Laserfiche WebLink
BUILDING- INSPECTOR RECORD <br />SITE-WORK DATE ID/SIG.COMMENTS OWNOR BUILDT:R DEI-CARATION <br />I h.r.by amm undd pe.alry of pojury thd I m .r.mfl frem rhc aonir.ctoB License Las lor the follo$ins reen (Ss.?oll 5 <br />aosinss md Pofsion Cod.): Any Cny or ( ou y trhi.h r.qorss 0 pcnnil lo conslruc1. alt6. improle, ddolirh or r.nair oy <br />{dciue prior ro ns issu&ce, also r.qun6 rhe alplicet for su.h pennir to fil€ a sisned srnondr rhd h. or sh. is licds.d Ereuml <br />to rhe proris,od ofrhc Conlricro.r Lic.n*d tr* (Chao.r 9, ( onncncing wirh S(lion 7000 of Divisiotr I oflh. BGin.$ dd <br />ProaNions (-odc) or !h{ hc or shc is crdnB lnftfroor ed lh. b6is for th. allcs.d c\nption. Any liolarion .l sdi.n 701 L5 b, ey <br />arplicanl lo! a pcmil subj(lslhc npplicanltoacivilpeoahyornoldorelhefiv.hu.drendollds($500) <br />l. G osnr oflhc pNp.ny. o nyenployG wilh was6 s lhct ble coh!.Mrion. trilldo rh. "ork md rhc srodft L nut <br />imdddl or o ll6qt aor s.rc ( Se 7014, Busins and ltofsio6 Cod. 'I he Conttcttr's Li.dc krv doe not Eppl) ro M ownd ol <br />rh. In,!6ly vho bilds di inp6'€ $mtr md who do6 *.h sod hilnrclror h6.llor rh6o8h his or hd ovn cmploy6. <br />provid€d that such nnprovmls de ml htdxLd orofigcd iorel€.li howev6, th. btuining or inlroisnmt is eld vilhi. one )@ <br />oiconDbnnl lhe Om6 arite $ill havc rh. t[d6 of povins $,( he or sh. dil nor build or nnFo\! lhc Plopsly for $c plqD* of <br />I. s oNn6 oath. propsly. m cxclusivclycor Eclins silh lictu.d co.radouro coN'tud iic prcj(t (S{. 7044. &ame <br />and Prhsin Cod€: Thc Conlr&1ols Li..nse ll{ do6 not apply ro eo$ns olprop€nyrvho builds or tnprovB (hddn. <br />md who.ontmcrslorsuchpmj4rsBilt.Contmro(,IicsEdpuB@ttolh€GntradolsLicoetjR) <br />_l m .x@p uda sdtion_. B. & P.C. tor this r€Nn. <br />D.r.: Ortrd: <br />:!0atsEa:i.l:a!!8Elsa-I&.r <br />DECr.AE4uQ! <br />I hdcby ami,n trrdc. Doallyoapsiuryon€ ollhc follosi.s dalaralions: <br />_l nale ond will ,nai.tain a cdificorc oaco.Hr to S€li-l6urc lor *drkds .onlpcnstion, a provid.d aor by S(tion ll?00 of Ihc <br />Llbor Cod., aor rb. Flomoc{ o f lh. iod for whi.h <br />'hc <br />pdon is is!.d <br />I ha\ e and will ,nainiain worl.rt comp.Ntion insu.ance. d rcqui.{ by 56r io. l7fll ofrlE bbo. ('odc, for lh. p6loDndcc ol <br />ion idudc. !-rio lrkl poli.y numb6 ac <br />()n. <br />_l co1iEn'ar in rhc prtuftdnc.oithc worl fd $hi.h nrh pami is issu€d. I shallnot employ a.y rErson in any heod <br />s 6 ro b..omc erbjd lo lhe wort6 conrposalion la{s of Califomia, ed arft rhd if I should bccome subj$l to thc <br />\rcrlas compensalionprovisionsofSc.lionST00oflhctiborCode.lshall.fonhwnbco ply $hh thD* prolisio6. <br />mmp.@rion co\d*. is utrl,\vitrl. dd stall subjd u dploycr ro ondd t alris dd <br />sddnion k' dre con ol comp.neiion. dmas.s a\ pioeded ld ihc <br />DC-c-. nI7o <br />I h*hy.8irm x.dd pd.lty o lp.rjury lhgI I m licctrEd undo provEion ofChaplE 9 {.ommdcinu $ilh serion 700\)) olDivision l <br />of rh. BNin* dd Piolsiotr Code, md mr liccN is in aull aorc€ ad eftd. <br />Lt_q1 1Bs4- <br />ATTI.ICANIDECIAAAIION <br />I hdtt! a1lfln undB p..alty ot pcllury onc ol th€ lollowins d(laal ions: <br />t)a/[1ol.r'on Pmn \.Asb6ros Norificaron F.doa' Rcaulat'ons I I rlc a0. Pmo)\t <br />--\lquncd <br />Ldrs oaNorir(d ion <br />-l <br />cdliry thar rh. f.dd.l regulario.s ESddinA sb6tN ronoval se nol olplicablc ro fiis lrojel. <br />-l <br />cdiaylhd I havc rcad Ihis applicalion dd sratc lhar $.,hor. 'nlomanon s coEd I asetocomp,) tri/frallC.kyondCounryH:::*::ffi-i\Hlii- <br />Pdm,ren,m.ipr,n,): /6; e L^-, r <br />Forms/Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />Subfloor/VenUlnsulation <br />Roof Sheathinq <br />Shear Wall <br />Framing <br />lnsulation/Energy <br />Drywall <br />Ext./lnt. Lath <br />Brown Coat <br />l\,4a so n ry <br />Pool Fence <br />T-Bar <br />Handicap Req <br />Deputy Final Report <br />Engineer Final Report <br />Flood Zone Certif <br />FINAL /- t'/-[2 ,/r/z{x '{fr) <br />Certificate of Occupancy <br />Notes, Remarks, Etc <br />\ <br />I a <br />I 1 <br />I <br />.\] <br />y6 kt,4 E <br />FrvTtrJf\Y I 4 <br />s r b^''l <br />_/ <br />I <br />Set Backs <br />,}rt q <br />COIEIAIqIIONI.EIDIICJCENII <br />I h6cby arm uodr lEnalty oa pdjury tha! fi6. is a octtudion lodine a86cy lor lh. pstomrancc ol lhc {orl fo. which Ois rtmi is <br />issued (S( 1097,Civ. C ). <br />I <br />l <br />---T------