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BUILDING- INSPECTOR RECORD <br />SITE.WORK DATE ID/SIG.COMMENTS OIINIiR BUILDDR DEL(]ARATION <br />I heeby amnn under pcnally of perjury Oat I d erenpt Fom rh. (onlraclo* l-i.erse t-aw foi rfu aollowinS reMn (S€c.7011.5 <br />B6in6s and PloGssion Code): Any Cny or County \rhich rcqut6 a p'nir ro consrucr. alid, irnprov€. dmolish or r{rt any <br />srrucrut, r"1orb its tsumce, als r equirs the applicMt lorsuchp€nnilto file a sign€d ealendl thal hcor stu is licdEd pusuani <br />lo rh€ ltrovisions ofrhe Contractois Lic.nsd Law (Chaplcr 9. Commencins *ilh s.ction ?000 ol Llivision I of0. Butin.s ed <br />P'lf6siois Codc) or llt.r nc o! she is exempl lhEelion od the bais lor rh. allcgcd exdnption. Any violalion olsdion 7011.5 by any <br />.pplicaN for a pflnit subjecls lhc applica $acivilp..alryolnornoreih five hundrcd doll-s ($500). <br />-1, <br />ar oM.r oarhc prop.dy. o ny employG wilh \as6 6 thetr $le co,npdtsation. silldr lh€ \o* rd rhe srtudue is .ot <br />Ltrmded oroilcred lor sale(5(.?044, ausi.s dd Proassio.s Cod€ Ile ( ontacrof s l-ic6$ Ijw doe nol apply !o an owns oa <br />rh. psl).iy $,ho b{ilds or imprcue tnqon. and vho do6 such *ork hituell or hmlf or lhrough his or her own cnrploye6. <br />pror ided that suc h ibprovnenrs m .ot i.letcd or oitq.d ro. elc. lr. hov6 d. the b0ildins o! imptor€m€.n i5 eld vhhin on€ ,m <br />of conpleriotr thc Ot!rcr tslildE vill nat lhe hrdor olroling rhrd ne or she did nol build or inProv. d. lmpdly tor lh€ purlt* ol <br />-1. <br />downdoarh.rnolsry. a. exclusivel, connad'!s *(h liccnsdl .ontacro6 ro connnd Ihc [r)jcd (se 7041. abins <br />d Ptolsion Code: lhcConta.tor'sl-i.ens.Lawdocsnorrypl,1oanoNn€roaproptdyvhobdildsotimprcvesthqeon. <br />and sh..onlnclslorsu.hprejedswilhaConlEcto(rlreB.dpuuu.dronE(ontador'sl-icos.La\Y) <br />I s ex.mDr unde S(non , B & P (' lor,his reen <br />rvots[E8ll:aufEtt4l&Ntr[clr&lrlgr <br />I hscb, allinn undd penallyof pqjryon€ orlh€ roll$vins deld,rions <br />-l <br />hrlc dd willmainlair a Cenificaleofconsdt lo S.lflosuc aor Mrkem conrp.ns.rion.6 psvidcdlorbySelion1700oflhe <br />Llbor Code, for rhe pdfonnec. oflne wort for which lhc p.mit is isued <br />A h.ve and wiu mainrain workes' conpeBario. isoec.. s rcquted by Seclion lToO o I Ihe LaMr Cod.. for lh€ pafomd.e ol <br />lhe trork lor*hEh thispdn 6 issd.d M, wotkgt comptralion coier dd Nlicr nunrbd a€ <br />.rV\i c &^.l.{- <br />**.A\Cw \l)*\c\lLl <br />-l <br />cenifyrhar in lhc ll<form,nce olrhe Nork lo. \'hich this psnil is issucd. I sh.ll nol employ ary p€6on in ant manda <br />$ stotE(onE bjsl lolhe \ork6' clmpdsd io. I.ws oacalilornia, aDd alreclhal ir! should bdo'n.subj{l lo the <br />workdJ comp€nsalion prolisFns oiSeclion 1700 ollhc ljbor Conc t shall. fonhwnh.onplr wirh tlrsprcvisions. <br />WARNING: FailuE lo sddc \vorls' com!ftsation co!€rase is unlawrul. and strnl subjecr snploler lo mfrintl psatis and <br />ciril fines trp to onc hundred rno6a <br />L<; <br />DECI,ABAII)N <br />I heeby anim unds pmalt, olpajury lh,r I u lic.ns.d undd p.oyision .f ChtFd 9 lonDd.ins vith Sdion 7000) oa Division 3 <br />of lh. Bsi!6 dd P6l6ioB Code. md ny lic.N ii itr aull lor.e dd cltet <br />Oto -gru %2\ s38 <br />,rt", \I rt \LA ".oVrOr"! D"l Co" ^^u,..- {" : <br />COIflAUqIIoNIENDINC.AGENI:I <br />I hc[by afir,n undd p6ahy of p€rjury rh6r th6e G n <on$tucrnrn hdin8 08€ncy for lhe pErofrecc ol dE work io. which lhis p6nit s <br />issued(scc 1097, Civ C) <br />AIIIIIAII.IIDCIdEAIII)N <br />I lE try alrdn und.r p.nalry oap€rjury on€ of lh€ follo$in8 decl-at io.s <br />Demohtun Ptrits-Asb.$os Notificd ion F.ddal Rqulations (Tnb 40- Pan6) <br />-Requrcd <br />k(d oaNolifi .atio6 <br />I ce.riiy thar rhe r.rlsal r+uldions rc8adinA 6Lrslos renrovalare nol apph.ablc ro rhis pmjsi <br />IcdiilvlhitIhavereadlhisapplicalionddslar.lhdlhcah.!.inlonnalioniscoFeclIasr*to.olllrwnhallCil]a.dCoumy <br />odinancB ed sl.le kqs !€lnlins ldin! consrndion. ard hdeb, authorizc repr*enrariv6 o a lhis Cily tud County to 6ld ulon th. <br />ADpli$nt or Agol SiS .lurc <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />Subf loor/VenVlnsulation <br />Roof Sheathing <br />Shear Wall <br />Framing <br />ln s u lation/Energ y <br />Drywall <br />Ext./lnt. Lath <br />Brown Coat <br />ltrlasonry <br />T-Bar <br />Handicap Req <br />Deputy Final Report <br />Engineer Final Report <br />Flood Zone Certif <br />FINAL Z/t q/zO -t^&--r, I <br />Certificate of Occupancy/ <br />Notes, Remarks, Etc <br />Le er r ad&6s <br />- <br />.b.ve renrion.d J)iopdy for <br />-,* trl"ro[r s _ <br />=aN -TgAt{ <br />Pool Fence