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Address UniUSuite <br />Sate Work Remarks Date Signature t.D. <br />Selbacks <br />Fom6/Stell/Holdowns <br />UFER Ground <br />Slab Flool <br />Steel <br />Pool Fence <br />Masonry <br />Notes, Remarks, etc.: <br />OTVNER€UILDER DECLARATION <br />I hsreby afiinn und6r p€nafty ot psriury that I am €rorhpt lrom th! Conlraclors' Liconac Lrrv tor lho foltou/ing raason <br />(Ssc. 7031.5 Business and Profsssions Cod€): Any Cily or Counly which requir6a a pormil lo conslruct, allor, <br />improve, dcmolish, or repair any slructuro, pd,or lo il6 issuanco, el6o r€quirss th3 epplicanl for such pormil lo lilo a <br />sign€d stal€mgnt lhat hs or shs is licans€d pursuanl lo lh€ provisions of lh6 ConlracloE Licgnso Law (Cheplor 9, <br />commoncing wilh Ssction 70m ol Oivisioh 3 of lhs Busin€Bs and Pror6sioB fue) o. lhat h. or shs is 6x€mpl <br />lhergfrom and lho basis for th6 alleged oxomplion. Any vlolalion of Soclion ?031.5 by eny applicant for e pomil <br />subjoclc lhe applicant to a civil pdnelt of nol mo.6lhan ovo hundiod dollers (35fl)). <br />-1, <br />as oivnor ol lh6 propoo. or my cmployoos wilh $agos es lhsir sols componsalion, will do tho u/o*, end iho <br />slruclur6 is nol inlcndsd or of,ercd tor sab (S6c. 7044, Bu6in6s and Prof6sions Cod6: Th€ Cofll.aclora Lic6ns6 <br />Lary do€s not apply lo an own6r of ths propcrty who builds or imp.ovo€ ther6oh. end wllo dooa Buch vvo* hims€lf or <br />helsalf or through his or hsr offi employ663, provid€d lhat such improlemonls ar3 nol lnlond€d or ofor6d for 8alo. lf, <br />hovt/€vsr, th. building or improvomsnl i6 soU wnhln on6 y6ar o, complotion, lho O,vner-Buildor will have lhc burdon <br />of pro ng lhat ho or Bho did not build or improvo for the purpos€ of selo), <br />_1, as ovrnar of tho proporty. am oxclusiv€ly conlracling wilh licons€d conlraclols to conslnrct lho plojocl (S€c. <br />70114, Businocs end Proroasiona Cod6: Th6 ConlracloB' Lic€nio Lrw do€s nol spply lo an own6r of proporly $/ho <br />builds or improy€6 th.r€on. .nd who contEcls lor such proj€cls with e Contraclor(s) licanE€d puEuanl lo lh€ <br />Conlraclors' Lic€mo 1et .). <br />_l am d.mpl und.. S6cllon:_, E. A P.C. tor lhb r.60.l <br />Building Remarks Date Signature <br />Under Pinninq (floor ioisll <br />Foundation Venlilation <br />Roo, Sheath t(4b-?,7 I)2,-4,.---t? <br />lnsulalion / Energy <br />Dry Wall <br />Exterior Lath <br />Brown Coat <br />TSar <br />Handicap Requircm€nts <br />FRAMING <br />FINAL (Shellonly),o,,1,: <br />FINAL lTenant lmprovem€ntl l,L,rl Z 7 <br />BUILDING -.- INSPECTION RECORD <br />t.D.