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BUILDING- INSPECTOR RECORD <br />SITE.WORK DATE rD/srG.COMMENTS O\!NER BUILDEN DILCARAAION <br />i hdcby ailm u.d€r p.nally of p.dury lh, I m .xmfl ton th. ContrdloR LiccM Lnw ior lhc folbqog ..&n (S( 703 L5 <br />Busin6s &d Prof*ioi codc): Any ciry o, coudy which r.qu6 a pqfti lo codtud, alr6. ihprovc deso,ish or qEn D) <br />srrcruc. prior to irs isumc.. also ..quir6 th. applicMr ao. such p.flnit b filc , siSn€d strt.mdl that h. or she is lic.ns.d prsel <br />lo rhc lovilioB ol $c Co.racror'! Lic6s.d rrw (Chapo 9, Comn..ci.U wirh Sctio. 7000 of Division oarh. BEine Md <br />Poi€sions Co3., o. thd h. or shc is .rcmpl lhqclrom md th. bdis lor Ihc alltscd ddplio( A.y viobrion oascclion 703 1.5 by o,' <br />appliceraorapdnit3ubldbth.rppli.anrroacililpcnalrrol.orinorcrhMnv.hundr€ddoll&s($500). <br />L s ow.d oath. prop.ny. or m, cmdor€ wnh waB6 6 rh€n sE .omp6Mrion. wil do th. wo* ed lhc s1ru.1u. is ml <br />i 6dcd or ofiicd aor elc {Se ?044, acihe 6d Proi*ioa code Tic contdor's Lic@ tn* do6 not apply lo M oMd oa <br />rh. propdty $hD hrild. or inpmc rh@i, dd who <t 6 such mrk hin$lf or hds.lf or thmu8h his or hs oM mplo)€6. <br />provd.d that such inFovodlsE mli od.dorofiqEd for$le l[ howlE.lh. buildiry or iDptovdcnl is$Uwnhinonct6 <br />ofonpldion. rh. Ound Buildr will havc thE hldsr olpiovins rha h. or shc dt ml buiu or oq,ovc lhc FlFry aor rlE ,urpo$ of <br />l. s ovnd ofrh€ pop6ly. m cxclusiv.ly conlraclinS with licss.d conlraclou to cotr*Ncl lh. roj..t (56. 7044, Bums <br />a.d hlisn.Cod.: Th.Confelo.s l.icdsc l-au do6 nol applyro &osd ofrroFlywho buildsor i6prov6lhn6.. <br />od *ho co.r6cts for iuch ,roj.ds enh , co,trturo,{, licds.d pu6udt to rh. Cont dors Lkm tiw) <br />I m€r.mp( undd Scoo B &PC for rhis rc&rn <br />Y!BIU&::!a!'EENSAIq! <br />DECIABAIO! <br />I n .eby oaftrm undd p.Mhv ol pcjury on. ofin followin3 dabalioN: <br />I haw ud will maintah a C€nificalc of CoMr 10 S€lil$lrc fo, wo.k6 .onpo$arion, a povided aor by S4lion 1700 of rhc <br />tjtry Code lor rh. pdfommce oalh. "!A for whicb Ihc pmrn is issu.d <br />and.wiil Ba,n|am wort€6 co,npcNxon iNuBncc. N r€qunc{ by S*tion 1700 ofrhc t2bor Cod.,lor rhc Ffomece of <br />Nhich lhis !em,r t issu.{ My sorkgi co <br />ty'c u 065B1e o /-^(1 <br />I c.niayrhar in rh. pdfomn.. o f th. $orl fu whi.h rhis rmnn is isso.d. I snrll nor mploy any p6on in any menr <br />e 6 <br />'o <br />beom. sbj4l ro rl'c sort6' comFnslion laws oacalifomia. d asr lhar il I should b€con€ subjdr to lhc <br />\eorkss..'trFnsrlionp'ovkionsolSccriotrST00ofrhelrlua.de.lshnll.fonl,sirhcomFly <br />ys lo siminal p6ahi6 md\TARNINC FailuE to sur. worl6 compe.sarion svda8. is unlawtul. ed sh,ll <br />civil nn6 up to on. hundr.d rhorsd dollm ($100,000 <br />Cod.. intssl ed ariorrey s <br />pcnahv ol psj'ry lld I a liccns.rl undcr Fovision . f Chaprr 9 (connRncr3 wirh Scrioi 7000) oaDivisi{,n l <br />oa the ts6in6ed PolsioNCod., d my licre is in full lorc€ 6rd efa6t <br />'1- <br />CArII-rBU(-llAlLLtllIt1!-ACU(I <br />Fi.ltyoaperlury'hat rhm is a coNrrudio.lading aSocr, a(lhe <br />isucd (Se 1097.Civ. C ).lads\ Nam.: <br />AIIIEANI.DICIASAIIA! <br />I hr6la afm undB p€nalry of pdjury on. of $. iollowinS deleations: <br />D€moliion PgmitvAsb€slos Norificrtioo red€ra! Rcsulations (Till. 40. Paa6) <br />R€qut d l.ll(oaNorificalion <br />I1dft rh ,h. r.dfartur'!r,i( <br />ffi*x*''r*,,"r*,*', <br />reedins :slxsros i.,n 1al are ml opplic.ble lo lhis prur..1 <br />n ad narctlut thc aborr in l_v\irh all CiryandC.unry('r) tud(ilnntk,. dulxrrh. <br />l'd rit( n m. (tritrt): <br />ins coNnulion. ard hscby <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />Subf loor/Vent/lnsulation <br />Roof Sheathinq <br />Shear Wall <br />Framing <br />lnsulation/Energy <br />Drywall <br />Ext./lnt. Lath <br />Brown Coat <br />Masonry <br />Pool Fence <br />T-Bar <br />Handicap Req <br />Deputy Final Report J <br />Engineer Final Report <br />Flood Zone Certif <br />IL <br />FINAL <br />Certificate of Occu a <br />Notes, Remarks, Etc <br />Y//f/r'z 7 zr%:t4/ J <br />I