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BUILDING- INSPECTOR RECORD
<br />SITE.WORK rD/src.COMMENTS OWNER BIJILDER DELCARATION
<br />I h6.t' lllm !nd6 pctlly of pcJury drl I e cr@lx 6on 0t C.ffioB Lie lrt lor lh. folhwiq ,@n (Sd.7011.5
<br />86'.8 !i Profsio, Cod.) A,/ Cnt or CrMy whkh r.qui6 . Fni lo odrud. rXs, irlgror.- d@l.h o, t4., &y
<br />*utu. rir lo ir! isuc., .to r.quiB rh. @plter tu luch Fnir ro 6L. t'gn d 3ld@@t ih, h. or iE ir li.d!.d ple!,n
<br />ro lh. ProvliioN of lh. Conrsrolr Lkm*l L.* (Chlprs 9. CoDn.rBs with Sdion 7000 of Divnion 3 oatn. Bqind 6d
<br />Prcf6pN Cod.) or rh.r lE q ilE ir dd$ $atfoa lid 0E b8s ao, rh. rl8.d crqryion ny li)ldio. ofsclbn 701,.5 by My
<br />.qplxd fo,. Fnn EUdi 6. eplod ro. or rl p@ny ot b! mE rh [r. hunH d,lLD (t5m).
<br />)2. - "*. "r'r'. e'p.1y. o, my oployE srh wra6 s $.t Fl. onFlaion win .b rh. wt .d E niEle i' mr
<br />- dad.d n otu d fd .t (Sa 7Ot4. BuilB Md PmfgioE Cod.: TIE Co -lc i Ltoe I.r &d ior +pt lo & o[G ol
<br />tlEFrFry f,tb hlllb or 4DE tlEo'! .n q ho .tc id 6rt hi,Blf o. tcllor thmu$ hn 6lE oM dplortq
<br />F.vid.d $d uh imF.vEffi e d iddxLd or otu fr rt. li hoM. llE hiildlB d !ry!€ia, n oU witih @ )d
<br />ol @rpkriol tlr O*tr6 BlilCa will h.r tlE h]rdor of F!t!U [!d lE or i,'. did ml boild or iEFow lh. FiFty for tlE FrFo& of
<br />l. s o*E of th. Fopdy. u scluiv.ly contr-hs w h licsldl conrdd ro coldncr rlE Foid lse 7Ix4, ttuu6
<br />od h)iaM cod.: th. conk*rol-s Lic..r. l,aw do6 not apply ro M owns of propsly qh. build! or inplov6 lh6@n.
<br />ud who @ttrrrr.Ior N.h Foj613*nh, Coffrto(i) ltda.d pllt1@i ro rh. (.offis r Lt* L.w)
<br />-l
<br />e.rmfl un& S61bn-
<br />!"., :-zt{-z\X
<br />DECIJIAIIO!
<br />I hq.by rmm u.dd IF yofpquryorc ofrh. followint &rLElioN
<br />_l h.v. nd *il, uint.in r CclltE{. oaco.Gn lo sclf-l.le f hrt6 mFdio( u Fovii.d for by SElio! 1700 of llE
<br />t bor (o<h rq d. Ff()lffi or Emn fq *nah 0E F6it ! &u.d
<br />I hav. od will mainilin workd comp.Nr tun iNuran&. 6 r.qut.d by 56r iofl 1700 o I lhc lrbor Cod., tu. lh. pqfome.c of
<br />fi. worl for shth rlir FEn ir EEl My so 6 @nFrrion suftc 6ir rd rolty nurbq e
<br />Polrc) Nuhb6' -- _ Frpu6 .c\(
<br />+1:tld'r, rhd m rti Ffotu( orrlt roa ror wh.h rt! Foi ! sr..r I rtrll mt dpk'y ry F$n E &y Ilffi
<br />s 3lo b..otr $Udt ro tb. wrl4'comFB.rio. Lws of C.lifomia ud lsG thd if I should b6oe &bi.l lo tt.
<br />vod6' compa ion FivthN of Serion 1?00.f rlr L.tor Co<rr. I ddl fonhvilh o6ply wirh rhoe FovlbB.
<br />WARNING F.it c lo s@ wld onpnEdbn @6.sc i. uLvnll ..d tuI $tir a dpbF ro qhird FEIb !n
<br />civil [n6 up to oE huidrld (houi &lLr. (llm,m), i,.ddnio. to tb. cor of orrFldim. dar4€ B Fovrd.d for th.
<br />IECTA8AIIOX
<br />I h@b, lmm un(k Fndlry of psjury lhd Ln li.€oe.d u.da FDlition oachlpta I (comMcin* wilb selbn 7000) of Oivisio" l
<br />oa rh. IruilB lxl Pmf6ioE Cod., ill m, lt@ ir in tull toE. rd.nd
<br />CONSTRUCTION I.gNNING ACIT\CY
<br />I hor$y r,Im u,!dq FEhy of Fjury lld lhd ir . otrrtudDa lodlB .3@y for 0E Ffru. of th. *sI 6r wl*h thir FDa i
<br />i.a.d (S< 109r, Civ C).
<br />Lmda'3 Nm..
<br />AITII(ANLDESJAA.IIO!
<br />I hota,y ir&d udli p6ihy ot paju.y oe ol rh. fouo*dg <,..|&dioBl
<br />D.ttuhbn Pnn!&td6 Norifrdi- F.dd.l R.suldbN (Iirk 40. Pd6)
<br />-R.qun!d
<br />krld of Nodi.rion
<br />I .airy $r lh. fdlon r.B!Ll.B Etrdina ah6lor llmrd & d +pltrt,l lo lii! tmje!
<br />D5-,",*',"*-o,6lrplK 'on&dnd.thdrhc.bot inromrfd ii conrl. I .sr6 ro comply wirh .I ciry.n<l counry_ ontrred dd srd. t s Ehllg ro buildnE cotntuciioi. .i hs.tt lthorir r.FMtaiv6 of lhi! cny ed coufiy ro drq uFn 0E
<br />6orc nd.n d Dmlary rc !4trhr Dulo&l
<br />-f,;;ilil*WblE r<. <-z'(-zt
<br />\rmrrcumtrpa.o: N,eryl tha \t.. Sc<<rr n ()
<br />Set Backs
<br />Forms/Steel/Holdowns /.-) -2\(L(-2 o
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUl nsulation
<br />Roof Sheathing 6-/'/'q UC<-z ,,
<br />Shear Wall
<br />Framing I 'f/y-zl ft-)
<br />lnsulation/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 Lzz'27 lL.ct5 NE/4 qzt
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />DATE
<br />L+'
<br />1076 ofrh.lltirc.n., inidd ed
<br />S.
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