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BUILDING- INSPECTOR RECORD <br />DATE ID/SIG.COMMENTS O$NI'R BUIT,DI'R DET,('ARA NON <br />I hcr.lry aflirh unds pEairy orrerjun rhar I m crcnrpr lmm !t. ConradoE Licd* lar a.r rh. folld\in8 reie. (Se 70115 <br />LhsirLss and Proa6bn (ode): Anr- (nt or (ounr! rvnich rrlunB. Fnnil ro.onsirucr. alle. inrprcve denolish or rqtir nily <br />{o(xtrc. pdortu ns issu. ce. fto rcqtrirs rlE.pplic.nr lor srh pmn to lilc a sisned slalon{l rhal heorsh. is li..nscd l,un anr <br />ro ihc Fo\isio$ oarlE conrri.rois Li.cn*d I-a\'(( h.prd r). ( (nnnrri.in* \dh Sdion 7000 olDnisioo ! ofrhe Bunnsi and <br />ProrcssionsCodc)orihalheorshcisc\enrplrhs.aronrnndrlEtashaorlhcnllqedclmrxion.AnyviolalionorSdmnT0rl5hlan! <br />amlicanr ror a !.flni suhj(arh. aptlicanr ro aciulpcnalryofnor moErn,' fiy.hrnrti.ddollds($500) <br />Lsownrolrh€lrope1l.orfly€nrployGsilhs.Bssrhenskcomrensalon.silldolh€so*adlhesro.lu.i!.ot <br />rnrsdcd or orlecd lor sle (56 70J4. Businss dd Pm[sn]ns Cods'lhc Q)naact*i l-i.ds.lrlv do6nor.p!lylo nn o\rnd of <br />rhe l,spdy \ ho boil& o. i'npre\ 6 ihson. 0.d who &6 str h s od nnnsclf or nds€ll or lhrourt his or hs o\T cmplo)e6. <br />pturid.d rh.t such inlrovmnB e nor inrmd.d or olld€<l lor eL ll hos ( a, th. hnildin! or iryrcy.m.m is eld Nirhin on. ,ar <br />oaco'nplclion. rhe (\\ ncr Buiktd \yill Mrr rhc hldo of prorin! rhar h. or sh€ did nor huild or imrm\ c rh. FoFn! for Ih. pr[Jss oa <br />elel <br />l. as.\rnd.arhe Eordt, an.i.luiv.lyconra.'in! \ln[ li.ei..d..nha.hsro.otrsttr.t nr projrt (Sa. 7041. Rs'n$ <br />and ltof66iI ('ode: l hc Co ractois l,iccnsc hr doe nol applr- io an o\ n6 o l proErl y Nho blilds or ihpo.s rh6$n. <br />,trd $ho contacri lor su.h pi.jeck \irh a contr&k(t hre6.d trBtram ki rh( (bntra.br-s Li.emc La$) <br />l.h.\r 1 trid$ Se.(i(rr <br />Dslc osrer: <br />$oxK0Rs' coNPtm,saiI(,ri <br />DECTAAAUOI <br />I htrcbt afinn lodd Fnahtofpdjury otr. oarh. follo\i.g detmrions: <br />I harc d sill nuintai! a Ccn ificar. ol Co6dr ro Srlllnsurc fttr \ ork6 .onposrnJn, a l'or id.d nr b! Sdion I Tctr of rh. <br />l-obor Codc forthepdlonnonccoflhc\o fo! \vhich lhc p6mn n isucd <br />Iha!.andsillnai.rain\r.rk.u .onF.ma'ion incur.n...4 r.qrnedb!s&lionlT00oalhct lFr (tdc.lo! tte psfonnaice ol <br />rh. sort fo.whichlhis p.mn is is ed My\ork6s compdsrion insur..c. ctrd6 and policy numh.r ec <br />l.enifyrhar in rh. Frform.nc. ofrfu *orl ld shich rhis tdmn is issu.d, I sh.ll