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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subfloor/VenUl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />"t(,
<br />fia
<br />lnsulation/Energy
<br />Drpva ll
<br />Ext./lnt. Lath
<br />Brown Coat
<br />It4a so n ry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />U,tq6qFINALtzEl tj
<br />Certificate of Occupancy
<br />Notes, Remarks, Etc
<br />-i
<br />OWNER AUILDER DEII-AR tION
<br />I hacly rrm uidd Fuhy of Fjuy thn I m .rdn 106 rlE Cod,dm Lt.r t r for
<br />BuiG! rd Prcfdio. Cod.): Any Cily or Cou y which r.qui6 . ponil to cotrrtud, dls.
<br />6rcl4 Ft, 'o
<br />ir. ism. .lo rcquiE tlE 49lrul tor *h Fmit to fiL . .i8iEd orBt i:l',:'.1:-,-::,^.:t
<br />ro th. prcviiioN ol0! CoDlrdt$ t Lic.n&d trw (Ch.pl6 9, CoMdci.s $irh sdrio. 70m of DiYilio. I ol rlE &!!B od
<br />PhGsioBcod.)-lhdlEorth.idmFrhd.6!drndrhcbGEforrlE.lLXajdoBion.4.,vroLrio.oascdion7011.,by
<br />apoli@r tor. p6nn $bjd! th. rpDlicer ro . civil p.slr, of mr mrc lh& 6r. hundcd dolld(ltm)?
<br />-1.
<br />s omd of rlE FDFty. r mt oplorE wnh u!s6 6 th.r $L NmFdior ril6lh. $ul !d llE.durc ir br
<br />iddrLd c otrGld for sL (58.7044. BuilB &d PiDf*ioN ( od. Tn ( onlrlcioit l,ic.u L.w rt a.ot +ply lo & oqs of
<br />th. FFry wtb hr'ld. d itr+..s tlEq id s h. dc lxn x* huMll or hdElf or thmudr ti3 q ha os mrh,6.
<br />Fotij.d rh.l rucfi inFovodr 4 mt irrad.d orolEEd Lr sL l( ho*d6. rlE blrildiry or imFsYoE i! sld *llho on tq
<br />of.otrplab( rlr (xc builda wi[ h.E dt hldd ofFDrirg fid lEd nE did d hi! c,tFDrt lhc F!F, 6r E F,F. ol
<br />L s 0$16 o llfi. lropsry. e qclBiv.ly conrr&lins wirh li.G.n (onlt.doE xr sn.ltud rlE Foj.il (Sd ?04'r. &6ind
<br />&d iblsiq'C6d. Tn Conlr.dq r Li.ru t * dG n{ 4ply lo d o*.a of F.Frt r ho tdildr or idpoYd !h6on,
<br />&d *ho $nrE rr tor ruct proj<E wnh a Co"m.b(, li.dMd puR@ to th. conlt.dd t Li.e t *)
<br />-l
<br />n.rnpr und6 Sdion-. B &PC forthislteh
<br />.!!aatrf8[.I.autl$arl0!
<br />DICIASAIIq!
<br />I h.rn4 .lIm un& Fd, ol tElu r_ or of rh. 6lh\ in8 deLrll ioB
<br />I h,* rn wll nlu . Cdr,6cn. or ( o@n to s.ll-l6d for wl6a @nrp.n[lim, d Fovid.n aor by Sslion ]1700 of lh.
<br />trtrr Coda an th. Famc. of th. Nlt fo, utth rh. Fmir 6 is.d.
<br />-l
<br />h.\. 6nd will slimain worl6 cortrp.cdion iBuffic. s r.qun.d ur( sd io. l7m olrlE t hor (ilde for $. Ffollm. .f
<br />rh. *ort tur\hkhrhiFnn i rr6t6 onFudDi Nu@c. .ffii6 .,'d rnlicy nuhb6 d.:
<br />'alo/t
<br />-l.dify
<br />lhd hrh. p6fom.m. ot lh. wor* tor whi.h lhis p.mn ir i,!$.d. I sh3llnor drlllo, an, F$. i. &] 'trdd& d to bdo@ rugd r. rlE swt6'@hFErrn l&! of Clliforra D<I tsE thd if I tlDuld h.(E uti(rl ro tlE
<br />trorld NmFMtion pmvirioN of S.rrion lT00 of rhc Lltd Cd4 l rh.ll f(rthsilh comply u iln lh* Fovnio6
<br />WAnntnC tnlE lo M *ortd onedliirn co\os. a u.lntuL dd ndl $hjd r oPhts lo sini l FtshB nd
<br />cnil fin6 up ro on. hudr.d rho@d dou@ (ll00,oj0). i. ..,nilion to lhc cor of "ffff"*""**SdDn 10?6 ofllE L.EI C.<h ddd dd.nm ! 16 ------)
<br />n,. t l-23 1\ ^*r-^.Y y' ""1ucEtsElcarraAclaa
<br />TIOJ8AIIAtr
<br />I ha!b, slrm und6 Fslr, ot Fjury lnd I h li(a!.d uld6 Fnviliri of Cll,ptq 9 (onltffiing s'nh Sdtbo 7000) of Divitbn !
<br />or rh. B6i6 ed Prcr.s&6 (-od.. ! my,icrenintullfor-"d.fi*r.
<br />0l//l 'BqA74+
<br />Ae#t'*.* ' C ',/1
<br />1u'I 1 .;;*Y"':-oqtz
<br />co!llal1cu0!.1!!!l!clcE!Ijl
<br />I ha.ny rfrrm und6 Frny of Frury rha thd.. i odMi.. lav.lirS !8dr lor lh. pqf(fu..t'h. smt 6r \nth rhn Fn- a
<br />rsKi (sr 11D7, Cn C ).
<br />Ldnd r Ad&d
<br />-
<br />AIIII(AILDEIIJ8AIIOT
<br />I ha*,y llImr lnds pdully of Fjuy oG ol rlE lollo$ i.3 d.(lrt' ioN
<br />rx.$hDn PmrnlArb6tot Norificdnrn Fejdl R.suhisnr (Tirl.40, Pd6)
<br />R.rturGi Iir6 olMtifi.nion
<br />I cdih rhar r h. l.{o d r.luLr'oE r.,r.r.linr lt€ror 6ov.l ,. mr @pr(rbk '. I hir FnF
<br />,1J--,r, , n, , *..,*: ,r'i, .peli(drr dd dd. rhd rrE rbov. inn'r,di.n n.oE.d. I ure ro ftmply sirh . (-ny.d( oulty\<rdid6 dd SE. bs ELiB lo hrldEs confuciD( d h6.tt .dlFriz. qrendn6 ollnt ( t Md Counly lo 6ls r4oo dE
<br />!bo". MrDi.d pmpql' for iEp6iio. Fbd6 - , U .
<br />n*,o**n,-,.n-"*!I- .b.-( |tzv-^-) .,. ' IZt' :-
<br />,*u* -..,0n.,' 1i-): a- 1!:
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