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S!TE.WORK DATE ID/SIG.COMMENTS Oms-BuildqDelmtion I <br />I hocby affm uudc pcnslty of pGjury that I M cxcEpt fom thc Contlaclo6' LiccNc Law for thc following rmon (s.7031 .5 $4rinssr <br />ud Prof6sioo Codc): Ary City or Couty which rcquirs a pomit to @6truct, alts, iEpovc, doolisb or rcpai ey structuc, prior to its <br />issuocc, also rcquirc thc applirot for such pa'mit to filc a sigocd std@d thst hc or shc is lic@scd puu@t to thc prcvisioro of tbc <br />Cotrmtor's Li@ls€d Law (Chaptq 9, Com@cirg with Sdioo 7000 of Division 3 of thc Buines ud PrcfesioN Co&) or that hc or <br />shc is acmpt thac&oa ud thc bois for rhc allcgcd cxmptioo .Aoy violation of Sctioo 7031.5 by ey appliut for a pqoit subjccts thcffi i[i#r"-i]li;r-iil#J;-i,h"**#**,"#ffi "*ffir,**:h'#rwho builds or improvc lhecotr, ed who doc such work hirelf or bwlf or through his or b6 ou mploy6, providcd that such <br />improvcmcnts rc not intmdcd or offqed for salc. Iq howrys, thc buildirg or improvcmot is sold within olc y@ of complctioE, thc <br />Oma-Builda will havc thc budm ofprovitrg that hc or shc not build or improvc for thc purpos ofsalc). <br />_1, 6 ous of thc propaty, m aclusivcly conming with liccDs€d coordoE to @&*Dcr thc p(ojet ( Se. 7044, Buhe ad <br />Prcfsion Codc: The Cotrtractor's Licruc lnw doc uot apply to m omq of propqty who huilds or inprov6 ths@n , ud who <br />conmcB for such projats with a Contractor(s) lic@scd pusuat to thc Cotrtractor's Licruc lrw.). <br />-lm <br />undq Setion & P.C. for this roou. <br />Date:{F - a, o4*'.7WORKERS COMPENSATION DECLARATION <br />I h<cby affm undo penalty ofpojury onc ofthc following deluatiom: <br />_l havc md will maintain a Caificatc of CoNot to Sclf-lNuc for worko' oopcreationn re providcd for by Setion 3700 of tbc <br />Labor Codc, for thc pofommcc of the work for which thc pcmit is isued. <br />_l havc md will mintain work6' comp@tioo iuuecc, u rcquircd by Setiotr 3700 of thc bbor Codc, for thc psfomucc of thc <br />work for which this pqmit is isucd. My worko' coopcmio! imcc cuiq ed policy oumbo uc: <br />Cmia: <br />Policy Numbo: <br />(This sryrifi-occd not bc compldcd if thc pqnit is <br />ficarity ta in thc psforoe of rbc work for <br />for Ooc hun&cd dollm ($l0O) or 16) <br />which this pmit is isuc4 I shall oot @ploy my pcoo in uy roa m a to <br />of Califomia, ud agrc that if I should b@omc subjet to thc workas'I bccmc subjcct to rhc workm ' compcnsation laws <br />ofsetion 3700 ofrhc Iabor Codc, I fonhwith comply with thosc <br />&/7 6 ,azt,J. <br />WARNING: Failue to s6uc workm' compcroation covaagc is ulawful, md shall subjer u mployc pqraltie od civil <br />fmo up to onc hudrcd thouwd dollm ($100,000),io addition to thc cost of compcmation, dmagc u <br />thc Labor Codc. intqcr md anomcy's fe. <br />for thc Sction 3076 of <br />LICENSED CONTRACTORS DECLARATION <br />I hacby affm unda penalty of pcjury that I m liccNcd ud6 provisiotr of Chaptq 9 (comocing with Setion 7000) of Division 3 of <br />thc BNincss md Prof6sioN Codc, ed my liccmc is ia full forcc ud cffet. <br />Liccm Liccnsc Numbs <br />Date:Cootractor: <br />CONSTRUCTION LENDING AGENCY <br />I hacby affm unda pculty of pqjury that thsc is a coshctioo ladiog agmcy for thc psfotu@ of thc work for which tbis psmit is <br />issucd (Sa. 3097, Civ. C.). <br />[rnd6's Nmc: <br />APPLICANT'S DECLARATION <br />Dmolition Pmits-Asbestos Notification Fcdqal Rcgulations (Titlc 40, Pan 6) <br />_ Rcquircd tat6 of Notification <br />_l cdrrjle thc led@l rcgulatiom rcgading obcros rmoval ac not applicablc to this projer. <br />pz{cdify that I havc rad this application ed statc that thc 8bovc irfomatioo is conct. I agr€ to comply with all city ud coutyrordinmcc ad Stac Laws rclatirg to buildiog commction, md hocby authorizc rcpraatativs of rhis City ud Couty ro mt6 ufpa thc <br />abovc mcntioncd <br />Applicet or aSot sig. <br />Pleeco 4.0Pcmitte namc (print): <br />inspetion purposa. <br />b <br />Set Backs <br />Forms/Steel/Holdowns I 4/o t |i/,t*', <br />Erection Pads vt r' <br />UFER Ground <br />SLAB Floor f/ <br />SubfloorA/enUlnsul //l/t*7,' <br />Roof Sheathing ' xi<Nr/.1rN <br />Shear Wall /)/n-z <br />Framing 7l t)pLt& <br />lnsulation/Energy )ru.0 <br />Drywall {T-frLD <br />nt. Lath 7'Y 'ur4A <br />Brown Coat 7 <br />.Ma.^nqf- gzlart-H 1'l Jrl4D <br />Pool Fence I t L <br />T-Bar <br />Handicap Req <br />Deputy Final Report <br />Engineer Final Report <br />Flood Zone Certif <br />FINAL <br />Certificate of Occupancy <br />Notes, Remarks, Etc. <br />IX1 f..,v1t Qf.1 <br />Y vrY '-v/17 [ 7 <br />BUILDING- INSPECTOR RECORD 1? <br />03.31.06 <br />a l/ n7 <br />{,r[u I <br />qlt* <br />'L$l r <br />rLltfV <br />t-do't Addrs,