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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 />lnsulation/Energy <br />Drpvall <br />Ext./lnt. Lath <br />Brown Coat <br />Masonry <br />Pool Fence <br />T-Bar <br />Handicap Req <br />Deputy Final Report <br />Engineer Final Report <br />Flood Zone Certif. <br />/^\ <br />FINAL L{-l'"1 \'-V+-ltJi <br />Certificate of Occupancy \a= <br />Notes, Remarks, Etc. <br />O\I N ER BU I LDER DI:LCAllAllON <br />I hdcby .fl-rnn undd pdalry of ldjury lhal I m ere,npr liom lhe conricrors' l-i..nF Lis lor rh. Lllovin8 r@n (Sc.?01L5 <br />Rusin*s 0.d Prol6sion Code): Any CiU or Counly vhich requn6 a ponn ro linsrtu.r. alle, nnprovc. dcmolBh o! tLTatr oy <br />nruduq prio' ro its iisudcc. abo rcqute rhc .pplicer rDr s h Fmn b fik a sisn€d slarenol rhar h. or .h. n licmkd pu6u t <br />kr rhc pmv'srons ol rlE Conhctois l-iccns.d Law {c[ot,d 9. aommcncins wilh S(tion ?000 of Division 3 oalh. Bosin.s dd <br />P,olcsions Cod.) or lhal h€ orshc is €x.opl ths€6o'n aod rh€ hssis ror rh. all.r.d cGnFbn. Any riolation olScclsn ?0-r1.5 by an) <br />!mli.a.r aoi. pc.nn s!6js8rhc appli.o roacivilpcnahtoanornorethmfivehundrcddollats($500) <br />L s oNns oflhc prcpeny. or nry erploys * ith was.i 6 lhct ele o,nN.$l i.n, will da fic work od Ilrc nrLdue is nor <br />ioldd.d or orr.d lnr sak (sd 7{N4. BusinBq d! P$ fBions cGl.: I11c (onrracl,, s l-i.c6e I aN do6 nol appty ro M oMr o f <br />rheF)peny who builds or improv6 rhdEn. dd *ho do6 su.h Nork himsell or hds.lao! rhroolh his nr htr osn.,nplor.B. <br />providcJ rhd such nnlrolomlsd.nor inlodsl or o,Ised forsl..l[ horvfls, rh. hildins or iinpmBnmr is sld rvithin onc )@ <br />or compl€lion. r)E (}rnd Buikld sill harc rhc burdm oapoving lhd h. or shc dil mt boild or improve lh. pDpqly for rne $4r* of <br />.- l, 6 osnd orrh. popcrr. tun cr.lusiv.lt .onk.d irE $ irn liLskd contacloB ro construcl I hc !.qidl ts< 70,14, Bosins <br />and h.f6sionCod€:'l he Conlrt tn's l,icflsc I-a* do6 nol spplyro an oNnc olplopd, who builds or inprov.s lhddn. <br />and Nho.ona.tsforsudrFllds\rnha('ont.cro,(s)licdMdpurs'ullothe(oiticlrr'sl-icft.ljwi <br />I tun cxcrnpl und.rSccrio <br />\\(ItkIRs { 1)) 'l]NS\I ()\ <br />![!! 8tluuf <br />I h.rcby amm undd p.nrlry of Fdjury on. of lhc follosinB delealioN: <br />)p r,"* -o " ' <br />n .".- <br />" <br />cdrr'.are orcois, ro s.lLIBur. ror mrkdr' €n,p.n$rion, s provid.d ror by scrion lToo oafi. <br />Lat r.odc. forrh. pstomanc. ol lh. wo'k lor $hlch lh. psn s 'sucd <br />_l have and uill oainrain work?ro' comFNalio. iBorahc.. d r.quted by S4liofl 17C\) of lh. kbor Codc, aor in. pdfomance of <br />lh. work for*hichlhblaon is i*{'al Mw-^n -r - ^ * - - - n r ^ " ; - - - " " ". . is ad policy oudbd e: <br />"*", A2/l<D v-:tsCoaSt,J <br />LJC e <br />q, $ ro bdo'n. subjs! ro tlE sorl6' .ompcMrion laws oacalifomi., and <br />sor[6 comrlffition povisioEof S.ctiotr ]?00 ollhe L.bor code I !o ply *nh rho* pNvhions <br />IYARN|NG li.ilure h sule \1116'compeNalion co\emlc 6 $'ltjsl e dnplole lo sntri.al ldalris d <br />civil fins up h on€ htrdrcd lhousand dolls ($100.000). in <br />( <br />underpenalr]olperlurythat I otr li.msd tnLlLy Fov nol( [opro ,] (connnorx,a s([Scdio Totr0)ofDnision I <br />of lhe Ausin6s d ftolsbG Cod€, dd my licmc is in lull <br />,38 568 <br />,,c tzrq/ <br />(]]-lt-Il]-U-ll!J!!]jfM!-1Qr <br />I trcby amnn unds <br />'jqDlty <br />of pdju.y $at lhsc i5 a .onslrudio. lcnding agacy aor lhc psforroc€ ol lhc $or* for {hich lhir Fmit is <br />issucd (SK. 1097, Civ. C.). <br />ATTI.ICANLIECI,A8AIIQ! <br />I lEttry afilm under pe.alty olDdiur] oneollh. aollorvinp dsldalions <br />D.nnlnion Pd,nne^sbelos Nolificalion l:cnsal RcBularions llnk,&. Pan6) <br />_Rcqutcd l-.rrq oaNorifi .dion <br />-r <br />cdiry rhd lhe fcddal resular ioN Elodins arb6tx rcmoval de nor amlicable Io tnis projst <br />I.di6 rh,' I ha\c rsd rhis applic <br />ordi..ncB drd slalc lj$s ,rl.liDr <br />ihn c nrn( i(nrcJ fopti I lor <br />\t,Dli$tr1 o' .\[(trr Silnrl <br />pl, \rnn allCilland Counly <br />'ity md Coulrylo drd trl()nrh. <br />/t 5/tl.4r4icr>a <br />L.nder's <br />^ddrN. <br />tt