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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE rD/stG.COMMENTS O\,! NI'R BT]ILDOR DEI,CARATION
<br />I nercby afiim undd penalry ot pedury thar I cl.npt lion rhc Conlraclo6 l-ic.nsc lrs Lr thc aolloNi!8 @en (56.70]1 5
<br />Busins ed Plofdsion code)r Any cily o. count, whi.h rcarir6 a pqmn to codtud, .ltd, imprclq danoli.h or repair rv
<br />srrudue prior lo its isudcc- also requi6 rhe .ppli.mt for such p€fllit k' lilc a si8f,.d sar€mot lhal h. oi shc t licm€J pmuul
<br />lo rhe pmdsiom of $c Con!!.roas Lic.n*d La* (Chatrs 9, Co'nmcncinr Nnh S.clrd 7000 ol Dilision I oflnc Busin* ed
<br />Pofsions Code) o! rhal h. or shc is.rcmp lhddtom md thc b6is forlhc lllesed.x@prhn Anyviolalionoasetion 7011.5 bvanv
<br />.pplicel ror a pdir subjec th. rpplicetto acivilp allyofnot n!treIhd 6!c hundr€d doll&s ($500)
<br />l. N o{ n6 ollhc prepcny. oi dy .mplorcd wnt wa86 6 rhen $b .o rp.Balion. $ ill do th. {o!k d lh. $tu lue is not
<br />inbded or ofi6.d for sl. lsa 7O14. B$inB ed Eoa6sio6 Cod. Th. Conrador s Li.d. kq do6 nol tpplv to d owns oa
<br />rhcprcpsry who hlilds d' improv6 tlBen. ond who do6 such ro& hiNclaor hceltorrhtuughhis orhq own.hplove6.
<br />Fov'd.d rhar su.h i,nprovoe.ls e nol intod.d ot ofit61 aot elc. l[ hoNsr. Ihe hrilding ot i,nP.o(Nol it ell Bitlin one tr
<br />ol conplerior rh€ Otrrd Bund6 sill havc lne bMlcn of Foving thd he or she did noi bnild or inFove the Fopoly lnr lh. pulok of
<br />-l.6oMd
<br />olrh. pmpdy. &n exclusiv€lyconlrrclins \rilh li..tred conlradoE lo co6rtu.t rhe rmiet {S(. 704-1, Bui.R
<br />Cod€:'rh€ contracbls Li..ns. Law do6 not applylo downd ofproPeny sho buildr or improvs lhcr.on.
<br />ho conradsttrsuchprcjdstrnh.Co tuto(s) lict6e! pu6@t to th€ contactols Licre L.w)
<br />elc,nnr rnd.r sati.n B &P
<br />D,(", - [t- La-\g o"*.X-
<br />t ,.,\hr ,fl?,i ,n,lo pr rlr) "r po
<br />'uo
<br />on. o, ,t,. t,,o* ,rffiH$
<br />.r%a. *a,,tt ,-.t*,c6r,ricar. urc.is! ,o s.lr-lBure ror *orrteB onpensarion, 6 Fovid€d tor b, seiion lToo orrhc
<br />:-ti., .od.. ro, rl.. pdrol:mcc otrh€ \orr ro, sh(h rh. r6n( is isucd
<br />-lhavcand*illmaintarwork.ts
<br />coml,flsarion insuBncc.6 requnedbys{tio!3700oalh.ljh.r('od..fo.th.IEr0mm..of
<br />rh. work ror *hi.h lhis pmnn is issu€d My worl.re- co'np.@r io. i6trRnc€ cnri€r ud Fli.y nunbs e€:
<br />I ccn,ay lh.r in rh. pdaarnwceollhe Nort nn which lhis pd'nir is issueJ. I shau ao( .mploy dy pdson in aoy 'n$nde cb b.{onE subjd ro rhc{o*ds o,npNlion IaNs ofc.lilomia. ed qld rh.t ill should becodc ubjdt
<br />'o
<br />lh€
<br />$odd' co'npoerion ptovsila dl serio. l70o o I thc tilIr (tdc. I shall. fonhsilh comply lvilh lhos pi('visions
<br />lvAlNtNC F.ilure ro sur. M,kcB conrpoelnrn covgasc G unl.stul. and shall subldl e mplolq to onri'ral lsaliB d
<br />civil fin6 ut lo onc hmdrcd lhous d doll6 ($100.000). in ddiion to thc co$ oicodpqerion. deDaa€s d l,rovin'n r'rrh'
<br />sdtun.1076 oarh. bbr codc. inie6landrrorney s rc
<br />DECIABAIIQN
<br />I hmby.filrn ondd poalry o I p.rjury rhar I du licds.d uf,dB pmvision olchaprd 9 (comrnocins wilh Saiion ?000) orDirision 1
<br />ot lhe Busins dd ProlsioN Co&. ed lny Ii..@ L in full fora and cfial.
<br />COAiItsIJqIIINTENDIIC.AC}:NC}
<br />I hmby.mnn u er paahyotpciurylhd rha. is a coNkudion kndin! ascn.,lor thel,dfomdcc ofrhc \ork aor \ hich tht Fnnil a
<br />issu.d {scc 1097, (-iv. C.).
<br />AITLI(ANLDECLIBAIIQB
<br />I hftt,y allm undd pflalty olp*jury on. ol$.lollowin3 dalarations:
<br />OcnDllbn Pcnnni^sberos Norilicatioo F.d(al Regulations (Titl. 40. P{n6)
<br />Rcqoired Lcud olNotifi calion
<br />-lcdir)
<br />r\r rh.l.Jdtl r+ular'06 r.rd,In* sb6ro' Fmo\dl.d. n.I ad'crble rc \s PI )Rr
<br />@", r, ,*, , t.. ,*o ,n'r anphcarrrn ed srtt. Ihat r he atIre infomEln'n i\ .oEd I arre lo comply snh all cii, ,nd counrv
<br />onlinan.B md Slarc t ws,clalin! ro blildinS costrudion. dd hseby allhori4 reF6drativs otthis City and Countylo ol< ulon lh.
<br />ab.ve nrc.xoncd prcpedy lor iBp€dion
<br />Applic.nr or aemr Sien!(ur.: B
<br />,-.',". u.u" t,.Uut, X-
<br />*,". t,)- l?-l(
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subfloor/VenUl nsulation
<br />Roof Sheathing fFQ]- I -3-t?J ).tafr,)tYrat\ Etrf\:-
<br />Framinq
<br />lnsulation/Energy
<br />Drpvall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif.
<br />FINAL l-74-1")k-\84
<br />Certificate of Occupancy
<br />Notes Remarks Etc.
<br />-7 P
<br />td nc-d ],P F/O t4tzalr@
<br />-.l>
<br />Shear Wall
<br />Pool Fence
<br />,"," - lt tll-\$
<br />Lic.N Clss:-Li.c6. Nnmhcr:
<br />-
<br />Drr. _ Cotrlmdo.
<br />I
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