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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE COMMENTS OWNER BTIILDER DELCARA'IIoN
<br />I hcrchy arfinn undcr p.nalty of F.jury rhar I @ dcmpr frr. lhc G,nrr!.tE Liccnsc L!* for rhc nnb*ins rca{nr (Scc ?0.11.5
<br />Busircrs nnd Pnrt*i(,n Crtle): Any Ciry or County qhich rcqrncc n Fennn ro ([{tucr. alrr. impruvc. dcmoli\h or runJr u'ry
<br />drucrurc. r,hrro irs i(\xr .c. rho rcquir.\ rhc lnrltnd lor such Fnnil h filcn sisncd {utcnrnr rhd hcor shc is liccnscl Dusu,n!
<br />ro rhc pn,!i\n,ns of lhe Co racr.ir l.iccned lje (Chanl.r 9. Co nnrNiig wirh Sc.trn TUXI of Divisnr .l ofrhc Businc\\ rnd
<br />Pml'c$iuNA)dc) orrhtrr ltor\hc ir cr.nrpr rhcrcfromaMlhc hnrn li)!lhc rllcgcd crcnrrrion ADyliolari ofsNrioi r(r1l5byanll
<br />rrplica ntr!plrmil subjels lhc appli.rnrt,rcivilpcnalrtofnormrcrhrniivcnundrcddollars($tor))
<br />-1.
<br />as ownc! oirhc pmtrd!, or 'ny.nrplortcs wirh wrs.s as lhcn \ob con$cns0rion. Billdo ltr work ffd rh. stflctuft r tror
<br />i'n.frLrl or oaiclcd lhr $lc ( Ss 704,1. gusinc$ .nd h'or.s\iois Cdlc Th. Conkrtr\ Li.cn{ La* docs nor aprly k, m o*mr ol
<br />lhcpmlt y who huild\ or in{d\ c\ rhcNn. arxl wh. dcs such work hi,nscli or hcr*lf or rhmtr8h hrs or hn o*n cmnl.yccs,
<br />fiovidcd rln {]ch tn!rcrcnEnh m..r inrcnd.d orolttFd forsut.lr ho*c!d- rh. huiklins or nn|,orcm.r k bkl $irhrn.nc Fr
<br />otconrnlcihn. thc Ow.cr auiLld will hrvc rhc hudcn ofpmviry thd hc or shc did fr, hrild or inlmv. thc pr,Fiy f.r rlt purlls of
<br />I.^ownrrorrhcpn,pcnr-onrcxclusivclycom.rintwirhli..nscd.onhcrrkr.inr{tucirhf,pmFd(Sc.7()il.l.Btrinr.r
<br />rnJ lh)ll:\irnCodcr Tlr Cotrttk s t-iccnsc Lrw docs nor lpplyr. ntrowod.f!rop. y*ho hulld(or im!.orc\ rhcrcotr.
<br />and *ho cotrrock ln \uch rojccr! wnh i O, richd r lrctr*d p,^um ro rhr conrDckn \ l-iccn\c Ltrs)
<br />-l
<br />{mcxenrfl undq Sdion- B. & P.C. roi fih r.son
<br />Dd. O*n.r:
<br />u!)BK[8u:0!lt[usafltt!DlclrlxAlla!
<br />I hcrchy i,firfr uddcr pcnrlryofFrltrryon. oirhc loll.*inS dLrhrrlion.
