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BUILDING- INSPECTOR RECORD <br />()NNER Bt Il,DtiR l)t:t.(',Ali,\t t()\ <br />I hcrcby ofi,,n u.dd p.nally of psjury lh.l I dn .x.,nB 6orn rhc ConradoE Licffi t w for tlrc followins rc&e. <br />ausin6s d Prol€ssion Cod.) Ary Cny or Counly rvhich requirs a Fnir lo coosrrucr. all6. nnfuove. demolish ot <br />shctR, prior ro irs nsud... also lequt6 thc alpli.sr aor such p.mir ro 6le r signed $ddd rh.l h. or sh. is ltGcd pru!- <br />to lhc p.ovnr6 or thc Contracroar Licds.d lis (Chaprs 9. Conmdcma *irh Serio. 7000 of Diviriod I ofrh. Busin*s aod <br />Pmf€sionsCod.)orrhalh.msncis.xdnOrhdefrooadrh€bsisforlh.allcscdcrunplion.AtryviolalionofsElionTorl5tyany <br />applicdl aor . p.mn subjels rh. applicad lo a civil pcoalry of not morc ll& liv. hundr.d doll6 (S500). <br />l. s ownd ol th€ proFny. or my cmplor€ with rva86 a lhcir ele compcMtion. *ill do thc worl dd lhe $ruclw is no' <br />inrdd.d or o rTrcd lnr slr (Sd 704,r, ausins ed Ptuf*ioN Code 'the Conkadors Li.@ La* do6 .oi atpl, to an owns oa <br />Ihc popdy wno bik6 or i,Iprov6 tlEon. ed wh. do€ such ".lt himsclfo. hcclf or throush his o, hs o*r cmplo)t6. <br />prcvid€d rhar slch inlrowE$ e nor n od.d or onE.d ror Flc lr. ho*ds. rh. h{ilding or ihrmv.]mr i! $ld eithin onc )@ <br />of.ompl.1tun. ihc oRnd Bnild- will ha\€ th. htrdo ofprovinS rhd h. o. sne did nol l ld or inpro\r lh. plpqly for lhe pu,pos ol <br />l.6oq6olrhc prepsly. d.rclurivelv co rad i,,g Nirt licnrd conlraclo6 b .o.srud rh. lftld (sd 70.14, RBfN <br />Md P:if6ion Cod.: Thc ( o.raciors Lic.nsc L.w do6.ot applyro M owns ofplop€nywho builds or inprolcs rh(on. <br />dd who conrBcls ror such Fojds Nirh. CodEclo(r licccd puE@r b rh.contdo.s Li.mc bw). <br />I @.r.npl uod6 S*rion ,B.&PC tulhir i.aon <br />}oaEESS:.(ON!ENS !!O! <br />DECI AAIA! <br />I hseby nninn lndn pdralry of psjur_v on. ofrh.lollosing dcldari.fls <br />I havc &d sill main'ain a c.dificar. olcoramt ro s.ll-ltuur. ior Nod\m .oDpmalion. 6 |rovidql lor by S(l rcn I700 or lhe <br />Labor Cod., lff lhc p6fomdc. ol rhe *or* for shi.h rhc ptuir is sucJ. <br />I I hav€ ed will mairlaii wod(6 comp.malion ireurmc.. s r.quftd by Sdlion 1700 ofth. kbor Code, forrnc tEfomdc..l <br />lhc *orl for which rhis peflnil is istrsi. My <br />tf <br />=Io- /- /B <br />I ceniryrlFr in lh€ pgfuda.cc olrhe $orl lor Nhichrhispdn is 6su.d.lshallnot mploya6ypn$n in any,nann€r <br />$ a to b.corn. subjel lo th. work6' conpcB.lion laqs ol Califonria, md +rcc thd if I should b.come ubjtrl to lh. <br />workds.ompmarionpmvisioNolSdionlT00ofthcLab.rCodc.lslull,lonhsithcomplys'ilhthospro sio6 <br />WARNINC: Failure lo suc *ork6 NmplNrion .orcrasc ir unlartul, md shall subjd d dplo)tr to rinnnil p€mlti6 and <br />.iril n.e up to o.e hufllr.d rhousud dollrs ($100.000). i. addnion ro the cos of danrags as pro\id€d for lh. <br />ssrio.1076 olrhe Lab.i codq imq6r md artomr- s a6 <br />lrll( l.\R \ ll()\ <br />I h@by amm undr p@lty ol pdjury $d I d lic.{.cd und€r p.ovision oachaprd 9 (.o,tunfting *nh S..tion 7000) of Dn ision I <br />of lh€ ltusin6s ud ProisioN Cod.. d my lictrc is in tull io.c. dd €ff61 <br />q 3 <br />,.,"1a:&9- 18 c-r.o-,{ <br />( ()NSI RU(1 IO\ l.ta\DtN(; ,\(;IiN(',Y <br />I h.rcby aitum lndd p.trslty olpsjury tha th@ b d onnrudion lcndins asdcy for rhc poaofj@c. oarh. mrt aor which this Fmil is <br />issu.d (Sc. 109?, Civ. C.). <br />A.8E!,ICA.NLDECIA8AIIIIX <br />I h.dy amm lndn pcnalty of F.jury on. or rh€ rolbvins d6l{al ions: <br />Dcnrlilion PmrnlAsbelos Nolificalion fcdLyal Rqulations ll nt 40, Pd6) <br />Rc!uncd Lelld orNolificalion <br />I cslilyltut rhe fedtral rcsulario6 dsrdins dbstosrmoval.rs nor applrcablc to rhis pnjsr <br />I cdiay thar I havc r6d rh$ 6rpl,.axon ed slri.rhar lh. ahvc,nfonnBlion is.odL{r I rgreo.omplyNnhall(-iiyand Counly <br />ordinancs dd Sral. t-a{s ehins ro buildinS consttucrion, and hs.by aurhori rcprsd ariv6oll,isanymdCotrntyiocnlsulFnlhc <br />rla\c Drcnlioaelp'oFny fu insEcrn)n pu'Txxs <br />,\Ilplicrnl o.Ascnl Sknatu.c <br />Permire nrne tprinO;{ <br />SITE-WORK DATE ID/SIG.COMMENTS <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />Subf loor/VenUl nsulation A <br />Roof Sheathing 5"k1-ty I rwill 0LL l'wAxltr'/(2 i d\14 t E, <br />Framing <br />lnsulation/Energy <br />Drywall <br />Ext./lnt. Lath <br />Brown Coat <br />Ir/a sonry <br />T-Bar <br />Handicap Req <br />Deputy Final Report <br />Engineer Final Report <br />Flood Zone Certif <br />A <br />FINAL l0 -ll'lK I *.w101 <br />Certificate of Occu an <br />Notes, Remarks, Etc. <br />J t <br />-+ <br />^," -2-a9-/8 <br />Shear Wall <br />Pool Fence <br />I <br />.".*".**, o3q <br />)< <br />l-.tr-ba