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BUILDING- INSPECTOR RECORD SITE.WORK DATE ID/SIG.COMMENTS Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Subf loor/VenUl nsulation Roof Sheathing Shear Wall Framing lnsulation/Energy Drywall Ext./lnt. Lath Brown Coat Masonry T-Bar Handicap Req. Deputy Final Report Engineer Final Report Ur444d-FINAL il4lt4 -ti ur) Certificate of Occupancy U F Notes, Remarks, Etc. OWNEN BUILDER DEI,( AR TION I hdby r,Im undc Frly ot pdru,y rhr I d ddpl tm lh. Cdrddl Li.e ln lor rlE folbf,its t@n tsc.,o!l J &Bitr6r rJrl Prof<ion Cod.) Any Cny or couq which r.qrt6 r Fnil to conrtru(. slld. imgrove &tulth or rqt( e, 3Bcl@ Ftu to irs isulR tlo E$riB rlE +dtd for lct Fnn ro 6L.3i8n d srrffir dli lEordr i licq8 d Fmd to rh. FDrtioo of rh. Conlr.dois Lic.n!.n Lrs (ChlFa 9. Conmd.ing with SElion 70()o olDivnion 1 olo. 36ilB &d PmfdioE ao&) o. rhd lE r ltE t dco9r rhadom rd tlE bGt tor rh. dLs.d d@Fion A.yrnlilionofs.dbnr0ll t br !n, applicul for r p6hil tubjRt! thc lpplic&l lo s civ'l pdhy o t nor mr. rh6 liv. hurd.d d.lLE ( 1500) -1, E owno ollh. FoFty, or Dy .m9Lrc wilh w.t6 6 th.n rk omFErion. riu & llt *dt rn ,E tum i! mt idad.d r ofic.d fd i]. (sd 70fi. E6i6 ed Eordi.6 cod. ThG con|[crd , Lkru L.w &s rcr lpply ro m o*id of rh. ptuDqly who huildr or imlilv6 thoo( ad wtn .h6 k r *.lt hiela or lE*l f .r rluousi hit q hd o*n onplot6, Forildl rht'r 3u(h ihFo6d!e d itdrLd..ofirol frrrL.l[ hoEs.llE hlildi.a d iq,nâ‚¬6i it Dld wihli oE ]a ofompkioG th. O*n6 Builta will h!v. rtE hfdn olFovii8 di h. s JE dll Dl hlt o. BlF{e tlr FoFiy tor tl! F,le of _1. 6 o*c of rlE FeFr,, d.r.hsiv.ly.odrdins { nh l'.aa.d coitdG ro sdtud rtE Dmi*l (S< 7Or,{. B!'nG lrd Fotu im (-odc Tn. C6ntrd6a, l.i.dc l-!s &,6 nol lpplt lo e ornd olFopdry rh buil.L o. imtrv6 rhGa.tr Dd $t sd,r$ td o.h FoFl! *in. Coffio(i) lkdE d trEurr lo rE Con'rr.rd r l,rce l^J -l d .rdpr utrld S61a.-. ll & P C f6r lhb r@n. D . Oi.6: rlaB8lBlt(outErsarJQ!pEg.ASAUq! I hd.br rmrm lnds p..ahr orpsjur' on. orrh. rolhsms ddl'rar'ont: -l h4. drd *ill mhliin . Car'nc.rc of Congl to s.la-lBlE for portst @"rp.nsrioi. s Fovid.d lor by sarion 171)0 of th. tibo. CGj., lor lh. Flollrm. o t lh. utd tor rtth llE FDn b ie.d -l h!r. ind *ill @ior!i. Nrtnt comFMioo iMEq s 'qui6l b Sdioo lTtxl otltt t bor Codc tu th. FfMG of rh. *o.k aor whi.h lh! Fnn b s.d My Nrt6 dmFr$lior iduecc ced &rl policy numb.r E.: I dif, rh, in ifi. Ffoffi. otlh. wo* lot shich lha pdhn it nsu.d.I .t!llno' aploy m, p6$n in &yME o N ro b(.ft rubjer b tEen6 onrFldion Ls of Cdifomn. ud rsr lh.l if I should b.tdc $tit' ro r "nrt6 @mFsrion Fo\irod of Sdion 1700of lh.t bor (-odo I llEll. fonhwilh comply wilh lho$ r.rilioru.wanNNc F.ilu. ro m mrl6' compddion orslsc ir oUNtuL lrd !h.l! sbjEl - drphF lo ofiii.l Ftlb dd cnil nn6 op ro ok hondEt rhousd &'116 (llO0,00O). in .&nion to rhc cor of .omF6ri.n. drEg6 a Prcvil.d for $c S<iion -i076 ofrh. lrt r Coda inr6.n !d.fiorEy r f6 lrErsErotrrtacrQa DECI3BAIIO! I hd.t'r rlTm un& pqdty or pqJury lha I @ !6i.d !.&t Forssn or (1l!pla q (.onmocins wnh S..lnt 7000) o I Dn ision i of rlE Bri.d.d Pr.f6ioE Cod.. !d ny la@ a b full I{a !,rr cffBl r0lllalcuoN.LEllMlqElc I @ ,tfui un&r rEuny al Fjua dr rh6. s . .odMbn trding .gtry for lh. p6tol1re. of lh. qlrl &lr *nich rhir Fnil t tsuqi (sd.10s7. (iv. ( ) AIIUTAILIIICI.AAAIIr! I had', rrm utds polhy oa Fjury oE of lh. folhs'.s d<hr.lii6 Denohbn Pdnnr-Alb..ros Norificltion l-.dfl| RcBularhnr (l'ill. 40, Pan6) -R.q!nd tnr6 of No{ftrlion r+ulllbB Esedins 6b6G romvaluc tror lprhcabl. ro rlu phjcd rcidrhisipph.((,nd sl!lrlh.lrhcnhre 'nli,nnar(.i iscon(r l.geh.o,nfl\\ilhsll(\r)rfrl(iu ) As rclai'\8 ro trildi.s c HD.db&. rFgdrn6 of rhir( nyd Coumr ro rdoForlE l-raMtr <a-r- ,,,,.12 itll lB Pool Fence Flood Zone Certif. l-6dn'r Adddl I