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BUILDING- INSPECTOR RECORD <br />COMMENTSDATEID/SIG. <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />Subf loor/VenUlnsulation <br />Roof Sheathinq <br />Shear Wall <br />Framinq <br />ln s u latio n/Energy <br />Drywall <br />Brown Coat <br />Masonry <br />Pool Fence <br />T-Bar <br />Handicap Req <br />Deputv Final Report <br />Engineer Final Report <br />Flood Zone Certif <br />.101/FINAL ,t/',,K/N TL <br />Certificate of Occupancy <br />Notes, Remarks, Etc <br />I m ctmpl unds Sclion-, B & P.C. to. fiis r6on. <br />lla8sE8s:caMfE!.sAIl9r <br />DECI.ABAI,IO! <br />I h6€by afiim undd poahy ofrdjury one oathc followinB ddldatioN: <br />-l <br />hav. !d will m.iorain a Ccniar.a!. of CoMl lo SclH.tur. for wrl.r! onrp.nstion G Foviddl aor bv Sstion l70o of the <br />Labor Cod.. toi $c pdfomanc. oflhc sorl for which th. pqnit b issu.d. <br />-lnsv.andwillmai <br />ainsork.G'comP€Ealioninsuran..tsrcqunedbySdlionlT00oflh.lrborCodc,forlhcp+'Lm c"r <br />rh. \orL lor $hich lhls pemn is isual. My .omp.salion i6u, .r6i6 mdpolicynuhbd €Z\rrl <br />\'b@q.\d \1 <br />-l <br />cdirrrlrr inlh€pdforda...ofrh.work lor lvhich rhis ptrmn is issucd.l shallnol enDlov any p.rson rn any mdnkr <br />$ s lo b..ome subjer lo rh. *ort6' coop.@lion la$s ol Califoni4 dd tgr lhal if I snooh b-o'n. sbjdl to <br />qoltm compoeIlod rrcvGioN ot S.clion lToo of th. L.bor Cod€, l s6all. lonhrilh cooPlr wih <br />dpbrd ro aininal duhi6 md <br />ior. ddaB6 s provid.d aor rh€ <br />wAtlNlNC: Failurc ro sur. *0116 .omp.6.1ion co c B unlawtul. and sh,ll subjd 5n <br />up ro on. hundr.d lhousd dolla6 (31 <br />Cod.. inl6d Md anorrey sv <br />! h6.br afirm und6 p.nllly ol pdjury lhsl I d li6en und.r prolision oachaB6 9 (&ndo.in! Nith S.<lio' 7000) 'r Dn ision :l <br />ol rhe Busin6s ed Prol*io6 codc, od hy lic€ns 6 in lull forc. drdtil(t <br />C\1(-q <br />t"1 <br />I hd.byalrm uid6 p.oalqofpnjotythd rhq€ ta coostucrion t ndiit lsdv roi rh.Pdfom ccofrh.work tor tr'hicn rhG Pdmn b <br />issucd (Sc.1097, Civ. C.). <br />L.n,ld'! NanF <br />L.nder', A'ld6 <br />AIIIIIAIII.DECIABAITAtr <br />I hr.try afinn undd porhyotpdju'r_ onc olthc folloNins ddldariotrs: <br />D€molirbn Psnirs Asbclos Notificarion Ftdral R€sulations (Tnl. l0, Pd6) <br />_Rcqun.d l-cts of Nolilication <br />I c.niry lhar lhc f.d$a1 r.Sulariotr Esrdins dbdkx tdno\ al r€ not applicable lo tht pojd <br />-l <br />(sllly rhar I lFvc rod Ihis applicarion dd sr.rctld lhc isc.'recr l !,ehcomfl) sirhallCiir"and ( ounry <br />oldinoncB and Slarc ti$s relatins lo <br />,ba!c ,n.ntion€d prop€nl for impdt <br />reprsdr.iilLs o f lhis Cit <br />+;r*,,\pplicdnl or gqi Sig N(urc: <br />t\V.s e <br />SITE.WORK <br />Ext./lnt. Lath <br />OWNER AUILDER DELCARATION <br />I hdcby amrn unda pnahy oapsiury lhal I m dcmPl 6orn lhe cohr.dou l,icense Law folile aollowinr .cMn (Ss.?011.5 <br />Arin63 dd Proision Codc): Any ( iry or Couflly uhich r.qun6 . pqnit k' co6rtu.r' ans. improve &nolish o qar mv <br />sLrudm. prior Io ils issudrcc, also Equt6lheamlicMt lor sucn p€mn ro nbt siSned stalddl rhd h€or sh.6li'm'd pusutrl <br />lo lh. proli.ioN ot lh€ Contacro.s LGnsed Lar (Chafle 9, aonnflcing *nh sdrion 70()0 of DilGion I ortb' BGinBs d <br />Prof6sions codc) or rhal hc or she is.xcnpr lhsefron dd lhc baris lor rh. rl.gcd cxenplion Anv vnnarionofsc.lion T0ll9bvanv <br />.pplicad lor a pd .ubjes rh. .pplica loacivilp.nanyofnotmor.lhnnv.hund,.ddoll&s($500) <br />-1. <br />s oNn6 oflh€ p.oFdly, ot m, .mployG Nirh $a86 6 rh.t sl. &npdMrion will do lht Nork ed thc nMd' n mr <br />inie cd or ofide{ iu elc (34.7044. Busins ad Pmfsions Code Tfu Conrmdn s l-ico.. kw do6 nol .ml, to m orvnn of <br />rhcpopdr {ho boikh or iqrorG th6n.5d sho do6 such $(i( himsello. h6.1loi thoush his o' hd own emplo}eB- <br />provid€,j rhal such inpovonds 6€ mt inrdded or ofdsd for $lc lL no$Ba. th. b{ildinr or inrprovon is sld *irhin on' vw <br />;l.ompldiotr fieOsF Builds willh,vclh€ hrdd orproving rhd he or she did nor t ild or inprove lh. po!61, for lh€ puryos of <br />l.6osncrorrh.trop6ly. m qcluntlycont.cri.s $ith lic.6cd contaclo6 ro conntu.r lh. projdl (Sd. 704'r. BNiae <br />dd h!ftsion Codc:ihc conrracrofs Liccnsc l-aw does nor apFlyto o owoa olpropdv who builds ot imprcvcs $(6n. <br />and who @nt6G fo. srch Droi..lssth 0 Conimdo(, lic.aEd pmmr ro lh€ contactois Lic6s.law)