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SITE.WORK DATE IDiSIG.COMMENTS
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />UFER Ground
<br />Sublloor/Vent/l nsulation
<br />Floof Sheathing b//11(,5>tx
<br />Shear Wall
<br />Framing
<br />lnsulation/Enerqy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />l\/asonry
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif .
<br />FINAL 1 zlr,t lt ?Awr,+/67-
<br />Certif icate ol Occupancy
<br />Notes, Remarks, Etc
<br />/p
<br />OWNER BUILDER OELCARi]ION
<br />I hcrchy oliirn undcr ,,.n.liy of pcrjury th0t I am cxcnU tiorn thc Cnntracr{ni l,i.en\c tlw r{n rh. n,lbwnrg mson (Sc.?oll 5
<br />Bu\ioc$ anl Protc$ion Codc) Any Ciry or Co! , snich &qutc\ r Fm r (, .onnfl.r, rlrcr. imF,vc. dcnslish nr rcndn ony
<br />(rucrolc. prirb nr irsuand, rho mqun.srhc rytlicunr fd such p$nn ra {ilc r siSncd slalcnrnt lh0l hcor shc h liccn$d nusu,nr
<br />ro th. rovkiotrs olrtE Contracrols LiccnscJ Lrw (Chl.,rer 9. Comnrcncins wirh Sccrid' 7O{Xr or Division I ofrhc Busnrc$ rnd
<br />Pn,rcsnns C.dc)orthar hcor\hc n crcnllr rhc,crron lnd rh. basn fin rh. .llcgcd crcnp..n. .y vrh'ionofSB_rion70ll.5 by rny
<br />aptli.anr ror r p.flnir subjcck rtu aDplicaol rorc,rilpcnaxtolnor morcrhrn firc hudrcddolhr (S50o)
<br />,, N owicr or rhc floFdt. or ny.nplo)rcr wirh wrEcs s rhcn *rc c.trrprtrstnnr. rvilldo rhc wo* ud lbc iarur. i\ nor
<br />i cnlcl or .flirci lL, slc (Sa.7(!4. Blrimss lnd Profe$bns Codc Th. Contr&tr \ l-i.cn\d llw docs N aml, to rtr o$ncr ol
<br />rhcphl.ny who huildx or impmv.s thffi,n, dwhodud\{.hw(,*hnnscllorh.rscllorrhmuahnisorhcrowncnDlorccs,
<br />providcd rhar suc[ inlpme'rcnh m mr inrended or onbrct ,nr eb li howcvcr. rhc Soikiin! or iryn*Tntnr is r,kl wirhin nnc )tnr
<br />olco.Dlclion. lhc Opncr Buiklc w1ll hrlc rhc brdcn ol lrovin8 rlrr hc or shc did mr $uild or i,rqlnlc thc pR,rcny f(r rh. puls$ of
<br />-1.
<br />trsowtrcr o, rhc pmrEny- a cxclusivclycolrrrcrnrswirhlicctrrilconr'GtnrhconntucrrhcF,j..r(scc 7IN-1, Burtrc$
<br />aftl Pmf.ssi{ Codc] ThcCotrr(ld s Lrcnsc trw docs ior rrtlyt..notrncr offropc ys'ho huinG.r improws rh.rcon.
<br />rnd vho conk(ls lor such !(jccls wirh a Co.rrndo( s) li.ensd nu6u lo rhc Contrtois Lic.ns. lju ).
<br />Irmcrcnnr undcrSdrion J.lt. & P.C rbrrht..rson
<br />L 4/zZa*r
<br />]laliliuut.l!]uuiDrmrz!DI:(r &[&!
