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BUILDING- INSPECTOR RECORD <br />SITE-WORK DATE ID/SIG.COMMENTS OWNEI BUILDER DEtI:^RATIOI\ <br />I h@by attm undd pculry of p6ju.y rhn , M .rdpl 6_om lh. Conl,.cl , Licco. Lw for lh. aollow64 r.ei (Se.?01 I 5 <br />Burn6 rxl Prrfdbn Cod.) Any Cny or Couny shth rquiG . Fnr lo Nrntu<r, rnd. ,r4mve darlisi or rq., ey <br />nruc'u.. pii,r to 't! isuec.. ils. rqui6 rhc arplad fd such Fni to lil. . !i8..d nnffil lhn lE or J'. ! li.d*d puBan <br />b rll FlvirioB of rll Cont.rd r Lk nr.d L.* (Chq'rs 9. Comtri.s *ith s<ri,. 7IrcO of Divnb. I or $c BUIB &d <br />Pref*ionr Cod.) or rh.l lE o, 3hc ! .roF rhdtnom dd rh. barii for rlE .lLS.d d@F'on A.y v'olaiotrDtsdrb. 7o.t I 5 hy oy <br />dpplicsl for r Fmn sbrd tlE .pplk6nr ro . c ilF lrtof mt mr.rb& liv. huid,.d d6lld (tt00) <br />-t, <br />s o*G of th. Fpdry. or fry oplorc *nh *.*6 B rh.n sL Nnpssdion. I'ill & llE *ort .id tu tuu. i! mr <br />idorlct d offd.d fs eL {Sa.?o.u. tkilB 6d Fma6hE Cod. Irt cdndd'r l]ff t& {tE N 4ply ro d orc of <br />ih. FoFry wh tui]& or imFo!6 rhaE( dd sh. &6 sh K& hin$lf or h*lf or lhmlah ht o, hq om 6dor4 <br />FDviLd rfid trn idFElEt ft mr i dd.d doraEl6r r]. lf. lF$6u.l,E bitlirE or n4(@i.d ir sld $ihi m yw <br />ofonplrion. rlE O$G Boilda witl h!v. lh. hnlo otFowB lhd lE o, rtc di{ ml hnld o i4.tr8 $. FoFq ft,r tlE p'irtE of <br />-1. <br />s o$nd o I rh. pmpdy, on .(lsiv.l, codra<itrg sith licds.d co.,lrackr6 ro co.ro.l rrt Foj..l (se 7044, Buncr <br />.n EoEdoi (ild. Tn Comrdoar l-'c.M L.s &J6 tut qDlt ro d o*n6 olFoFn) $ ho hild! or iiFora rn6@tr <br />Md *ho co.rracl3 fd 3u.tF.jGl! snh r aonrkonr licft.d puuul lo lhc codr.dr'r Lic* l,*). <br />-l <br />d .rmF un& S..rion-, a & P (- for lti! 160. <br />D.r. onnF <br />\r oRx r:Rs' cotrrPt.Naall( lN <br />lll:CLlBAIlll! <br />I h6.t\ rmirn u.d(lErnr! of rEruD on.or'hcin[Nn* &Llulr'o^s <br />-l <br />h,rc ti Fill mi.r.i.. cdifEd. of CoMr ro Sdf-lM fd NlGr orrFMi@ ! FDlii.d tor by SEl.n ITOO otrlE <br />Lltior C.de lor rh. Ffoll@cc of rhc ert for whi.h th. Fmn ir itu.d. <br />-l <br />hav. md will nainr.ln worl6r' comp.Erlror iNurm., s r.qntqt hy sdrb.1700 oari. tjb.r Cod., for lhc pafomft. of <br />lh. wmt lor which lhi lcrnil i! ier.d My mrka' .onpdntnrn iare. ffir {rl polkt rmb.. e. <br />PolicyNu6b6- <br />-l <br />cdifyrh,l in rh. rEfolrl]d.orlll! wort l *hrh lhB p6E( n i'ru.t I JBll nor mPlot D, Fsn in dy nmF <br />e a h bdoe $bj..r ro 16. *0116'6mp.Ndhn h*! of C.lifomi& sd 6sr tha it I slould tdom. $bidl lo lh. <br />*!dd'sDFqrionForni,6ofsdionl?mofrlEkborCdclJEll.tclh*nho.lpD*nn sr F)ltio6 <br />w,{RNINc liailLtre ri s...u. \orloi cotnpsalor col.'rsc,s uilatrlul, an shallsu <br />cnil fD6 up h oR h$&.d rhouerd &llE (t100.000)- in lddno. ro rh. .(E n'n. d&rus6 a Fo\id.n for rh. <br />sdrion 1r)760f rhr lxhrcod. .ded.nolk ,'4 <br />tr,lj.t&ula: <br />I hcby arlirm ututr rEnlh, of Frjury rhd I Fo\sion otchlprg 9 (..nnocins *nh Sdbn 7uJ0) ofl)'vtin l <br />of rh. aciK.!rl PNfsioB Cod.. a'd d! lt.e n d <br />Ct(4/cto Tilf6 <br />/o iz't I 6' <br />I hrcby lafm mda Fnlhy o f pdjury thd <br />ireEd (sc 3097. civ c ). <br />nn lql'os !r6.y for rhc pqf.flMnc. ofthc *orr for wh'.h rhis Fmi a <br />R.quftn Lnrd ol t{difrdnn <br />I llra tu comply wnt.llCiU tud ( ounry <br />.ir6 ofthir ( ny sri Codryto ord lpor tlr <br />u- fu€cthao <br />-,,tcs-)a:(8 <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />Subf loor/VenVlnsulation <br />Roof Sheathinq <br />Shear Wall <br />Fram ing <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 />Engineer Final Report <br />Flood Zone Certif ^\hru{rA' Fl/qt 2-2o-le,*rt^IttrI <br />FINAL 2-20-t\I <br />Certificate of Occupancy <br />Notes, Remarks, Etc. <br />M dnrlloyd lo om'nal FDIiG sd <br />6 <br />Irfiln'r ^d&B <br />- <br />AIIIJ(AtrLDICI.A8AruTN . <br />I hdtby Ilmund6 Frllyof Fjuy ocotth. tollowins &cllrrriod: <br />D.mliio, P@neAstBoi Ndili.dion F.dd.l R.3uldhs (TnL.r0, Pd6)