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BUILDING- INSPECTOR RECORD
<br />SITE.WORK ID/SIG COMMENTS OWNsR BUILDI'R DELCARATION
<br />I h.rub! ifinn undcr |Enllry,,I Frjrry (hnl I .n cxclnPr ,iofl rht Coitrn trs Lacnr lrw for rhe fullosir8 rcirsn rscc70ll5
<br />Busircs\ ud Prclcsio. C.dc): Atry Cily or Couniy whi.h r.quncs o pcnir k, .a,n{ru.r. .lrcr. im[ovc ddnnrlish or tPiir mv
<br />drucrurc. Jtri(r tu irs Gsurmc. !l\o rcqun.\ rh. +rlicanr tu uch !.rmir b filcd nSncd slalcmnl lhtrr h.o. shc hlien\cd Iursu! r
<br />ro lhc fmvisions oi rhc Coirrtrcrols Liccnscd Lar (ChaPrcr r, Co NcrEirrS wilh Sccrn)i 7ff)o ol Divhion I orrhc Busincs rtrd
<br />Protcs\ion\ Codc)drrhar hcor sh. hcicmpr rheElronanil rhc blsn io. rnc lllcscd.rcnlriotr Anvviohrnrnofsc.rionToll 5 bv rnv
<br />rppli.rnr ror r p.rnrir sr$Jcdslhe {rlicrnr t, n civil lc.rlty oi nol ftm rha fivc hundrcndollrs (S5{x)
<br />t. rs oNncr of rhc proFdy. or ry cnDl{,}tcs wiih *]3.1 a\ rh.it k . c.mp.nurn,n. $ill do rhc wor* and rla nMUr is mr
<br />inrcdd.rolTcndfrslc(Ss70{,l.Bo\ln\smdPmlis\ionsC{'dc:'lhca,nh.nt'sLiccnscLlwdocsn.r.Pflrroino*ncror
<br />rhcNpcny *ho bnilds or n\mvc{ rh.Ntr. r whod(trs$.h*{,*hnnscllorhcrcllorrhruughhrsnrhcrown.mll)tccs.
<br />F)vnkd rh{ srh nnFow'nnr\ e nor idc'xi.d d oficdl ttr elt ll lD*c1u. rh. l{ildir8 or inrlFvcnrm i\ :.ltl $irhi" nN ).rr
<br />ol con!n.tn,n. rh. O$ ncr Buiklcr $ill hovc rhe hmdctr oflfolirr8 rhat tu ot shc did nbr htrild or irnProvc rhc ptuFly fo. rhc Puqnsc ol
<br />l.ar.wkroflhcphJEny,ur.xclusivclyconlr.crinswirhlicen\rJ.onh.nrsbcotr{todrh.pnlc.l(Scc?044.Busncs
<br />anl lt,lcssi,nCodc ThcCookncioi\l.icen\ELaqd.csn.rrnplyh owtr.' of n()lrny sho buildsor nnDnncsrhcrcotr.
<br />rn who.onrrichaqsuch!rcj.rkwirhnConlr'.nr(\rlic.nsddNsuinrlorhcC{,nta(trrLiccnsLi$)
<br />I nn cxcnr|n trndcr sccri{)..8 & PC iorrhhrcoson.
<br />\.ode.)4- 14 ?e-t\'() R(l:ld\' ( ( )NI PE\S,\tl()N
<br />lrlrl-BrlllQ!
<br />I lrcrch!rlfi' ruD,lrr Ir rlrtofll(qury nc.l rhc l,nINnrg {lcclxrrfotr!
