10193680 - Permit (2) - Laserfiche WebLink

Home Browse Search

BUILDING- INSPECTOR RECORD SITE-WORK DATE ID/SIG.COMMENTS OWNER BUI T,DER Df,I,(' RATION I he.by amn. undd pcf,alty oa pajury lhat I m .r.mF 6on rh. cohlhdoE Lic.M ljs aor rh. follo* ins r.Mn (S( 701 I 5 Busin6s and Frofsion Code) Any Cily or Counly which r.quir6 a p6nit to codrucl. ah6. nnprova .lenolish "r r.TEn sny shcru.. ri.r ro i's iisud.., abo r.qun6 rh. +pli.dr aor ruch p.rh lo El. a sis..d srar@dr .(har hr or shc i! lirtucd N4uanl ro thc lrovnioN ofrhc Conr6.lois Lic.ns.d l!$ (Chaprr 9. Commcocina *irh Scclion T(IOO or Diiisn'. I nrrh. B'Lvn6s and Pmfsions Cod.) orlh.t h.or sn is.r.trrFlhd.arohmdrhcbaiiilorrh.all+.d.rdprion.Anlviolario.oiSdtionT0ll.sbyany apphcant for a pâ‚¬mil subjdslhe applicant lo acivilpâ‚¬nallyofnot mor.th livâ‚¬ hun&cd dolldsl$500). L a ow.d ofrh. FoFrly, or my .mplord wnh wau6 a rhei $lc .o,npdMrion. *ill do (h. sort dd fi. sn$u. b nol ,nlnlqr or orscd ror sl. (Sc.7044. Busin6 d ltofGions Codcr I h. ('ontra.lois t,icâ‚¬e tnrv do6 nol apply (J an o*ns oa thc ploFsly who build, or inprcvB thâ‚¬n. md slF do6 such s* himcllor hd*llor throush his or hd own o!ploy.6. pio$d.d thar such inFov.lffirs ft frn idddai or ofidd for elc lf- ho*66. th. building or nlr.vmr il $ld s irhin on. ]6 olconplelion. lhe (rrs Auikis will h.vc Ih. hudd oaFovin8 lnol hâ‚¬ or sie did mI hild or i,np!v. lh. propqly for thc purFrs or l. 6 o* nq ollhc prolEny. o eiclusively .ontadin8 $hh licd*d co r.do6 to coNlnrcl ttE Fojd (Ss 70{.1- Btrstr,Es Md ft!ftssbn Codc: I hc conkacrors Licâ‚¬ns. tjN do6 nor apply ro tu o{nn olpiopdy who builds or nnprorcs rn.rsn, and $ho conr@1s ror su.h phjdls wirh r ConlEclo(s) lico*d pu^u rrothcCo radr'sLicdr.L.d I dn ex.rnpr mdd serion t!oaKD&!:loufl,!-lAu)! DEIIAEAIION I hd.bv amrnu.dd pdany oapdjury on. of$c f.llo*in! ddldalions I havc turl will ,nrintain . cdrar.src of CoMt ro S.lf lGurc ror *ork6- tumpsMion. a previdal lor bt s*rion 171{ o f rhc l$.r cod., for rh. poaolr@cc o f th. vort fo, whi.h lh. pâ‚¬ n n issucd l hareaod willmainlaio work6 cornpdolionirouraRc.6..quircdbrSalionlT00oflhctiborCodc,forlhepdfonndceol lhe ao* for which thi! pnrn is is.d My *ort4 comp6..lion iBurec. cMi6 d policy numb6 sc: Erpir6: I cd'Iylhal inlhcp.rfomanc.oflhcworl for trhichlhis p6mil t 'ssuâ‚¬d.l shallnor onnk,y aoy IE $n inmtnrend e 6toberomc bjdttoth.No 6s compaslion lass ofc.lifohia. dd arre lhal ii I should hccomc subjsl lo the \ork6' co,np.Nr io. povisiom oas6lion 3 700 of lh. t bor (_ode I shall. fonhwith comply wilh thos prcvisnrns. WARNINC Fa'lurâ‚¬ ro *u. work6' comluerion cov.6ae is unlastul. d shall subjecr d mplo)6 ro 6nnin0l FE[i6 and cn'l lin.s up !o on. hundr! rho6and dollds (nioi to lhc.osr ofco'np.Mrion. dana!6 as Fovid.d lo.lhe sNrron 1076 0rrhe l-ahtr(odc. inr{csi Ea\,-r I ho!b, alTrm undd p6ohy of pdjury rhal I m [ccB.d ud6 Eovision oachaplq 9 (lomnHcins wilh Sdtion 7000) orDi!tion:l oa th. aai.N ed Pols@B codc, dd my licft. ie in full lor.. a.d .lId A'IAVtlt l/^\^.-.^^ I hBlby om b und6 lm0lry o f pfijury r[d th6. is r.onskuc(irn Lndin8aso., for lhe pdlomrnce oflh. \so.k lor{h(hrhN F-r 6 ksucd(s( l097.civ c) AIIU(ANIIDCUAAUO! I hdtny dtm undd pcnaxy ol Ft- r_ on. ol rh. followins ddlaari.ns: Demolition Pdnits-Asb6los Nolifi.ar ion Fâ‚¬dsal Resulaliofls (Tirlâ‚¬ 40. Pan6) R.qut.d L.ltd oa Notifiqrio. I c.nni thxr lhc (!oralrL!trlrrhns 'qinJi'rg 3sl-.'sf\ '.m\nlrrc ror rt,p 'r1ll. t' rlrB r)r, r{r i.arionedslalcrnalrhcatrrcinlomario.ircorrd laarerocom plyNirhull (\ryand ( (ur\ rry and Cotrnry() c.rr qtrtrhcldi.B co.(rudion, and hse$r olrhortc rcprsdrativB olrfiis ( \ Ll)1/,')({,vra- 2r\=ln Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Subfloor/VenUl nsulation Roof Sheathing Shear Wall Framing lnsulation/Energy Drywall Ext./lnt. Lath Brown Coat Masonry Pool Fence T-Bar Handica p Req Deputy Final Report Engineer Final Report Flood Zone Certif FINAL t7/t/D r.'D.6Vr:nr (1 Certificate of Occu pancy Notes, Remarks, Etc W.---- Irr