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SITE.WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Sleeli Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenVlnsulation
<br />Roof Sheathinq
<br />Shear Wall
<br />Framinq
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coal
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Beport
<br />FINAL 7.2Vrao $(tu ,6
<br />Certilicate ol Occupancy
<br />Notes, Remarks, Etc
<br />OWNE BT]ILOER DELCAIATION
<br />I lEr.ty rftirm u*Lr Fn Jry of Friry rhr I d.enp' 86 rtr Ctuon tffi tr* lor llE folhrt lE$. (SE.-11.t
<br />BuriKs .,n Prnf6.n,n Cd.): Any Ciry o, Cou y whth EquiEr a Fmn k, conrlMr. rld, ittpow. &mlnh d EFn x!
<br />rturE.Fiihilt iffi..ko tqliB rlr qdi.l,Il aor*hF. r' 6L i8r.d {c.Id lL lEoriE klEnlcd Ftulr
<br />ro fi. FovisoN oa rlt Conmdolr Lic.rsd h, (Ctrtirr 9. ConreEing wilh Sdlion 7(m of Divni,n 3 otll! Buritrt .ttd
<br />Prcf.arion! Co<L) drlrr lEd,lE n.bngr E!'d.d dE h.rt fd llE nlqld ckr$i.x. Ary virLlbn of S'eri,n 701I t by uy
<br />.0rli..d for . pemn .!hl6ts Ilr ryplic&r b c civil F.Mlty of arr mE tlu. fiw hu rd dolEs (SJ00)
<br />__1, !! owmr of rrE li0Frir. or m, c4'loye: *ith w'36 r IlEn sk ong.nsnioc *i[ &' d. *6t rrd rlE tr.ara b d
<br />i'rdiLd oficrd r[ rl (Sa1!,1. E6idr tnd P,nr.<ri,N cd. TIE Co LlntL!!el-.*&Bbrqrlrroio*ffiot
<br />rh. rnldy wln tuilt or inF *rt tlE@ !!d *hoder*h urthirellr lEelf or lhouSttir d ltr6wt.rpLrr6,
<br />tftllt d rhi skh irtmm6 Etnl ir.dd.d notuld 6r sl li l!]Ett, ilt rriBrn{ n iqffilr it 5U *lnhm Fr
<br />or6n?t rt tr rlE ovmr Brt 6 wi lEE rrE t d.n olFovirs lh& lE c dE dil [, tliE d ,frcr iJE FqEly tur lh plFE of
<br />_1. D owd of dE F p.ny, m .r.luriRly .oddin8 *irh lxr.cd .otuIl6 ro onrrul llt F$F (Se. 7044. BBms
<br />orn E arsir Codc: Tnc Conrrrrofr Lk..tc Lr* dG. mr lprly ro .n o*Er of pmFn y who buildr or inp,oEr rh.r@n.
<br />nd *ho ol*ds rq *h rmF.$ sirh. Colrrn-l.rlr, lilnid puMn h ilEcoddols lirE L.r)
<br />I e .rnlP uilr Serio(_, E & P.C for rhi. Er$r
<br />woRxrfs. ( (rMPIq{saaI()N
<br />olclda f,lQd
<br />I h.rt'y trfi nm unds lxdlr] ot Frory oft or rh. folhwin8 tlchrd oni
<br />I h,E dl *ill minrh. Cdirrd. orconrnr ro S.lr'lnre rd *ofrn tu.p.f,ei)n. t. Irovi:!.d for hy Sslion -u00 ofthc
<br />lrbo C.<L. ror th. Ffoffi. of llE mn for whih llE Fnl n ns!.d
<br />_l h.w lnd eill oidtin sorLE @n .6!tior iBurd., 6 Etui,ql bysdbo -1700 of lll L.bor C.r,., rd rh Fffrrlrm ol
<br />rlE vnt fo rhih rtu Fmn a ir{od My wl6 6iFndk). iBullN ffir rn F,li, nunbd 4
<br />_ErpiEr
<br />_l difyrh.r in rlE F t(,mc of rlt {qltd $ahrhir Fm! t irtr4 I drll d.npLy.ry FM ii ry nmE
<br />$ as ro tEcoE $hr.d to rlE *tri6 .onp.nelion hw. of Crlifomia. rn r8r $.r it I lhdld benr erid lo tll
<br />srl6 onp.Nlio.pEviti,6oasdh lT0oof llE t bo. Cod..l ltrlL fonnairh @nlplr *ni lt r pDvtions
<br />WARNINGT hi,ur. ro sE wk s' ongcntrion .ov@sr i! unh*tul .d 3llll lubFl rn stPbF t, oinnd Folir.,'d.r nE3 up lo oE hu'n!.d ll,utln &ilu (Il@tm), h rrldnar ro th. or of o,Fn-liotr drd&. u Fovitn an. rlE
<br />Ser ion J076 of rrE libor CdL. inl.Etl .d ,rmyt aca.
<br />D.L: AplBdl: - --' _ r-rti'rso-criffi,rc-nnpr(1 {rlalrr{
<br />I llEtt llirm ur&r FdIy ol Frry rhr t o li(ard udd Fovti,n ol Ctqrla o (oltmEinr wnn Sdn. TcUl) ot Dinb. l
<br />of rh. BusiEss.d Prof.shN Co&. !n oy lL.e 6 ad tull ruE.rd.fi(l
<br />LEnFCLs
<br />-
<br />IOIiIIXCITON.LIdDIBGIEENII
<br />I h.Ehy rntlr u,ncr rEDlry ol Fq!ry rh, rrErc Lr r 6nrMrb. hnaing.8cry fr llE lEf{rlrrrc or Ot * l tor rnrh $t Fant i.
<br />sud (sa. .t097. civ c.)t ndcar Nam:
<br />t nd., t Add.s'-
<br />rIILII:AULAECIJSAIO!
<br />I hodry snim unLr Fnrhy ol p.rjury on. of llE fo,hs,n8 d.chralnrnt:
<br />D.mliii'n P.mns Art 116 Ndlr.dirn litl,c.rl R.gllri,nt {Tir!. tO. Pin6)
<br />-R.q!iEd
<br />Lakr of t{rifdiM
<br />)\
<br />-l
<br />csr ify lh.r $. ftd.il E$LriB ,qadb! r$.tu lfi,d E ml q?li.bL to lht pEir!.
<br />I .fiiry rha I hw Ed rhn .p?lirb. sn ,llc |n.1 0r !&, nl,l.lrfin!/cng I .88 b otrply r nh rll Ci y rtd Cout,
<br />odin.Nr.In srrlc tio! rhrig ro hilding c..s@rro!. !4EiE6rlu'lr4.tf.ra diE! orrhit cn,.nd c.ury ro.itslpo, or
<br />rh.E M.i.d FoFry ra i6paro"o.ry.-1 /. ,7' \ 2 _ I I
<br />^p,{6,d^s6.sr-ruc-,1t f, Y X.,.. I /l I ;,?dh,i.-,D.bo:_G;O€#
<br />BUILOING- INSPECTOB HECOHD
<br />Rev 08-07-2015
<br />Flood Zone Certif .
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