<br />Ihavc ,klaillnBinrrintrCcnificalcolConscntt,S.llIr\uElinqorkcli.o lFrn\dtrri.ds pnrvi]ddfrtrhySc.rir lTl])olrhc
<br />Iitir Codr- l'or ilE pcriornFtrcT ot rhc *uk for whi.h rho p.nnir i\ isurd
<br />I h0vc and will ndinrrin w.rteB compcnsuln,n insunrcc. G rcquied hy scc'io.l70o olrh. bhor Cudc, nn $c p.rrbantrn.c or
<br />lh. w.rk ror*hichrhn perdir is iNEn My*orkcs omp.trsaln insurdncc carii.r end Bni.y numh.r dc:
<br />c*r",, - *h+", E{n/-q lr s lur\rt
<br />l.cnili rhll h lhc Nrlormi.cc ol lhc wolk fd which rhi\ pcrnn k i\\u.d. I shrll nor cnDloy rny F.rv'n in rny mrnncr
<br />$rsloti.omslhF.rhrhcsorkcis'conrpcsalionlas!.fc.riiornia.rndoer.crhirill(hourdhcconrsubjdro'h.
<br />worlcr( .ornp.n\rrionpmli\nrnsorssrioi l?moarhc L[nrCdc,l shrll. i.nh$ilhompl, uilhrhoe pmvisianr
<br />WARNINC: !{ilurc t(, Kurc qorkcn ..ntrn$di(nr corcraE. is unhqrul. lnd lhrll hjcci a..6ploycr t, cimi'[l tf,nrlri.s nnd
<br />rivil lincs un i. otrc hundrcd rhousand dollm (SIO0,om), in rddibn rr rhc co{ of cohpcns,rn'n. dr.hgcs trs tr.vidcd ror rh.
<br />s..ri,n':1076oflhc Lnhtr Onc. interc( ntrd
<br />D e - '?'
<br />D!:( t,,\RA',u()N
<br />Ihcrchyafifl,undcrpcnihyofpcrjuryrharLn|i..tr!:dundcrrri,vhionorCnaprcr9(mnxxncn,s*irhSccrion7( 0)oiDi!isi,{.1
<br />of th. Busin {srid Pi{,r.ssion\ Codr, ud u),liccn{ n in tulliorc md cry,
<br />lDll't3Q3lra
<br />^GL
<br />rolgrxlJEllaNrllDtrc-dli.ENrl
<br />I hcmhy rifirm undcr lcmlyo, lc4urythrl rhcrc is, c.0{tucrion lcnJing alcn.y f(r rhc psfornhcc ofrhc $or* lr whi.h rhn Frmii is
<br />issucd (Sc. 1097. Civ C.).
<br />AIILIC NfDElllla ]1Q!
<br />I )mhy rllinn !ndcr pcnrlry orp.rjury om oirhc lolk,wirr dcchrnri, \
<br />I)cnn,Lirim Pcnir\ As6.nos N.lili.rriinr li.d$al Rc!ulnrtrrr\ (Tirlc.l0. Pxn6r
<br />It.q t.d lrrr$ 0lNotilicrrion
<br />-l
<br />ccnify lhar thc fdcrrlrcSuldio.s ng,rdnE,ch.$.s rcR)valarc nor q,pli.lhlc t, rht pmjcct
<br />d, ""nn,,n,, nu,","uU,no 4plicrrion lnd rr3rclh lh. ah,rc inrorrurion is cor.ct t r8f,m b ompl, wirh all cir y .nd Cou.ly
<br />ordioanc.s and Srarc lje\ rhrins lo huildins construcrioD. dd hcrcby,nrhorir rcFrcscnlorivcs oflhk Ciry snd Countyro cnrcr uton rhc
<br />rh)v. nrnri{nrcd pn)!.ny lor ns
<br />/rr+
<br />1
<br />knuda
<br />--o i.,,
<br />-
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />Sublloor/VenVl nsulation
<br />Shear Wall
<br />Fram i ng
<br />lnsu lalion/Energy
<br />Drywall
<br />Exl./lnt. Lath
<br />Brown Coat
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Cerlif .
<br />FINAL 4 /ta /ls 5>94
<br />Certilicate ol Occupancy
<br />tD/stG.
<br />UFER Ground
<br />Roof Sheathino
<br />lvlasonry
<br />Notes, Remarks, Etc.
<br />Ixnd..( Addi.*
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