|
BUILDING- INSPECTOR RECORD
<br />COMMENTSSITE-WORK DATE rD/srG.
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subfloor/VenUl nsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq
<br />lnsulatron/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 />Enqineer Final Report
<br />Flood Zone Certif.
<br />FINAL \\D ^-dtS )
<br />Certificate of Occupancy \}\
<br />Notes, Remarks, Etc
<br />t
<br />OWNE{ DUTLDER DEITARATION
<br />I lE.!y rrm uftla Dqd) of pGjuy $, I a q.hpl from lh. Codrdd- Li.tu t^ for th. follovlu rann (56.?01 LJ
<br />BsiI6 .!d Prolaioo Cod.): an, Cny or Couny $hah r.qun6 . Fni lo oIdru.l. .116, inp.orc damlirh ot re.t &,
<br />n^.id.. FEro ic igft...to r.q'rn6lh ePltln foi sh Fhn ro 6l. r tigl.d {!.@<d rhr h. or iE it tj.6.d Fa$rr
<br />ro rh. Foviriod of 0E Co.l,-td r Lns!.d L.w (C14r6 9, Coffiing wi.t Salior ?000 of Dvnio! I of th. BuilB &d
<br />PlDt6i,B Co&) th,h.diEtddFdESom0drEt.nr6rllE.!ks.d.tdiFior A.ytiohb!orsdbn?01Lbro,
<br />fo. . Fni $ti6t3 rlE .lplkd lo ! civil Fony orml Dc rhs nv. tun&cd &'llc {t50O)
<br />6 osE of rlE EoFly. or oy.r@l6tG wnh *.a6 s rlE $LsmFnriotr $illdr E$ntdliE.Mwitd
<br />M orq.d fo. rL {Sc.7044, BNiK ed Piofdi}B ( od.r Tn codn.ln r Lic@ L$ &d.d +tly to e o"E ol
<br />r& FoFr, wrb hrild irqlE tt ba -d*'Ib dGBh 6lI hiNlf or ha*lfo. lteuelni! d hs ou @9b]6.
<br />Fovi:lcd th.r ru.h imFotErE6 ft mt ird'd.d trotu tor f,L t( lEltr. tlE b diry tr iaorgrd i! sld riltlt oE )c
<br />ofotrpldblr tlt ol*E &itlc *r! llE dE hr&I ofFovug lhd h. or JE drd ml hild m inFotc lh. FoFty 6r dt FrPot ot
<br />-1,
<br />s o\,c ofrh. Fopar, @ .x.luivcly co r.clirs wilh lic.roql co,rr!.tot lo conilru.1 lhc Foj..r (Sa. ?041. BNi.d
<br />r.d rtphlid Cod.: Tn Conlr.dol! Licdsc Ltw dc .ol +ply lo s oM6 otprcFny who b{il& or imProc tho@9/'
<br />md eho c,ntEclr ror su.h F.jd! wnh 6 Conr@1o4, lic6!.{ pudar kJ rh. Co, r.clor'! l.GlM br )
<br />I !.ronfl undo sdri,)n^'ir41-u \Z-
<br />lrlrLllttltg]
<br />I hd6r.tt6 !,!ds pody of Fiuy6 of tf. blbwio8 daL.rbE
<br />-l
<br />b.vc -d *ill mtrun. CEiiftr. of Coc. losdfnNtuwtd @tgquriol\ ! FoviLd fot tt S<ibo !,00 oI t
<br />t&r Co<lc tu lh.Ftu rcolth. Et 6. xtil rlE FD, i s!.d.
<br />I h.v.$dsill i dn m*dt .olrydllion i,Mq 6 Gtu,.d 4 sdirn 1?00 of lhc tlbot cod., aor rlE Fftu of
<br />lk w* for * hrh rhi Fmn ir isu.d My wdtqi (dFcd
<br />'o. iBuft. cri6 !d Flay nmhd rc
<br />'n
<br />rhc ltrforhmc. of thc work for qhich rhis Fni $ ilsu.J,l shsu nor mtl6, &, p6.n in uy mens
<br />$bJel lo lh. w&6 onFMion h*: of (nlifomia !.d ,s€ rhd if I slDuld t $mc obj.$ ro llE
<br />wort6'omFulhnFryisioBofSeiioDlT00ofllELlborCod..lJdl.a(frhwithcomply*nhlho.pbvlioB
<br />waRNlNC, l.ild. lo BW m 6' @np6!.iion @r6is. ! unL*tu|, od ddl rubFi 3 .riplols lo oiniid FEli, td
<br />cMl lin6 u, ro oe hodrcd rhoEud &'U..r {tloo.O@). o tdd iln ro lh. .or of cooFBdion. ds sB . FDri,crl for th.
<br />O
<br />I@, Im ur& pa.Xy or Fj'ry th. I @ [.@.d ur& FDGir. ol Ch4lq e (olMirtB wnh SdritD 70m) or Diriirn :]
<br />ol dr BultE !i Pmf6ioB Co& itd 6y li6g i it tull ture rn.lI81
<br />coNilaiJl:Illlu.LluDltlc-ac[lcI
<br />I hd.try .frm und.r FEhy ot pqjury thn thd. i ! coddtiion L.dins .sd., lor th. FtollMcc of t. $srl lor *hicn thi! Fn( a
<br />6u.d (se 1097,civ ( )
<br />ATTIJSAII.D!/CIIIAIIO!
<br />I hcrby .fiB u.&, Frhy of Fiwy oE of O. foltowing dakai,N
<br />D6 Ubo tmig^rt trd No{ifEain F.(bil R.suLlbu (Tnk 40. 1116)
<br />-Lq!@d
<br />t/ 6 of di6.rn
<br />-l
<br />calib th.l ltc l.d.ni r.suhlioB r.sedins st6l.s rd'vil r. noi tmlt.bL lo lhn prcjdl
<br />)fltrca,ry rhd I h,,.'*rrh!ipplEarkr!nndcthd 'h.rh.\. rrutubn scoBd I
<br />'o,ilmM<d dd sr . Lrs cldilts !o burldrs cons cr6tr !d h6.h turhrE r.pr6Jt{
<br />!h'r. nEr ion.! parFny lor insp.rtion pulp.s
<br />Appn..ir or asdr srsrrur. X
<br />4 ,./i_,.
<br />I
<br />><Ttr{)
<br />4ra ro comply wilh aU Cny Md (iunry
<br />n+:4"1;"'
<br />II
<br />EIES
<br />,
<br />I
|