10190380 - Permit - Laserfiche WebLink

Home Browse Search

BUILDING- INSPECTOR RECORD SITE-WORK DATE ID/SIG.COMMENTS OWNER BUII,DER DELCARATION I h6€by amm lndr pcnalry oa pdjury rhar I m .renrpl ftor lt. Conrraclod Licd. La* for rh. ldlowins rarod (se 70l l 5 B6in6s and Profsion Codc) Any Cily o! County vhich rcqun6 a pftnn lo connrcl. all6. nnprovc, d@olkh .r rcpair y sttudsq prior ro ns isu c( als rcqutd th€ aprlicer for su.h Fmt to lil€ a sisncd surdd thal he or 3h. i, licms.d Puu@t ro lh. pmvisioB ollh. Cookrcroa! Lic..scd tjw (Chapls 9, Co'thc.ci.s $nh sdlion 7000 of Division I ofrh. Busi.N md Pof6sio6s cod.)or thar h. or shc t €xmo th(€fiom &d th.ln i for rh. alleS.d crarytion. Any violarion oassrion ?011 5 by y applicanrtorapmnsubjsrslh.applica.rro6.ivilp.nantol.olmoiclh fivc hun&.d doll&s {1500) 1.6 own6 ollhc propely, or ny cnployB wirh $.g6 s rh.n eE compqstion. *illdo rh. sorl dd lhe slruclw is not intddcd orolls.d ior slc (Sc.7044. BBins ahd ProacsioB Cod. IhcConlractoasl.icenscLrwdo6norapplyiounown6ol rh.Fopdry sho bo & or inFovd th6ac ald who dG such *!d( hitu€llor h6.lf or rhoush fiis or hr 6$'n .mrloye6, piovid.d rhar str$ imprormts mnoi hlali.d orofr6€d aor eL l[ ho{'5d. tlE ilding ot iqrovc'Mr is$ldsirhin on. t@ ofcorpLriolr lh. Osnd tuikk will harc lhc hlr&r of prclins lhal h. or sb. dd nor tnikl or imFo\€ tfic popdy lor lh. pul'br of I. soMcroflh€ popdy. mcrclGiv.lycom@cting wilh lic..sd contmcloE kr co8rtud lhc pNjdt lsa. 7044.Iriin< a.d Aoksbn Cod. Th. Co @roas Lic6s. Ldw doB rol apt,ly lo o o*na of prop.n, who builds or inprovcs lh(&n. od who comds for3uch prcj.<lswnh aCoirBcro(s) lica*d puEd ro rh.cont.doas Licm. t{s) I an.rcmpl undB Sdion . B. & P.C. follhls i6on. ]lABtr&ElllOIilfENsAIIAx !&cl,A86r!or I ha.by .mm uodq paaly ol Fjury onc oarh. lolloui.s drlarariod:) I h6v. rnd will mintdin 0 Ccnificarcofco6dl ro S€lll$urc fo! wo 6s.onpmr.rion,6 provideJ aor bySarion !TlrudIrh. tjbor Codq lor lh. pafomanc. oflhc wo* for whici thc pd ir k issu.d I hav. snd sill ftainuin sork6 .onpcBation iNure.., d rcqlircd bySerionITOI] oflhe tibnr Cndc.lbt rh. psaonnanJf lh. wrk for whkh lhis p.nnil i3 is.( My vork6 @nF&[ion iBursc. .rid drd policy numb6 dc: I c€riify lhat in lhc p.rfomm€ ollhc *ork ror whth lhis p.ftn is i*u.d. I shall nor Rnplo, m-v po$. in any men.r F 6rob<!6cslbjdlo$.wo 6' comp.tuarion lam of Califomi,. daBElhal ilI should b€codc subjd roIh. wo*6' conpdalioo prcvi3io6 of s.<lion 1700 oalh. t bor Cod., I shrll, aonhwnn comply wilh lhos pro\ isiois WARNINGT Failur. lo Ku. worl6' co,trptrolion covdose is unlawtul. and sh3U subjcr e arplord ro dnnin.l penahis md civil nnes up io on. nundrcd thoGand doU6 hc cosr ol.. rpensdnrn. lan.8.s as prrnidcd for ihc ur!u-8rr&il I h@by.mm lndopmalryoarsjurylfi.l I an li.en*d und.r provision olcnapl6I (connn€nci,s *nh Sdrn,n 7000) ofDivhion 3 of lhe Bnsin6s ud Proadioos Codc. ud my lic6* 6 in tull forc. and .ft(l ,.""*",**//k//4 I hftb, amrm u.dd Frrty oa pdjury rhar rhq. is 0 i$ucd (s6. 1097, Civ. C.) rudion kndins ssmcy lor lh. psfolr@cc of rh. $ ork for {hi.h rhis Finn i! a.ttucarlDfttaa{Ilar I holte aninn undB p6ah y of pdiury onc ol I lrc lollotr io! daler.t ions De,nolition Pamn$Asb.sos Nolifi..tion t'.Jdal Resulatio.s ( rnE 40. 1'jru16) R.q!ir.d Ldlr oa Norificarion I cdily rha lhe f.rler.l rcgulalioB e*edin! dbesros ronolal ec not applicable lo this prore.l. r.ad lhG apllication md slsr.lllal rh..bov. irfomotion t cotrd.I asre 16 conply *nh allcir!.trd ( otrnly L€\ys Elarins ro buildiry conshr ad hqct'yaurhornc r.pr*mari!6 oirhis cilr ond Counlylo.nls ulr.lh€ ^,, /t/ao/,4 Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Subfloor/VenUl nsulation Roof Sheathing Shear Wall Framing ln s u lation/Energ y Drywall Ext./lnt. Lath Brown Coat Masonry Pool Fence T-Bar Handicap Req. Deputy Final Report Engineer Final Report Flood Zone Certif FINAL Y/t/rt 5r168 Certificate of Occu pancy Notes, Remarks, Etc. -----r------