Laserfiche WebLink
BUILDING- INSPECTOR RECORD <br />SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDER DELCNRATION <br />I hsebr amnn undtr p€nalry oip.dury rhd I tun cr€,npl Fo,n rh€ Conrictoa Lic.ns. ti$ lor ihe lollowins raari (Sd70ll5 <br />t llusi.* &d Profgion Cod.)r Any City or Counly qhich rcqutd a pdnn to coNtrucl, ah6. impro!€. ddnolbh or rqEn any <br />srtudu.. pnor to ns isuanc., also requn6 the applicdl lor sucn p.mi ro lile. sisned sl.tmflt lhal h..r rhc b licosed puNdl <br />ro rh. prcvnnrtu ol $. conlmclois Liccnsd tas (Chaos 9. Co'nhcncin! wnh Sdlion 70C{ of DivGion 3 olrh. Bsins md <br />PoaNions Code) o! thar hcorshct.&drr rhdenon dd rhc bosk lor lnc allescd .rcnrpt io n. A.y 0oh!tun ol S..lion 7(]l I 5 by any <br />appli.ad aar a pmir subjdc rhc applicant lo a civil pcnalty of nor noE rhd nv. hundretl dollds 11500). <br />-1. <br />6 otrn€. orthcptuFlr. or ny cmplorB wil,r *.86 sthen $b co,npos ion, $ill do Ih€ soIt ud lhe stru.ldt is mr <br />imdiol or olldcd aor sl. (Sa.?0.14. Busi6 ud Per6sioN Cod. Th. (onrracror's !ic.e Lts dod n.r appl, lo an owns ot <br />thelrcpdy *l$ blilds or improvG tnq6n. !d who do6 suct s$rt hinrs.ll ot h@lf or rltrough his or hd .wn cmPloy€6, <br />provided th0l $lch improvmls {€ mt i.rEdcd or orddl for sale I[ ho*6'd. th. hildins or inprov@r is $ld Niihin on€ ]ur <br />olcomplaion. rh€ OMr Buildd $ill have l11. hrd.n of prolin8 thil h. or sh€ did nol build or inprc1. $. FDFry lor $. puFe ol <br />-1. <br />aso$ndoarh. prot6ly, d. .xclusi v€ ly conl racl ins Nith lic$cd conriacbh ro .oNnrcl lhc prcjd (S(. ?044. Bcin6 <br />md ftDftseion Cod€: l h. cdntrrcloa s Li...sc Las do6 .or appl, to m oNna otprorEny who builds or improv6 thcr€on. <br />and sho.on!6dslorsuchpmjatssiihaContraclo(rlt4s.dpuRuarrorhcContncloisLicffiL{N) <br />_l an .x.mfl udd Sdio <br />]!48(!a[r9]!t[!s4f,la! <br />DICIA8AIIOI <br />I hocby omrnr trnd6 pcnalty o t pgjury on. olthc follo$inr d.{ladiom <br />-l <br />have dd *ill 6ai.rain 0 (tnificarc of Congt lo Sclf-l6urc lor Mrlds' .Dn9.ns.tion. 6 provid.d tor by Stlion r70o o t Ihe <br />Llbor Codc. for rhc pslofr@c. olrh. wort for lhich rhc p6nn G issued. <br />-l <br />h.ve.ndqillm0i ain uork€( corlpcNalion insuraicc. as Btuted b, Scdbn <br />thc Rort for *hi.h lhis D6sn is isucd. My wdrkdr conpqsat'on i6urlncc.trid <br />Cp,q0 csrpgngrfl(r\ \rrsuta:qlT78n <br />-l <br />cenrlyrhar iorhepcrfonBnceoirh.*orh lor$hi.h this!-qmir is issued.lshall nol dnplo, any peMn in any'ndnct <br />$ s ro b.roEe subjar ro rh. rrr k6 comrENr ioo larvs of Calilodia. and r-lrcc $ar il I should bdo,ne sul,je' to th. <br />\rortm.o,npeNrionpsvtioreolS&1ion1700orlheI.borCode,Ishall.fonnvirhconDly*ilhtho*Pbvisioru' <br />\tAltNlNC Failure ro *cue *orlGs comp.rearion .ovchgr is unlasful. ard shall subj*l M cnplotq lo fliminal poahiB and <br />cMl fines up lo onc hu.dr.d lnousd dollm (S100.000). in addilion io lh. con df.o,nPcMrio., danas.s s proidd lot rh. <br />sdron 1076 olrheL,boraod.. inrq 6t .nd a uorn.y F11" TtA <br />I hcehy lllinn unds lorhy o t pdjury <br />'hrt <br />I an licmsd ion orChafld 9 (.onrmdrnrs {ilh Srlion 7000)oiDivision l <br />of rhe trusin* dd Prordsiotucodc. od ny li.mc is in lull force ard cfl(r <br />, C -'ol/pZtl T3ltlto <br />t6 -l- <br />AITIICANLIECIAAAII(]N <br />l@.finn undcr peaally oi pcrjury onc ol$c loudsins dRldarionsl <br />Dmolilion Pnbns-Asb.slos Nolifi carion Fdssl Rcgularions ('I nl. 40. PM6) <br />-R.!ut.d <br />t llEof Noincdion <br />-l <br />cdiry lhat lhc icdoal rcguhliom rcgedirS 6b6los rfloval ec not applicabL b this Poj..l <br />dir cdity rha( I have rad lhis applic.lion sd sral€ lhal lh€ lhov€ iolomal iod i5 .ondl. I tr8rc lo comply virh all Ciry Md Coul, <br />ordind.6 ed Srai. La$ Elniiig ro buildins conslruclion. ed hdcbt alnhoD. r.pr6atdiv6 of this Cily od Couiy to ats upon llE <br />pern,nen,,,(pri,,,): )f Ug,nnr Pr (,& <br />.,., . tl-1 [6 <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />Roof Sheathing <br />Shear Wall <br />Framing <br />lnsulation/Energy <br />Drywall <br />Ext./lnt. Lath <br />Brown Coat <br />lt4asonry <br />Pool Fence <br />T-Bar <br />Handicap Req <br />Deputy Final Report <br />Engineer Final Report <br />FINAL /2-t{- lg J/zS.{" f"/1) <br />Certificate of Occupancy <br />Notes, Remarks, Etc <br />-\ <br />Subf loor/VenUl nsulation <br />Flood Zone Certif. <br />I <br />i*W <br />colilalc]]llN.LlrDllcacEd(I <br />I hercby afllm und6 Denally of pdjury rhar lhd. b a coNro.lion Lndins asdcy litr rh. FaomMc. ofrfi. utrk ior whi.h rhis p.nnn i <br />hsucd (Ss.109?, Civ. C.) <br />--------T------