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BUILDING- INSPECTOR RECORD SITE.WORK DATE ID/SIG.COMMENTS OWNEi BUIU'ER DAL(' RATION I hdcty .rm ulxrd Frn) of Fjury $i I m ci6n}l too E Gdr-(B Liru L!* for llE follo* itE ,.s. isd 70ll 5 &!iiB di Proa<i,. Cod.): a.y Cny or C(My f,fikt Equi6 r Fnr ro strnxr. ,h6- impror( &mlilh .r lq.i -yffie Ftr'n hr iM.. tlo r.quiE llE {Dltrx fd trh Ddnn ro [h.r'!$drimr il'i lE or JE i liGEd F,ur b in Fviiod of rlr (tdr-rd . LisB.d tr$ (O:.pls 9. ( otrffiins *'nh s..rion 7000 ot Di1nb. ! ol llE fr6iE rrd PrcE3liod Co&) or $r E (.lE i! 6onF tha.non.ld rlE tElii lor rh..lkr.d.rdrFk'I A.rrioLrionols!.rsn 70ll t brEy rppli.d for . Fni $bjcl] rlE rp?lic$l ro !ciilFshyorml tuc thd li\. nu.dr.d dolb. t$m) L a o\nd olrlr tn,Fd), or mt @pL,6 $ i'h $.16 6 rh.r $k.ohp.Gdnr.. tr ill& lh. uork ud rlE ('r{lE. dn ituarLd or oltdd for nl.(5-.7044. B6ins ed PmldioB Cod.: l1E ( o.rrdcroi3 Lt.G Llrv &6 nor.Onr t) an oM6 of rh. prDpqly sho ttrilik or ir{hr6 rhaarn. Md 1lh0 &6 tu.h mrl hnN.lfor hd.llo. rhrough his or ho o\n. \Jl,!d, providol rhal such inlr voErE G mt inls'd.d or off6.d for $k I l, ho*Bd, !h. hrildi.! or inpro\.mt ir $ld sirhin oru t@ olsmpl6i,., rh. oMd UuiU6 will hrE rh. hlrd6 of F.\ins $d h. or !h. dil not t! d o. nnproir lh. ForEly nr rh. lful.$e of L s o$ n6 of E FoFy. m .rclKi!.ly .odrdilu $ irh li...*d cotniaroB ro coi!tu.1 rh. prolrl (sd 7ol1. Auting !d fiDkin Co&r Thc ConrBloar Lt.e L!$ do6 &r .p9lr ro.n oeE of FoF y *lb huil& or inpr6\6 rh.on, Dd "lr. 6dm. fM ruch FoF snh . Coffio(r) Ii.N.d pGEr 16 rlE Conrardi Liru t^J I m.rmF udd S<inn \IORXERS' COi'PENS IION Dioif,allo! I ha.by .mrm unds FMI'V of Isjury orc ofrhc follo*in8 &rl@r irB I ha\r ed trill m.inrlin r ( cniatr.r. o, Colwr to S.lf-lBurc ft, u o,\d' .ontddion. a Fo\ il.n a.r nr Sd ion u00 of rh. Lrbor ( od., lor rh. p<loman.. oarh. wo for *tich lh. pcrnit i! i*ucd I hsr.lnd*ill m.inl.in "ortd conp.Mlion iButffi.. N r.qua.cd hysdn!.l7o0ofth.trb.r(-od.. fo.rhcrt rhcw rmshklrhirpcm uslu M)tr0,16 sXFsdFn 'Nd,4. (ME dn pol(y nu,nbcr 6. c*- -(f.tyqlL.a.,^ J i/iuva44 , / ""*,*"dn' t/-wceAa 5+ zzt4 ,,,,;r>z/o/Zo,/ I caiit lhtl in rh. Ft(rucorllE uorl ru \hth lhB Fir n isal, I .r!llmr aph! dt Frn in u! mmF n ato t6orcrut rr ro rh. srt6' coflFs bn h$ of ( .lif.mia !i R 'hd rf I srFUE tEorc $b<cl n, rk usa6 mmFuihi lro\ irir6 of sdirn !7m oarh. trhr crxl.. I $ARnNc kilur. ro sd. $oild mnFl$lion m\m*. i unl aphF b cihi l Frtb -d iotr d,Ngd t! Fovid.d tu lLro oR hond,.n rtuend dollB (tl00.{) l. in dd'r '. n)b I h@by dlm und.r psully of pdjury lhd I m li@!.d und6 Fotuion ot( hlrln I (.omm.in! f,irh Sdli)n 7(x)(r ) or Diyilk. l of rh. aai6 !d Pmf6i.N (-od.. &d my lic.M b in full tuft rn.tf6l p G)r G 6co rLo2 r r)\\r kr r rI)\ rr \rr\', \r,r \( \ I hottry lirio urd6 rrulry of p6jur.v $d rha. i! . codo.rio. ladine 4ffir tor lh. Ffo.Ie. of lh. \ orl li, $hi(h rht Fni il ireu.d (S<. l0gr. (-n. ( ) AIfIJCAIUTEUJSAIIII! I hady rtrrtr un& F.fty of Fjut, oE of rlE hlbsans daL..rioN: Damlnion Pmir+Arbold t{oifi.trior F.d6ll RcsuldbE { tnL 40. tar6) _R.qdr.d tnt. oltJo{fidion I dii ihd rlE fo.lnrl rcsuhi'B rqrdil4 abce.t -. nor qrlrclhb ro rhii rrojd I .6rit rh.r I h.v. r.a, rha .mlkd bn rn 3rd. rhd r ordi.!k6 !n s[r. lt{. Elr i.s io h]ildin*.o.ddd :i::ffi:y'eail"/h-", ro conrl! \irh rll ('ir\.nd (-ounry r'hB (n! rnd.q h r. dr6 upozlE -" o, /to/Lb/ Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Roof Sheathing Shear Wall Frami ng 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 4ht/tr..t:rh /s/y'r* \ Certificate of Occupancy Notes Remarks, Etc Subfloor/VenVlnsulation