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BUILDING- INSPECTOR RECORD <br />SITE-WORK ID/SIG.COMMENTS OWNER BUILDER DELCARA ION <br />I hscly anm undd Fnahy of !6jrry rhar I m exmB tum lnc Cont.cr6^ Li.ens lr* ao. th. folloNins rcen (Ss.701 1 .5 <br />Busins atu Profsion Cod€): Any Cily or Cou.'ly shich cqun6 a pcnii lo co.situc{. ah6. inprove danolish o. rqw my <br />srruclue Irior to ils i$uec., 5Lo r.quir6 lhe applica lor srch p.nnit lo filc a sisncd slat@€nt lhd h. or she i, Iics.d pursudt <br />ro rh. Fovbions of lnc Conlracloas Licens.d Larv (Chapld 9. Cooncn.ing vnh Sdion 71100 ot Div'sion .l oa$. BosnEs Md <br />Prcacsions Codc) or thal h. or sh€ is cx@pl lh@6om ed rh. bdis iot thc allcB.d .xmplion. Any violarion ofSeclion ?011.5 by any <br />applicantlorap.mnsubjedslhcapplicanlloacivilp.nahyoanolmorerh&fiv.hu.drcddolltrs($500) <br />-1. <br />6 oNnd olrhc ropdty, or my dbployG with was6 6 ih.ir $lc con+oelion. sill do r. wolk od th€ $ne1@ n nor <br />imci.n orofidcd aor elc (5(.7044, Busins d Pro l6ioN Cod. Th. ( onrrDclois Licsc lnw do6 nol tpply ro o om( ol <br />rhclropsly sho tril& or inFnovefiaotr dd *ho do6 such sr himsell or htslf or rhNulh hi. o. hd o*'n mplo'6, <br />piovided rhat such inprolonals e not inlod.d or oltod forek.lr, how&d,lh. buildiq or inpm\mdl is Fld wirhin onc re' <br />oaco pldiorl lh. OM.r Btild6 will hav. tlE hr&n of prorins lhd h. or shc dd not hild or inpov€ fie pspqly for tfic purFs or <br />-L <br />6 ownd olrhc prcpcrry. dn erclsivcly coorracrins B ilh lic4.d contrcrou Io coNlrucl lhc proi.d (5( 7M4, BBms <br />d Fmftssion Cod€: Th€ conkictofs Licds. La{ do6 nor,ptly ro an oqnq o I propsly who buil& or nn[ovcs lh6@n. <br />lnd \rhd erhts for such Fojds with a Co.tEcro(s) licm*d p6mr ro rh.Conl.aclols LiccN L,w) <br />I m.r6bt ubd( S6do. .B &PC lo.rh6rBon <br />Oan..: <br />l!9.8trE8I.C0!l8E!!A]lo! <br />OECISI{I()X <br />I her€by nmrm undcr Fnah]. oi Ddjury odc of rhc iolloreinr ddlar.lio6: <br />I halc ed qill nBinlain s Cslilicat. or CoMl lo scli-l6ur. hr work6t comp.nelion, 6 r,o!i&d for b, S..lion 3700 olln€ <br />bboi Codc lor lh€ pdaol:mcc of lhe wort hr which the p@il i3 i$!.d. <br />-l <br />havc ed will nri.rai. wo*.!s co,npeNalion iBrrancc, 6 rcquiEd by serion 1700 oaln. kbor Cod€, lor lh. Pdfolrmcc of <br />rhc work aor which rhis panit ir issud. My worrets- smp€.elion iNudn . .did dd polic, numbd a.: <br />l..difythar in rhc pertomanc. oflh. tr'ork lor which this ps,n( G i.!d.d. I shall.ol enploy aoy p€.son in any md!6 <br />$ 6 ro b.comc subjd b rh. *or[$ comrosarion l.ws ofcalifomia. ud asd rhat ia l should b.comc srbj.cl lo lh. <br />*! 6 smp.salion pmlisio6 ofs..lion 1700 ofthc Lahor Codc.. fonhwnh coBply silh Ihoe pnrisioB <br />WARNING: Iiailure lo sue Norksa co,npdsrion ..veaEc is d nploy.r lo rinrinal poallB aod <br />ciril lincs up to o.e hundred tholsdd doll tun, d na*6 6 poid.d ror rh. <br />Seclion 1076olrhe lnh)r Codq i.l <br />? <br />I h6eby ailnn uder p€nahy ol ptjury rhar I Chafl 6 9 (onmencins Nirfi Sdion 7000) of Division :l <br />af thcBusinsmd PmfsionsCode, odiy licc@ t in lulllor..mdcfisi <br />(c)a( <br />lhsebyamnnundd p..alrlofpdjurrrhal lhd. is a <br />issu€d (SE 109?. Civ C.) <br />lqdins asm.y fo r thc pGfonnscc o f t he *ork lct lvnic h tn is p6mit is <br />dxfucaNlDEo/aauoa <br />I ho$y amm und6 rEnaly of pGjury on. oalhe aollorin! dsln l ions <br />Danolition Pdmils-Asb6los Norilicarion Fcddal Reguldions (Tnt 40, Pa16) <br />R.qrir€d Leud olNolifi cltion <br />cdiry rhar lh€ fcddal r.rulaliotr Ea,rdinE sbsros rmovrl mc nol applicablc to lhd piojd. <br />.otr(r loSrero omply Nirh allcirrdd county <br />r.Dtsdrariv6 ofthis ciry dd counryro ml6 ur.n lh. <br />^..,J <br />- <br />-lo,( <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />Subfloor/Vent/l nsulation <br />Roof Sheathing tt/*/tt erho/7A -,/at -, <br />Shear Wall <br />Framing <br />lnsulation/Energy <br />Drywall <br />Ext./lnt. Lath <br />Brown Coat <br />Masonry <br />Pool Fence <br />Handicap Req <br />Deputy Final Report <br />Engineer Final Report <br />FINAL |r/r9/tf' r ?Dta,.ra ./12* <br />Certificate of Occupancy <br />Notes, Remarks, Etc. <br />DATE <br />Policy Nutubs:-ExPi6: <br />T-Bar <br />Flood Zone Certif.