Laserfiche WebLink
BUILDING. INSPECTOR RECORD <br />Rev. 08-07-201 5 <br />SITE.WORK DATE !D/SIG.COMMENTS <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />Subf loor/VenVl nsu lation <br />Roof Sheathinq <br />Shear Wall <br />Framinq <br />lnsulation/Enerqy <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 />,tt I <br />'/l/lrt1 -rr*YJr:7tFINAL <br />Notes, Remarks, Etc. <br />IherehyallirmunderpenaltyofFrjurythatIanrexemptfronrlheContractoN Licenselawforthefollowi.Srcaen(Scc.7031.5 <br />llusincss and Prolbssion Codc): Any City or County which rcquircs a lrcflnit to construct, alter, irnprovc. dcmlish or rcpair any <br />struclure. prirr to its issuance. also rcqrircs lhe applicant for such frrnil b filc a si8rcd slatenBnl that he or shc il licctoed pursant <br />lo lhc previsions of thc Contractor's l,icenscd [-aw (Chaptcr 9. Comrncncing with Scclion 7(XX) ol Division 3 o[ lhc Busincss and <br />ProtessionsCode)orrharheorrhcisexempttheretromaBlllEhasistbrrlEallegedexemilion. AnyviolariooofsectionT03l.5byany <br />applicrntforrpennirsubjeclslhc npplicanlroncivilpe0rllyolnolmorethatrlivehundreddollars($500). <br />_L as owncr o l'thc propeny. or my c.nployccs wilh wagcs as lheir sole cornpcnsation, will do thc work md thc structre is ml <br />inend*l or offcrcd for $le (S4.7O44. Busincss and Pmfcssk)[s Codc: Thc Conlraclor's Licensc ljw docs not apply to an owncr of <br />thepn)peny wlx)buildsoritrprovesthersLlrdwlhdoessuchworkhimselfothcrselforthroughhisorherownemployccs. <br />prorid('d that such impmvcrrcils are mr intcrylcd or ollcrcd for sah. ll. howcvcr. lhe h{ilding or improvctmnt is sold within onc }ril <br />ofcon{rletiur, the Owrrcr Buikler will ltsvc tlr burden of proving lld lr or shc did not boild or impmve thc prclrny for tlt purpose of <br />salc). <br />_1. {s owner of lhe propefly, rm cxclusively contracting with licenrd conlrsch)N to construct lhc pmjcct (Scc. 7(X4. Business <br />aill I'n)lLssiilCode:TheContrackrr'sLicenscLawdoesnotapplytoanowncrofpropenywhobuildsoritugroveslhereon. <br />and who contracts lor such projccts wilh n Contractor(s) liccnsd pursuant kr ttrc Coolraclor's License Law). ' <br />-Ianlexemptundclsccli()n-'B.&P.C,li)rthisrcasotr'l)nlr:_ <br />WORKI]RS' COMPI.:NSATION <br />DECLARATIoN <br />I hc'reby allirm undcr pemlty ofp..juryonc ofthc lbllowin8 declaralions: <br />_lhaveandwillminlainaCcniticateofcotlsenttoSelf-lnsureforworkcrs'comJrcnsation,as prcvidcdforbyScction3Tmofthc <br />Luttr Codc, for thc perforrunce ol'thc work lbr which lhc pcrmit is issucd. <br />\(haveandwillmaintainworkers compctrstioninsurance,!s requircdbyScclion3?00oflheLabo.Cod.,fortheperfomrccof <br />lhc\ork for which this pcrmit is issucd. My workfrs' comlrcnsrtion insurancc cffiicr anl fDlicy numho ue: <br />A rg D t)s <br />*,,,,n", lpe u q33zqo ,,.,r,,",, /e-of - z'o20 <br />-I <br />ccf,ity that in the Jtrtornuncc of thc work for which this pcrnrit is issusl, I shall not cnrploy any 1rcrson in any manncr <br />s as lo hccorrc suhjcct to thc workers' conrpensation laws of Cnlilornia. ntrd agrcc that if I slnuld hccorrc subject to lhe <br />wodicrs conrpensatioD provisions of Section 3700 of thc trbor Code, I shlll, fo(hwi(h conrply with dDs prcvisions. <br />WARNINC: Failurc k) scurc workcrs'conrfcnsation covcBgc <br />civil lines up to one hundred thousand dollirs (Sl{)0,(IX)t. in r <br />Secti(,n J076 of lhe tilxrr C(xle, iilere$ and attoruy s fees. <br />is unlawltl. nn(l enrJrkrycr to qiminul Fmltics ud <br />lion. d{nulges N provided for lheaddilion ro rhd <br />t,,1" 'Z''11'?1)21) <br />I hcn'by al lirm undcr JX.nally ol pcrjury thnt I arn liccnscd undcr ol Chaprcr I (commncing with Scction 7000) of Division 3 <br />of tlN Busincss snd Prcfcssions Codc. ard nry liccose is in lill fbrcc and clfect. <br />[-iccnsc a,".., G -4 f, Liccnse Numbcri z <br />CONSTRT'CTION I,I:NDlNG AGENCY <br />I herchy aflirm uuder lEilal(y of pcriury that thec is a coilslructiql leildirg a8ercy for rhe pcrfomance ofthe work for which this p€mit is <br />irsued (Scc. .1097, Civ. C.). <br />l,cndcr's NJnrc: <br />l-Ln(lcr's A(khos\: <br />APPLICANT DECLARATION <br />I hwby affm!nder pcnahy of perjury onc of the followirrg declarations: <br />Dcnplirion P€rmils-Asb.stos Norification Fcdcral RcSulations (Tirlc 40, Pan6) <br />-Rcquired <br />lf,ltcr of Notification <br />cenily thar rhe lideral reSulnriors regddinB rshestos rcnxrval arc not applirable k) this projed. <br />rhal I have r.nd rhis application ad stalc thrt lhc abov. info@lion is corcct. I agre to clmply <br />rcpresntatives of this City <br />wilh all City and County <br />and County to enter ulDn tlEand State Laws relatir)g t) huildiilg <br />atxrrc nrntionctl propeny f'()r inspccti()n puqnscs- <br />or A8cnt <br />rc-\ <br />P(nililft natrre oile <br />Certificate of