101106193 - Permit - Laserfiche WebLink

Home Browse Search

BUILDING. INSPECTOR RECORD SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDEII DELCARATION I hdclry aiUm undo pqalry ot pdjury lhar I €rcmpr &oft lh€ ContEclots Li.cM llw ior lhc followi'rs rcen ise.iol I 5 Busins and Profsio. Cod.) ny Cny or Cody which ..quLG a pdni ro codtud, ah6, impBv., ddDli.h or r.par &y struclure pnor lo ils issu c€. also r.qun6lh. lpplicmt lor such prflnir to filc a si8ncd slat.m6t lhar hc or sh. is licdcd pNuml ro th. povisions ofrhe Coofac$is Lic€nscd kw (Chaflcr 9, ComFe.cins vith Serion 7000 olDilision I ofrh. Rusin.s Md Proacsions Cod.) o. lhar hc or she i! .xe6g figcEon dd (h. bai! lor lh. al.!€d .rmFion, Any violaliob ofsdion 703 I t by dy .pplicoilorapmnitsubjElsthcrppli.mtbocivilp.nallrofrol,norcthmt!.hundr.ddoll s($500). I. a oMd ot$c prcFny. or hy .hplorr6 unh uas6 d th.r $1. @mpcniaion. vill & $. ed( and th. slru.l@ ts rcl inrodal or off6.d for sle (Se.7(x4, Bai.6 Md ProfdioB Codcr fic C.nrradols Licm t w &6 nol apply to e oMd of ihcp'opdty wh. hil& o. iBFr!6 rlE6I! 6nd wbo do6 sch m& hic.laor h@lf or rheugh his or hd 6M .d'9loyc, providcd lfiat such inpowls e rcl inlad.d or oft€Gl for slc. lL hosdE thc buildins or inprovereln t Fld within on. r€t orcompldioh. thc 0,*16 Buildd will hav. I1E hldd of!rcvin* thd hc or sl'c drd not hild o. inpllw &c polqty for $. pu.!o* of -- l, 6 owd oflh. pop6ly, dn .rclusiv.ly co.traclin8 vnh Iic.nsol cont ctoa lo orelrud lh. Fojel (S( 7044, asmd &d Alisir. Cod.: Thc Conr&toas Licdk l$ do6 nor applyro M ow.6 ofprop.ny vho builds o. inprclcs rhdoi, ed wno co mds for such ptrjds wirh a Conrrado(s) lic6E d ,,o6uer ro thc C.nradols Lic.e tiw) I m .ropt u.d6 Sedon , a. & P,C. for $ir r@or Dalc: Orn.rl UOBKE&:1(OIIEEIIAIOB OE(:IABAIIO! I h6eb, afinn unds p.nalty of pslury ok ofrlt followin8 delrarioB I have Md will mairrai, r C.nir,.a& olcoBot 10 S.ll l6ur. for Mrk6 @6pm.0io.. 6 roud.d for by Sclioo 3700 ofthc Labor Codq lor rhc p6fomdc. ofrhc qo.t for vhich rhc ponir t issuql. I havc and sill mainrai, worts comp€Bario. imu c.. 6 r.quired by serion l7O0 oathc hbor Cod., for thc p€foflmc. oa rh€*orLf.'trhi-hrhi,mmtrisi\.,.rlM\r.'ltr.onm.n\r.nin!tr,n-e./ni.'mdmlLrnm .^. L t6a<T( Xu 7"ct.t 3 )-7< I c.niry rllll in th. pnfomarcc of thc wort aor which $is pmn is issucd. I shnll nor onploy my pq$n in any nmn6 e 6 ro bdonc subJd lo lhe worL6 .onpqtslliotr laus ofcalifonia. dd ssc rhar if I should b.ronc aubjcr lo rh. worl6 comFaation Folisio6 oascrio. 3700 of the Ithor Cod.. I shall. fonhwith comply wiln $oe prcvisioB WARNINC: l,ailor. ro sure No*cs' conrpdslion .overaac cilil fines up 10 one hundr.d rhousMd dollus ($100,000), ir addnion n s.xl di altomeyt le. I ndcb, ailm uhde p6arl, of p6ju., rhar I @ licd..d udd povilioo ofcha$q 9 (.o,nn6.ing wirh Selion 7000) ot Division 3 of Ih. Busins dd ProfdnN Codc. ud '!y lic6e is in full lorcc dd efist. c -'({t\ =/as /-zt7-1 caNrauquoLuilDlxclcElcY I hs€by aflim unds perally of p€rjury lhar th6c is a connruclion lodifls ag€ncy tor lhc Fforrocc of thc sork for wni€h this Fmn b issucd (s6 109?, civ c.). d.ttl.lc NLDfct Btrlo! I lErt'y allm und6 p.r.ny oi p6j!,y onc ol ln. aollowins d(lmrions: Denolnion Pcrink-As&stos Noriliorion F.ddal R.gtrlarioN (Til. 40, Pd6) Rm!'ncil 1. fl .f N.rifi.iri.n I cslily th.t rhc fedsal re3ulations rcBtrdin8 abdos rmDlald. not applicabl€ ro rhis p,q(l. I.d,4 rh,r Ihi\credrh6appn\duonexjial.lhdlh.is .otrel. I agr6 to co,bpl) rvilh all Cily &d Cou y ordinucB dd Srar. Liws cblins ro bui abo* 6mlion.d pdp.ny aor icpsrion ftFL--ori.\.: ol(lrs Ci)_ md \p0li(rnl o, ,\[cnl sipnittrrr Set Backs Erection Pads UFER Ground SLAB Floor Subf loor/VenVlnsulation Roof Sheathing Shear Wall Framing lnsulation/Energy Drywall Ext./lnt. Lath Brown Coat Masonry Pool Fence T-Bar Handicap Req Deputy Final Report Engineer Final Report Flood Zone Certif l-\ FINAL 4-n-2t Ytt[\()l Certificate of Occu pancy Notes, Remarks, Etc + Forms/Steel/Holdowns