n6$- idrbnT. EFddiA6 ollhB Cny Dd Coonry ro ard uFnrrE tJ \J It!ho\. mrion.d PrtrFn\ for m.F.r ^r,u-* * o*-, an-,".1r\lc/c / h- Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Subf loor/VenUlnsulation I Roof Sheathing ///tp /n .-&il/) Shear Wall ._ rL Framing lnsulation/Energy Drywall Ext./lnt. Lath Brown Coat Masonry Pool Fence T-Bar Handicap Req. Deputy Final Report Engineer Final Report Flood Zone Certif FINAL lr/) 1!Y-i.l,6,t',41 Certificate of Occupancy Notes, Remarks, Etc. |'/'-' I