<br />I hcrcby rilnn unncr a(nrllyol
<br />-l
<br />hrvciftl sillnuinuin a C.ny'rar. o,Con*nr t, Sdlri{u.. rd \orkcrL .om,f,nsarnn. is rrovddr ior bySdion lTmof rhc
<br />L,bor Codr. ior lhc pclfoflumc of lhc *ork tbr qhich lhc p.nnil h nsucd
<br />I l,xvc and $illn,rinrrin RorkcK co lxn\ari,r i'xurrn ., J\ rcqunrd hySr..oi lTqr.lrhc lnborC.dc.lorrhe rcrfomrn.. of
<br />rhc work ruwhichrhi\ pe ir is u.n My*.rk. c. rtcn\rri{ irsurun.c cflricr rtrdl.licynunrhcr rr.:
<br />I..diiyrhar inrhc p.rl'ormtuc oltlE wo lbr *hi.h rhis ,rnnn h knEd- I\hrllnor cmployrnypcrv n'nnyn'0trtrcr
<br />k, N ro hcconrc slhj$l ro r hc *orkc^' co.fenrd ioo laws ol Crlifomii. rtrd rgrc rhrr if I slhrld bc.om {bjcd ro rhc
<br />qo'kcB mmpensarion pr'lisn,ns ofs(rn,n 17fi) ofrhc uttr Codc.I rhrll. Ldhwirh otrtnl, wirh llFc I)lovi\ions
<br />IyARNING Fiilurc ro Kurc sorkcn'conrrcrs.lior clvcruAc is unh*ful. rnd \hrll \thjer rn cilpk,ycr ro simiml pcnrlrE{ md
<br />.ivil fitrcs up lo onc hundrcd ihousand l.ll{s lSl 0(l()). nr iddiri,)n n, rtu con or cotrrp.r\dnin. d D8.s 0s rmvidcd tur llrc
<br />Scclotr 1016 oirhc tr$or Code. iNcre( {krr
<br />a44 //t/lo,-<
<br />I.|!!r.!!! rIa\
<br />I hcr$yaifi n undcr pcnalry oIrrjury rhlt
<br />cl,t$ua.lJqtrlNrErDtNc-aa[Ncr
<br />IhcEhyaflirmunJcrlrNlryolacrjuryrhdlncrchasnrrruclinrlctrinsaErcyror'hcp.rfntui.colrhcworkrhrshichrhi\Pcrnriri{
<br />issucd (sN 309?. cir c.).
<br />lJlldrr'sAddrc$
<br />-
<br />AITUCANLDEII.AAAUON
<br />I hcN$y arlimr u nd.r pcn!]ry otpcrjrry oic olrhc r{nk'wins d(hrri,,n\:
<br />DcnDlitiotr Pc nns,^sbc(os Norincarion l-cdc l Rcsuldions(lirrr.l0. l',n6)
<br />-Rcq!ircd
<br />Letlcr of Norificartun
<br />I \ cn'lt h.r rhc lcdcra. rcEuhhons rcgardrn8 osl.c{o. rcm\ r' r( nor nml'fibk r. rhN pmJ.rr
<br />-(.*'#,t**,^*snplicdrion'nd{.rharrhcab.v.inronmrioniscorer.lasreIocompry!'rh![cnyaRrcounryordin\cfhd shk L*s ftlnr'ng t. hu'ldine cun{rurk'n. ard hcrchy aulhorizc rcprcsnrlrivcs oflhis Ciryand Counlylo citcr utbn rh.
<br />aho\e 9qFncd llmFny ro, m\nsrion pdr},{\ t t ,, .
<br />^,,J-,in*-,,w-,"*,3fu/k4a14/4@ "",,,
<br />g- t' tf
<br />"^t*^^rt*, b'J,bar L UJLlliar^s
<br />BUILDING. INSPECTOR RECOHD
<br />Erection Pads
<br />SLAB Floor
<br />Pool Fence
<br />nnvnio. olChanlcr 9lconnrn.in8 wnh SNrkn 7000)olDililion 3
<br />oi rM Busirrs rnd Plnisi(rlCodc. nnd n1y I'rcd\c n i'r
<br />I
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