<br />I h.vc and w ill nrninuio ! Ccnii.rlc or Gtrs.nl ro Self ltr{rc li,r workcn conD.rsulion * rrviJcd lor hv sccrirn ]?O r of lhc
<br />L:kn Cod.. tur rhc pd tbrro.cc of rhc *o& f$ whkh rh. pcmil is hsucd
<br />lhnvc rn.l willman rin *ork.ri co rPctr\rriotr insurrrcc. !s rlltri'dd hySccrion.lT00 olrhc trbor Cbdc l'or rh. |rrf''num' ol
<br />rh- wurk tur Bhich rhh pcnnir ii iskt Myvortcn conrPcnqrion in ran.c cutrict trrl Ix,lkt nun sec
<br />P.li.t Ntrtrrh:r
<br />-
<br />-lccnilrrhrr
<br />rhc pcrhinuncc ntrh. *ork tu ulri.h rhi\ p.rmil i\ n.u.d.I shrllnol cnrPLry rny Pcmofl ir lnv mrnRr
<br />{, N !J bc.uN subjccl h rhc wo*dr comNn\rliotr h*s olCrlif.rnia. itrd i8tc llni if I \houkltEconrc nrhFcr k, rltc
<br />worlcn LrnnFtrsrrion pn,vi\ion\ olSsri.n.lr0Oolrhc Lfttr Cdlc.lshtrll. tonhwirh.onuly lirh rh.s l)n,ri\ions
<br />IYARN|NC lr ltr,c ro {.rc qrrkt'\ c'i!n, cor.n8c is trnlnslul. rD.l \hrll suhFc( rn ctrlPlotcr t' cri'ni'ul FMlrc\ xtrd
<br />l(xr.filo). fi rd iln lo rhc cosr of.otr1tlctrsrli,)n- drnr8.\ rs l,rovidc(l lb' rhc.Nil fiD$ ut to om hu ,lrdd lln,usrrd dolln
<br />scclui 1076 oirhc l- xrCod..idcrc{inil
<br />kr rar,ie\a.1-.ogea
<br />!Igll!! rlll
<br />I l(Nhy rlfinnuodcr pd'ulry.l pctjury rhst I ro ticcnsd undrr P(triri()n.rChrprc' 91.onnmrc i'rgsirIsc.ri( Tlrx))ol l)nr\n ]
<br />.l rhc Bn(iNs\md ttofc\!nn,\ Codc. rfd nry liccn\c is in h'11 f(tr.. ntrd ctlt.r
<br />CONS RIJ( IoN LENDINC AETN(]Y
<br />lhcrchy finn trnd.r p.nalryolrierjury ih iho.i\a.onstru.liorrlcndin,!trrcnylorlhcPctio!rokcorrh.wo*tffshi.hrhkpcanitis
<br />n$rc(l(S( lm7. Civ C )
<br />AIIIICANI.ITTELATAIION
<br />I tmhy.0innufdcr p.n,hy or Pcriuly onc ol lhc li)ln,$ins d.chr.rions
<br />D. n,lirion Pcirnil\ AslEno\ Noriti.rriotr I'dcrrl RCEUlolnnx (Tirlc.l0. P n6)
<br />R.quncd LcrlrYUl Norilicrri,trr
<br />I ccnililhd rhc radrrxl r.Sulilionr Esirlils rshcdo\ rctrovri nrc n.rrmli.rblrt' rhis rojccr
<br />r.oftd I aSre lo.omply wnh rll Cnyand Colnl,
<br />,cFc{nrarivcs oflhis Ciryand Couf,lr lo cnrcr upon rhc
<br />-*,.-S/:olrg
<br />rf."n'trrl,r tr,,'.,,1,r,*"pnlrcrrnn-FdiJrcrh h.fitr. rrlh nur' "
<br />"r,l Uc.,r,.l sEh L{. rl,,rrry ro huiir in. \ nF rru, rnn :ur] hcmh) Juth., i/r
<br />Jh c nV,,ncd nr.ncny l"r 'n\B!.-rtr,
<br />r turt,{\;;."n:;;,;;;.,.-qlqddq Lore-z-
<br />*-,*-,/rn,,,QIoraeh \-og€-L\A
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Sublloor/Venti I nsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />[/asonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif
<br />FINAL llzha Tq Atwr<d-,,,", )
<br />Certiticate of Occupancy II ur
<br />Notes, Remarks, Etc
<br />DATE
<br />Licctrscch$-ljcc sc NuNbcr
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<br />('onlrn(lor
<br />knJ.i' A,ldrc$
<br />fT
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