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SITE.WORK DATE ID/SIG.COMMENTS OIINF,R AUILDER DELCAf,ATION
<br />I h.rchy roirm und.r Fn.h, ol Frrury rhd I m.r.i{,r fmm rh. ConrmroE Li.Im L.w lor rlE li,lk,*in8 ceg,n (s.{ 70.11 5
<br />Busimsr .,n Pror.*ion cti.l Any Cily or Counry shtn r.luirc. ! Fni lo onsltul. .lrq. nrl'nrt, &fr,lBh trr FFn tny
<br />rlMR. prs k, irs nsuB!, tl$ EIuiE. rlE rpolter lor .Eh Fmi ro lik ! risft<l \r.rcmnr rirr h. or dr ir lirnid FU,ud
<br />16 rtE FbaLionr ot rlr G, Err'r l-itnrd L* rct! o 9. Grnmrine rnh S(lhn ,(rn of Dilnbn .t of rh. B!.im( ud
<br />hofcsrionr c(,<r.)or fi.r lrrn {E n.r.rr't llE.arom.,Id lhc h.{is n, rlE .llr.d .rcnpr i,n Any vioLrbnorSdi,n 7(,.!l I h).n,
<br />'ppltlnr ftn r Ffrr, \!hF{i! rn qii{ird h r(i!ilFtulryof rr nrE rhrn fiv. hundEn doll(r (15001
<br />-1.
<br />.. orE ortlE Flr.nr. rr hy.rthF.r s h rrSs rs rlEn s! mtrp.nslbn. r d, d!,qi rn 0l ctim ir dn
<br />in.ri.n doficEn ln sL (Sa 70.!. AuriB ud Pmrsrhsr CodG: TIE Co Erq\ LirN t wd-ft,{!tll,hMowBol
<br />rh. pftrdy *lb hir.h d rifroB tlE6t nn wkl &F rh rrt hirer.. h.rclf or rln'uah hi! c tF os .'rvt')6.
<br />Fovi.lcJ rhlr teh ltimkrdr e r{ ircd.d n oltu ftr sb ll lbltg. rtE triBi4 d int rrld i. old *fin m Fr
<br />ofsil,tria dE ()*F Blitld vill llEr|E ln dor oa Flri'B rlrr E 6 {r dii [r r!i! n invoE rrE FIdy ft, E F,FE of
<br />l. rosrrof ilE FFny. d.r.hrnrly.o rdr8 *iih li$Td offirnh m.{Mr rtr FiF!d hr'aEdr Cd. Thc ConlL-roi. Lt.nr L.w dB mt .rpl, ro o*mr or pmFny $ho bli
<br />aid qh) .onttu\ ktr (kh pro,.d\ r{h r (in rr.ttri\rlx.n{dfu
<br />Lci.tr,t 0tr,1., S..n.n
<br />,,","./D -A'3o/? o",-
<br />IIEI:LA.BTIIO!
<br />I h.,rhy rllrtr, un,l.' N lr) ol l{'r,trt or nl th 1L'll,N n! tlo.hrrri,ntr
<br />lhsvrrml*illnBrnn,in {ortcri rotrIrn\nrnn nxurr'trr. r\ rcqomd hrS(hun l7(Xrolrh.lihur (i\lc. hr rhu lrrnnnut.ot
<br />rh. *orl nrlhf,hrhi\ p(nnir i n\xrl My work.r! onlrn\arion 'n\urrtuccadd inl Fn(y numh.r a.c
<br />I enifr rh.r in rlr F.ro,mft of rlr so fn qhich rhn Frnir is irskd.I rhrll mr cq*!y.ry Fr$. i. m, mnEr
<br />s rs b b.oE lubFr ro ilr xrf n'Nrrnoirn hw( of C.lifomi.- !d igE rhd if I rtnuld tr.6ft dFl b llr
<br />trortF' .arnl|tHrir I'nrtri'nt ot s.nir l7(n or rlt t.hr Gi.. I d L rodh$i'h on?lt *irh rtb
<br />.ril fiks ut ro nr hundr.d rhrlrd .Ltla lllUr,fllD, r .ddn r!.! .i FftnrH ftY rh.
<br />S(rx,n l(,76nr rh.lrhn (irk. d.rc{ ! lr o,r\'\l!\\
<br />,,,,,/ o 2- - ),.t t V noo,u.^
<br />I h.rct'y .,l!fl unrld FBn, .r Fri,y lhd I m liu€rl uftl.r Fsvinn .f ClEpld I (onnEins lirh sdlb. '7tf,xjr .t DNrb. l
<br />6r rlE BuriBs d Pn,fts.nr Cdi., !i my l!.ne i! in full f.ft .rd cficr.
<br />rolu&tcurlNtEdllllti-&GErtr
<br />I h.rtry dfllnrxM.r Fnrlry ot f.rjfir rhrr rhm i\ ' d,n{ru.ri,n lcndine dgcrct lor lhe ncrfimurcc oliL work for whi.h rhis Finn Lr
<br />i\u.d (Ss l(,97. Cie. C )
<br />ATEUIANLDESJAII9B
<br />I fiolr'yrfln,unl( Fulry ol F,JUry nm ol rt ftnkr*'tr3dr{lzflri,n\
<br />Dcrnnion frroi'! A\lt(o\ Nrirr nn trd..rl RcBuLIins ( l'irk Jtl. Prn6r
<br />-Rquncrl
<br />l.rr.r of Nrirxlrrm
<br />-l
<br />Mily lhd rlE Ld.itl rc8uLrrri r8rdm3 .{Enoi ,emrd d. d .t rrl-.nE h dis poFr
<br />l.rd'lyrhd ltu\. rc2d rlul lmlrarnn nl d.k ! l.Bre rooq y r[h.llCity lnd (i,unty
<br />orJru rs !'ri Srdc l,$i rldin! r, hu'll'ry r(RddnBorr Cny.tn ar y ro ..!d
<br />'rpn
<br />rlr
<br />ak,Yc rnri'L{ In'Fny r{r Nlrtrnn
<br />\ppli$nr or rs$i \i!'vrnr.
<br />5:f€u€^J
<br />\-- /
<br />Ptt " -,,.')-t
<br />o')-lat!
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/Vent/lnsulation /^l
<br />Rool Sheathing ru - to-ly 9.Wc)
<br />Shear Wall \J
<br />Framing
<br />lnsu lat ion/E n erqy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Beq.
<br />Deputy Final Report
<br />Engineer Final Report
<br />Ar-.f -")[.ttJrt\
<br />Certiticate of Occu pancy
<br />Notes, Remarks, Etc
<br />BUILDING- INSPECTOR RECORD
<br />Flood Zone Certil.
<br />FINAL
<br />-l
<br />have el * ill truirrlh ! (tn irNlr. or (inr{ni h Sclrln\urc rnr workcrr co !rn\0ri(,n. i{ lmv .d itr hySeli,r lrurol lhr
<br />tihn Crrl.. lnr th. Frfoiriufrc o, rh. w,trk nr whiLhth. Frnrir is isucd
<br />--r------
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