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BUILDING- INSPECTOR RECORD <br />SITE.WORK DATE tD/stG.COMMENTS O\INI'R BTIILD€R DIit,('ARATION <br />I hscby arm undd pcnally of psjury lhat I ex€nrpl lrom lhc ( onlmcloc l.iccnse Lw lor th. aollowing r@tr (Sec.7ol l.5 <br />B6in6s d P.ofsion Code): Any Cny or Counly shich rcqun6 a pmnil to construd. al!6, inptove, dmolish o! rcpnr ey <br />srtucr@. piior ro its isuuc€. also rcqun6 lhe appli.el for such Fnit lo file 5 sisn€d al@or thd h. or shc it li.osd pusudl <br />lo lh€ Fovisions of $. conlraclois t,ic.ns€d kw (Chapl6 9. CoMc.ci.s *irh Sation 7000 of Division I ofln. Busin6 sd <br />Prof6ions Cod.) or thd hcorshc B qcdpr tha.6on Md rh. bsis for rhc all€s.d cxoBtn l\.,viol.lionolsclion70115by y <br />,fi,li.anrtordp6mn3ubtcrsthc.pplicelloacivilpdallyofnotmor.rhanlir.hundr.ddollds($500) <br />l. 6 osn6 ollhc lroFly, omry emPlo)€s with s a-!6 6 th.ir $lc codptuarion. $ill do th€ \ o* ad th. slru.lm G nol <br />io(H or ofiEcn lor el. (Se 7044. Auins ed PDasiors Cod€ Thc Conr.ctoa s Licre Law do* nor tpply ro an oNnr of <br />rherrnpdr (no b{ilds or nnpovG th6sq ad who doB such *.d. hnnsclf o! h.rlr or lfitungh his or hd ovn cmPloy.6. <br />providcd rhar surh mproBmrs @ nol htflded or o,fald fitr slc Ir, ho(46. rlE hlildios o, inPIo\ ddr is $kt \ei'hin on{ yEr <br />oacomphbn. lhs O$nr Buildo Gll h,rc lh. htrdd ol provins Ihn nc or Ct di.l nor b{ild or inPto\! d€ lropoly fot $c p'trpos of <br />-1, <br />as.Nnd olrlr popdly. dn erclusivelyconlraclins *,(h li.cds.J . onn a.ds b consrrucl lhc projRt lse. 7044, Bu$nB\ <br />d Pol6sion Cod€: l hc cdntacrofs Li.ense Law doB.ol apply lo sno\snd olproPeny who buil(ls o' idProvB rhaeotr. <br />and *ho.onta.lslorstr.hprcj€cls{ilhaConlBdo(rlrcc.scdpusmntloth€cont.clofsLicm.La\r) <br />I m.r.mbt und.r S6ton ,B & PC for'hisrGon <br />D.r.: oind: <br />UORXERS' COI\IPENSATIONpEc!48{t!o! <br />I hdel,, ailnn ondd p6ohy of lEjury oo. of rhe follorsina drle.rioB <br />I hav€ dd vill Minran . cBlificar€ of Co,Ml to Sclf- lreure for wo.k6 co.'P.n!arion, 6 Folid.d for bv S(rion 1700 ollhc <br />t bor Cod.. lor thc rrloddce oflhe vork ior wticn the Fmil is isu.d. <br />I hav€and *illiaintain work.rr co,npeGarion insu.anc.. ar rcqdncd by S(tion 1700 oflh. L2b.t code. for lh. pqlonnocc of <br />rhe Nork (tr r hich this pdnrit is i$uen. My worreu comp.@rion iNurmcc csi6 and polic) nurb.r dc: <br />Policy Nunb€. <br />-Expircs: <br />I cdlily rhar in rhc pqaoflnaiccoanE wort for $hich rhis pcrmil is ilsudd.I dDllnoi dnployry pden in a.v m ncr <br />s {s ro bc.om. subiet to lhc vo 6 .oiptualion laws o I califomia. Nd 5sc Ihal ifl shoold b€comc subjd ro lhe <br />r0lt6 convdMtion povisioN orScrion 1700olrht tlbor Cod€. I shlll. lonhwi$ comPly wilhltosprcvisioN <br />WAiN,NO: F6ilur. ro *u. sorlss corp.Nrio. sv@r. i5 u.hwtul. and 3tallsubjal & dplovd to on ral Falti6 Md <br />civil fin.s up lo one huhdr.d ihoused <br />Sctiotr 1076 orlhc ttrbor Codc, ime6t <br />addnion to rhc cosl oi conp.@lio.. dmas6 6 provdeJ ao. rhc <br />l2ir(raafra) <br />I h.Eby amm uod6 FDlrt of pdjury tbal I m lic..scd unds pmvtion ofchaPl6 9 (commmins *irh s.dion 7000) of Dirision I <br />ol rh. BsinB md PmfBioN Code. and nr licm. is in full fora dd cfi<r. <br />q5 EL{ <br />tr I r?G' <br />I hGby nflim und.a pdnhy o I per.,ury thal I <br />issued (56.' :1097, Civ (.) <br />on lcndiuasency rorlhcp{fommceollhe\co!k ror \rhich rhis p.mril G <br />AIII,rcAULIIECIAAAIIOX <br />I ho$, dtfm undd F.alty of pcjur,v ore ollh€ follo*ins ddle.lioal <br />D.molirioo Pd'ts-Asb6tos Nolificatio. F.dsal Resllalions ('1 Ic,10, Pan6) <br />-R€qun.d <br />Lcllr ol Notifidion <br />Set Backs <br />Erection Pads <br />SLAB Floor <br />Subf loor/VenUl nsulation <br />Roof Sheathing (t L\'ti '--2..,+-U) <br />Shear Wall <br />Framing <br />lnsulation/Energy <br />Dryvva ll <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 />FINAL /2.1-/5.[,/,(rh r vd <br />Certificate of Occupancy <br />Notes, Remarks, Etc. <br />Forms/Steel/Holdowns <br />UFER Ground <br />Flood Zone Certif. <br />,",", t) 1rr lrg' <br />thc leddal leau lal ions rexddins 6b.slos rsnoraldc nol @plicablc lo lhn nnrje.r <br />I hr\. i.rirhn r|rd(xto <br />dd Co mt ro ole trponlhe <br />S <br />- '7-' <br />Vuzatut? <br />tI/rE/tfr <br />tt <br />tt <br />t-