nor dnploy ony !.rcon in 0nymanner <br />s 6lob..omc hjd lo I h. $orlGl olnpasl ion la$ s of( rlifo,nia. md asre lh ir| sh.uld b.conc subj(r ioth. <br />\od(6J compdsalio. prornions oiSdion:r700 ollhe l-.bo. Code I sh.ll. fonh(ilh comply Nilh rhosepmviri.is <br />wARNIN(;: F.ilu( tu ruft \vorkas' comr.netnrn Lo\sa8. is unla\ iul. and sh0ll sut d a. dnploi"o Io aininal FEki6 !.d _ <br />cilil nn.s trp b on. hundEd rnnN.nd doll0N ($100.000). in 0ddirion lo rlrc con o f co'nlEnsar ion. darares ar prt\'idud aor lhe <br />Sdiion 1076 of rh. ktior Ode imtr6' md 0tromc, s ac <br />_ Applidnl:_ <br />llc!!ffDtoxlnac]lla <br />DE('IARATllTN <br />I herlhy amrm unds Doalry ofrcrjuy that I anr liceis€d und.r [ro\ision orchdflc 9 (.ohnmcin! sirh se.lion 7000) olDn isi.n l <br />of rhe Itusin6s Md Pma6sions(ode. md vliccBc is in lull torccandefi(r <br />ffi*.-' <br />r!-t8t!l: rlD!(!aair!a! <br />I h6drl.lllm tr.d€r pcn.lry olpcrjury one ollhe roll$\iu dalnrslbns: <br />DcnFlirion Pennns-AsbarosNotincdtun l,edsal Rcruldions(lirlel0. I'an6) <br />R.q0n.d L.trs of Nolif€tion <br />I corify thar rhe tudal r€xuldioB rcgedins 6b6ros rmoral ae .or appli.abl. ro lhls p6jd <br />lc.niaynhlls\cr€ad'iisappli.ationmdslatelhdtheabo\€iniornalloniscorella[rEki.onrply*ilhallCiiyind(,runry <br />onlinancB and Slare t,rs Elatins r. buildins consrrucrion. d hcrchy aulhorizc rqre5rdild of tlG cn, dd counr-! ro mr6 uFn rhe <br />abole nmrioncd prcpeny lor insp.dion !urp.sB. <br />\l,plicrnt o, Ap.trt Sis altrrr <br />Set Backs <br />Forms/Steel/Holdowns I <br />I ll t2. <br />Erection Pads I t1 /v4!.1 <br />UFER Ground 10 (ty <br />SLAB Floor 7 <br />Subf loor/VenVlnsu lation <br />Roof Sheathing ll <br />Shear Wall ll ',I%tuott <br />Framing /J1 o4/1t/o z{,"'.? <br />ln s u lation/Energy 7/4 Miltt&YAY-P- <br />Drywall Elt AUor,luJ (avt <br />Ext./lpt. Lath <br />Bro Coat <br />Ivla n <br />Pool Fence <br />T-Bar <br />Handicap Req <br />Deputy Final Re port <br />Engineer Final Report <br />/),floo( Jone Cprtif I <br />i (,'40ic g,&1['w" <br />tl <br />FINAL 2-te-?) <br />Certificate of Occupancy <br />Notes , Remarks, Etc <br />t.hrts <br />^. Wtltt<tfrYt frx Vll^ <br />i ll n s0 I 11,4 <br />SITE-WORK <br />CQIiIaUqIIOIiIIIDIIG ElcI <br />I h€rlby aflinr trnds pgalry of!.rjury rhar rh6c is a consrrucrnrn hdins asdcy for rhc p6fomrnnc. ofrh. work aor vhichlhis p6mn t <br />ksu.d(Se 1097, Civ C) <br />I crdc' \ \d1c <br />l1 <br />l: <br />'t/, <br />',1|tfi)tAb