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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/Vent/lnsulation A\ <br />Roof Sheathins flnUf t\'2!-lY krul,r)I <br />-4tLr\ l#T <br />Shear Wall <br />Framinq <br />lnsulation/Enerqy <br />Drywall <br />Ext./lnt. Lath <br />Brown Coat <br />Masonry <br />T-Bar <br />Handrcap Req. <br />Deputy Final Report <br />Engineer Final Report <br />l7u-t--,,, trFINALt0 l4l t9' <br />Certificate of Occupancy U II <br />Notes, Remarks, Etc. <br />c/,v F4I <br />CA14 <br />ok <br />OWNI'R B!ILDEN DET,CARATION <br />I h6eby alild u.dd !.nally ot p€lory that I an rxempl 6om rh. Co.r,oclo^ Liccnse l !N lor lhc aollowiq r.Nn (Ss ?0:r l 5 <br />BBi.6s an<l PiolNion Code) Any Ciry or Coumy whi.h r.quir6 a p6mit Io co6rto.r, ah6. imProvc. ddolish or r.ran any <br />3rtu.1u.. pdor ro ils isumce ale r€qun6 lhc appli.an lor su.h p6nn lo file a siso.d srrhd thar h€ or s\c b li.mqcd pur$ei <br />lo rhe provtioN of lhc Conlmctois l,iensed ljw (Chaprer 9. Conm.ncntB Rilh Stclion 7000 oa Dilisio. I oflh€ BBines dd <br />Profe$ions tud.)orrhd hcorshc is cxcnpt lhdeEom dtl lhe bosis aorth€aller€dcronFion Anyviolsliooofs.dion 70115 bvanv <br />applicflorlo.apsnnsubjetslhcapptic.nrlotcivilpemhyolnoltoor.rhanfiuehundteddollds($500i <br />-1. <br />d o*6d olfie pmFlr, or my nployG sirh $a86 4 lh.ir eL amp.@lio.. viu do th. wdk ed th. rtn(1m is mt <br />ihrodcd or ofired for sl€ (Sd 7044. Busins rnd PNfsions Codq Tn. conlr.clois Li.ds. Law do6 not ipplv ro orro of <br />th.F)Fty $ho bril& or i,np.ov6ln@n. ddNho d(E !u.h$! hirself or hdlror rhmugh his or hd oM.nplovG. <br />providcd lhar such iqr@lddls m nol inle(l€d or oftr.d for slc ll how6d. fi. hildins or nnpmvml is sold sihin on. <br />'doaconplelio( E Own6 Buikkr *iU hav. th€ t d.nofFuing ihd hcorshcdrd Nl hild ot imFow lh€ Fopd, aor rh.por?osof <br />-1. <br />s ontrd ofric prepo1y. tun er.fusn ely rontadinB wil[ licosed conra.ro6 ro co.sltu.1 lhe p.oier (se 70'14 Ltusn6s <br />o ltlrsbnCode: Ih.Conlractoas l,icos.l-a\ do6norapplyro os.r o r Fropcny who buildsorirprcts fi6mn. <br />and who conl.,cls ror su.h p.jdls wiih a (onnado(s) liceNcd ptrAudnrothcConradors Lict6c Lorv) <br />I arc\€n,pr unde. Sc.rion .8.&t( lorlhisrc6oo <br />(hner <br />.\123r-LBSI-ql!lL!fl llllll1!(! !l llol <br />I hdeby ailion u.d6 poBh, oipdjury otr. olrhc lollotri!3 d{l[ari6N <br />! nav. dd sill naiorljn a cdiarcitc oaconHr to Self'lnsuE tu $orkst mn,p€nerion, d po\ iddl aor bv Scl'on 1700 o f rh. <br />Labor Code ior lhc psfomd.e o a$. sort for which thc lernit is isNd <br />I have and will mainl.in worlers comp€Nalion insurancc. ar rcqunedblS€clion:lT00ofth.L.borCodc.lorllEpdlonnanc€ol <br />rhc *ork for $hich rhis tsmn is isued. My workgr Lonpsdion iBut cc cffiir ald FIi.y numbd re <br />I cdify thar in rh€ r.rlon.an..ofthc \rork Io! \rhich lhis ps'nn n isstr.d. I shall nor cmplo, any r.rson in anv muns <br />$ drobeco esubjcdrolhewo 6lcompderion larvs olcalifomia. ed a-!r* rhal ial shotrld bdome subja' lo'lc <br />$rk6' sdpcrsmion provisions ol Sclioo I700 of rh. Ijh.r codc, I sfiall. loah\Yirh co'nllt *irh thos pmv*idns <br />WARNIN(;: lrailure ro suc $ork6 <br />.i!il in.! trp to one hundred rh.usrd <br />unlar,tul. Md shall subjdl u dtloys ro niminal !6alri6 dd <br />(ii!r r. rhc .on ol comFnsir dtunaBs s providc{ loi rh. <br />,r'rr..4 /tq/aorr <br />l)-t:!L!!trr9! <br />I hqeby ailim unds pe.ah! ol ldjurv lhat Ia licens<l Irolision of Ch.pl6 9 (.dlMocin8 \vnh Seclion 7000) of Division l <br />oa lhc Ausins and P.o r6sioB codc. dd nrylicos is in full for.. md.fisr <br />2-7, <br />I hq€by atlitu undd p.nak, ol pdiury I <br />issucd(Ss 1097, CN (')lddinJr alcncy ior rh. prlommce olrh€ work aor Nhich this p6!nn is <br />AITICANLDECI.ASAI&! <br />I hdlby afrm uidd p.mhy of psjury on€ of lhc follo$i.8 d(le.rions <br />I)o.olirion Pdoirs Asbcros Notificat ion F.d6!lR.SublioN (Titlc 40. PM6) <br />-Rcqutcd <br />kila oaNorifi carion <br />iom Elddin8 sbGlos r.moyal c .or .pplicable to lhis proj$l <br />stal.lhal lh. ahrlc infonnation is cord.I asre lo conply <br />a4 <br />Tilru),, <br />Pool Fence <br />Flood Zone Certif. <br />Lrn,l.' ! Addts <br />- <br />I