|
BUILDING. INSPECTOR RECORD
<br />SITE.WORK ID/SIG.COMMENTS OWNER B!II,DER DET,('AR TION
<br />I hdcby ailirm undd p.nally or t6jur,v rhd I m n.n$r lron rhc (n! racloE llcdc I^v lor ih. aollosin8 rea$n (s< ?0ll t
<br />tllsin6s ud Pr.fsion Cod.) A.y ( il y or Counly $ hich rcquts . r6mn ro .onntud, .116. inprov., ddno lish .r larn tnl
<br />srruciu<. rior ro irs is(dc., ako r.qut6 thc applica ror such pcrnn ro nl. s sirned sr.lmol thal h.or slE is licdsed pu$u lv
<br />lo rhc Eo\isions ff rh. ( o.hacr.rs Li..nscd k$ ((-llaDtr r). ( onnn€nc'ns \irh sttio. 7000 of Division I of rh. Btrsin.s and
<br />Pmfsions ( od.) or lh.t h. or shc k c(cmpt lhg.fton ind rh. haris for rh. alle!.d.implion Any viohinrnofSErion ?011 5 hy any
<br />aptli.a lor 0 pffit subj(c lhc q,plica r lo a ciril penalit of nol morc rhan li\ c hundrcd doll6 ( $5001
<br />l. d o\.d oarh. tmFnt. or my enrplo)r6 Eilh \ s!6 as rh.i, qn. ..mpdMliotr. \ ill do thc \. dd rh. $ru.18 is not
<br />inhrH .r oittr.d aor sl.(S( 70'14. BBin6s Md &ofdsions (ide thcConlm.rois l-icds La* dos nol arply lo ln.wnd oa
<br />rh. troFry sho hilds.r inpro!6 rh6an, sd sho d.6 such tro& hins.lfor heclf or lhmugh hk or hd oNn anrloy6.
<br />p.ovidcd lnal such nn[ro$ffiB m nor inrdd.d u olloql ior elc. lf. ho\'--s, (h. h'iklins .r imposEnr is $H lvirhi. .n. tw
<br />of compld irn. lh. (\\ nd tluildq * ill havc rh. hd.n ofro\ i.r lll{ nc or shc dt nol hlild or impmr. rh. rmFry for lhc ,u{re.l
<br />I- asornr.arh.rop.n,. an.rchBirclyconlracxns sirh lrccNcd.ont.clo6lo conslrucr lh€ Iroiei (S( 7ota. D$indr
<br />..d P\lfdsinr(odc:lhcContraclff'sl-ic.ns.r-a$do.snolaptlyroano$nsolpr.Flr$hohrildsorimDrov6rh6.on.
<br />and *ho.oirr.drtu$.hprojcisqilh.('onlr.ctons)licmsdpuricnrturh.(ttua.toisl,icd*l-a()
<br />I rn, r\rtr,n( unll.' S..ri(!l
<br />D.r€ Otrner
<br />$orKt:i5'(ontPENsAT loN
<br />DT(I,AAAIIIJI
<br />I hrrcl,) .lIi'm undc' lEDalrtoftHjLq on..lrh. nn[N ing d..ltu.rions
<br />I har. Md vill mimain a Ceflificarc of Conscnl 6 sdr lmu'e lor {ork6t comlE.sari{,n.6 ptulid.d for br. Sdln n l70{ ofrh.
<br />lihtr Cod., nrrh.tEaomoccof th. lort lorshichthr rtui is isrNd
<br />\fA c and Nill nminrain s ork6 .onpccalion iNtrra.cc. as r.q!ir.d by s<r ion :l700 of rhe L.bor Codc. r.r rh. Fr.rinin.. . r
<br />tha worl lor which ttu tdnn i! is$rd My $ orkm comFnsl ion insutuc. .arier ad poli.y ntrmbs a.
<br />tc-,. oh;D Ufe<,e"\.-6
<br />1.1t,,N" h., *.\J--V5be 2h lo3 Erpl,s: 4-!' 29
<br />l.difyrh.r in lh. l]Efomancc of lhc * orl for *hich rhh pnnir i3 issu.n.l shall nor cmployan, pason ii anymtnnd
<br />s, 6ro bcco'n€ subr(r 16 rh. $ork6s compdsotion laws ofCaliromia, md.sE rhat iil should b.coG sobjat h lhc
<br />\yo*ss .onpcnerion fltrilioB o f S.clion lT00 o l lhe lrhn (hd., l shall. aonh$ilh conrply v h rho* povisioN
<br />wARNING. Failur.lo srrc rort6 e,npisdion .ovd.*. is unla$tu|. and shall suhl.d in dPloyd lo sdinal FEhi6 anrl
<br />.ivil lins trp lo onc hund!.d lhoMd dollm (1100.000), in addiiion to lhc cos or.omFNlion. ddascs 6 lmvid.d r.r rh.
<br />sdion 1076 ollhe ljlrtr (ndc, inr.' 6r and anome_ s le6 0L,",:eL.--b'B-lct
<br />Lrc[lsDpMtrsagoa
<br />DI(]JEAIIOI
<br />I hmb! alllnn unds r60hy orps'juD rh.r I an li.dGl und.r porision orchaprn I (com,no'.ins Nnh S.tlio.7000) olDnision l
<br />.l rh. Businds Md Pmf6sions Code. ud n) lic.nsc t in lull furc. md efld
<br />,,."".",,".. 4 -a{
<br />,h,r G^18 't1
<br />r,.e\.\mh., 31 bo2a
<br />l.!-,.'e>3,5',-
<br />CoNSTRUC]'ION LENDINC ACi:NCY
<br />I h*by arnn undtr Fnrxy . a p.9u.,v rhai lhsc is a co6tdcli'n Ltd'ns asm., aor lh. pqtolrM.c of rh. $ort for shich lhis Ii6en n
<br />i$u.d (Se 1097.Civ. C ).
<br />Irndn'r Nam.
<br />APPLI(AN'I' DF(:LAR,ITION
<br />I hy.hy.ttm uddd pm.hy oipsjury onc ofrh. n lo$ing d(ldarions:
<br />Dmolirnrn Pdftns-Ashdlos Notifical'on F.Jral Rcstrkrions (Iirl. iro. Pan6l
<br />R.qun.d ldld of Ndilicltion
<br />I cdrifyrnat rhe Ldoalrelularidns r.BedirS asbalosreno\alare n.r appli.abl. ro this pord
<br />!y' l cdiry rhar l h.v. rcid lhis .ppli.al ion and $ar. rhd rh. dh.\ . inlonnal ion is cor<r l agtt io shFly vilh all Ciry a.d ( oonrt
<br />ordin.n.d Md Srar€ l-ass rclarin-s ro buildinS .oGttucrion. .nd h6cbr aulkrriz. rqrdmtdiv6 oflhis Cnyed C6!mr lo 6tE upon lhc
<br />6-E'/"
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUlnsulation
<br />Roof Sheathing
<br />Framinq
<br />lnsulation/Energy
<br />Drywall
<br />Brown Coat
<br />Masonry
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />lt I r -l
<br />FINAL uTqwo .tlvu/M 'uN
<br />Certificate of Occupiniy 7
<br />Notes, Remarks, Etc
<br />DATE
<br />Set Backs
<br />Shear Wall
<br />Ext./lnt. Lath
<br />Pool Fence
<br />,1,{.n' (ltr,!or iri'trI\(,,oitrnpni
<br />,,,,,"",',,..;:: ""-, ;:
<br />- (1"44t"--
<br />,,c'n'ikrtr,nn,,,'n,: &V.,s gL...,,-.-'..
|