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BUILDING- INSPECTOR RECORD <br />SITE-WORK DATE rD/stG.COMMENTS OWNER AU!LDER DELCAIIATION <br />I hqcby amnn undr penaliy ofp.dtry that I tun.rcmF from lhc contadoB'Lic.nsc L.w lorln€ lollowi.s rcMn (S€c7011.5 <br />Busin6s rnd Profsion Codc) Any Cily or Counry *hich rcqund a ldmir b consirucr. ah6. improve. d@o,Eh or ftp0r d) - <br />nrucruc. F,or Io irs asudc. aLo requn6 ln€ .pplicanl for such p.m lo 6lc t si8n.d srahenr thar k or sll. G lir.Nd pueui <br />lo lhe Forisro6 olrfic Contrcloas Lic.nsed hw (Chap{d 9. Con,ncncin-s *nh Selion ?0o0 ot Dirision I oflh. Busins md. <br />Prorc$ions Cod.) or tlml h. or shc is.xdnpt lhd€from ed lh€ h€sis lor rhc atl.8.J .x.mplion. Any riolarion ofSElion 70lll.5 bv ev <br />ffi#;;' ffi;-,ffi;;;;ffiil'-*:r**:$.", <br />rhe ptupdly Nho boil& or irnFov6 lh(@n. ud vho do6 such *o hnnselt or h6.lror rhorAh his or h€r o$n .nPlova <br />provid€d lhal such mprevonrs ft nor id6.lal orolTmd for sle lr, hor'66, fi. hildin-! o. ispmvo@n i. sold silhin one )@ <br />olcompldion, d. Or'nr Bu dr will haw Ih€ burd@ olprorin! $d h. or she dil ml boild or nnprov. fie plopsly lor fte pu{Es of <br />I. 6 o$ ncr olrh€ prepq1y. dn .x.lusircly conl,aclins pilh licn*d conrsdo6 ro co6nu1 th. prcjed (s€ 7l!t. Bsms <br />and holdion Cod.r Th.Conlractois l.icds. Lawdo6nor applylo mosns olprop€nt$ho buildsor impro!6lh€t6n. <br />..d who codmrs lorsuch lrojeb wnh a Co.tBlo(s)liceffid pusudr r. rlE(onl.aclor's Licsc LaN). <br />1 <br />DECIASAIIOI <br />I hEeby anirn Mdd F.ahyoapgjury on. oilhc louowins ddldario.sl <br />I h.vc ard will mainrain d Cdifical. oaco.mr to s.lf-lBuc tor *orkdt conrpasation, e Eovid.d tor by Sdion 1700 of thc <br />tibor Codc aor thc p6fomuc. o I lhc wo.L lor *ti.h lh. ldnil is isued. <br />I nav€ andwill mainrain wo&.r! .ool.6ario6 iGura..e, s r.llut€d byScclion l7(J0ofrhcl-aboraode,lorlh. pdaonnmc. ot <br />rhc $ort for whi.h liis D€flnil is $uel Mt workes .onpdttion iNumcc cnio &d !.li.y nunrb6 se: <br />-l <br />ccnify thlr in rhc pdfo':mcc of lh€ volk for whrch this pt@n ir issu.d. l shall nol dploy dy po$n h an, m nq <br />$ N lo b.comc subjcd to lh. wo*Ed coore@lion l,ws oacaliaomia. ud as,e lhal ia l sthrld beom€ subjd Io 'h.sorlm' ompmotion pBvtioB olssr,on 1700 ol lhc bbor Code I siall. fonhwih .!mpl, with thoF previsio.s <br />WARNINO Failu€ ro sue *.rkds' comp.Mlion uihstul. od shall srbjdt an flplora lo dinin.l pexhi6 and <br />civil fin6 up ro one hu.dral rhoo$nd dollds ($l rd ln cos ofcomp.nelion, dda!6 4 prorided for th€ <br />Setion.1076 orlhclrbrCod.. inld6l d atlo'rey sq' <br />DECI,AAAI(}! <br />I h.rcby .rtr'n u.dd p.aalty o lpEjury $ar I d Iicftsdl tr.dd prolisioa ol Chapla 9 (conmcn i.e <br />oa rh. BsinB d Profsions Codc, od my liccBe n in tullaor.caderl6l <br />Lic.Be CIss:-Lic.M Nun$d <br />conrm.br: <br />CONSIAUCIIONIIIDIIC3CIICI <br />I hseby atnnn undd penaht ol ldjury rhal th6. is a connrudion lodins asen.! tor thc pslonnancc of th. \eot! aor thich lhis pann b <br />iss!.d (S(.109?, Civ C.). <br />AIIUTANLDECIAAAUO! <br />I lEri'y altrn und.r p.nahy olperjury one otlh. tollo!'ios dslrations <br />DenNlitnrn Pqmirs shesros Norin.dioo l'.dsal R.rulaiions ( hE t0- Pan6) <br />onscoE(l l.!,6tocontly\rilhallCnyandftrunU <br />n,x r.rcd ativ6 ofthis City ond Counry'o nro upon lhe <br />ob.E <br />"EmiotrcJ <br />propel, (]r <br />,\pDli.ant or \A. t Signrl *,.lqr'/ -/ % <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />SLAB Floor <br />Subf loor/VenUlnsulation <br />Roof Sheathing <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 <br />Enqineer Final Report <br />Flood Zone Certif <br />FINAL 6/,,14 *lM ,/) <br />Certificate of Occupancy <br />Notes, Remarks, Etc <br />UFER Ground <br />PolicyNumbd: ExptrG: <br />- <br />LenJe' ! Addrs <br />- <br />--------r------