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BUILDING- INSPECTOR RECORD <br />SITE.WORK DATE ID/SIG.COMMENTS OWNER BUTLDI'R DELCARATION <br />I hseby rmrfl unds pdulry ol !.dury thd I an .r.mfl fmr, th. Conrado6 l-i.4. Lrw aot th. following r.Mn (58.7011.5 <br />Busin6s ad Prof6sion Cod.)r Ary Citt or aounly which rcqun6 a pqnt lo .odtuct. ahs, inprovc, &nolieh ot rqEr'dy <br />slnrcrurq rior ro ils tr$ c., .lso r.qut6 lt€ applicet for su.h Fmi lo 6L a si8n.d sldmdl lhat h. or sh. is licnE rl pusudt <br />lo lhc prov$io6 Jr thc Conrador's Licc.$d Law (Cnaqd 9. Comncocins wilh Scrion 70Oo of Divisiofl I oftt. Busin.is md <br />PmLsions codc) or rhat h€ or shc is.xcmpl ths€frod dd rhe b4is loi fi. .ll.Bcd .xmption. Any lioLnion ofs*ron 70ll s 6, dy <br />appli.air lor a DEfl.n subjels rhc applica roacililpcndtyolnol'n rcrho fivc hundierl douds ($500). <br />I, 6 owncr of thc proFny, or my cmploys w'lh q'as6 s rh.ir $lc corpms.lion. will do $e work dd $c slMm G not <br />inrsded or o[r.d fo. el. {se 7(x4. ausins ed Prcasions Codc '11€ Conrrador3 Lrsc Lae do6 nor apply lo e ownr or <br />rnc pNpsry *ho h'il& or inpmrG rhdan. od *ho do6 sucn m* himscllor hffilf di rkouBh his or hB own cmployc6. <br />tNlid.d rhal srch imprevorcnls c rcl hlddcd or o,Id.d tu ek I[ now6. tnc hildins or hp.o!@ b$ld*thinon.rd <br />ofcompl.rion, thc(}vns AuiBd\iU ha!.$€ hrd., ofp.olina rn he or she did ml huild or i,n!ro!c lh. popdly for th. purpoFof <br />- - l. 6 osr.r o t rh. trop6ln m .r.hsiv.l, .onradins wilh liccNed conrEclo6 lo @nntud lh. Frj..l (S*. ?044. Bsms <br />Md PDlsbr Codc: Thc Contractor's Lic.6. Law do6.or apply lo e ownd oaprcp.nyuho build. o. inProvd $d.on. <br />and vho .lntracrs for 3u.h projeds wnh a Conl6o(s) lt$cd pusuatn lo Oc Conuaclor's Lichs t *). <br />I n €xcmpl unrl6 Sdrion <br />I hs.by aflim !!dr p..rlly olprjury on. oath.lolloNins d(ldalioE: <br />I have and $ ill nuinlain , Cmific,tc of Co6nl ro S€lf-lcurc for rori6 &npo&rion, a Pmvid.d aor by SEIion l7C$ o r rb. <br />Labor Code tor lhc pgiomdc€ of $c vod foi *hi.n rhe paril is isu.d. <br />I havr a.d sillmainiain wort6 comp.Bation ilsurancc.4 .qtrn d b, Sattrh 1700 ollh€ Labor C!de. foi thc pnfomtn.€ oa <br />th. *ork 16r whi.h ihis potr n issu.d. My $ork6 comFerion iNudcc cMid d policy nuDbd ac: <br />I cdlifylhat in th€ p€.fomance oalhc work io *hich rhG pemn is issu.d. I s,Ellnol {rplo, a.y p6o. i. any nmas <br />$ 6 b b.con 3ubj(r ro rh. wort6 .onp.Bation ls"s of Califomir. ed ar@ lhai if I should b€.omc subjsl to lh. <br />No*6.omFMrionproviriosolSdionlT0oofrhcLahorCode.lslqllfonhsnhcohplysi'nlhosttrorisioN <br />w RNING: rzifurc ro suc \rorkas ompssalion covcagc ir u.la$ful, d subjcl dployd ro oinin l Fuhi6 d <br />iivi! 6n.s np lo on. hun&€d thousud doll6 ddascs d prov .d fo. rt <br />Scdn,n 10?6olrlE Labor Codq inlcr6l md <br />I h6cby amrn undcr poalry oa pejlrt thar I m licmcd urdq provision olchapro 9 ( <br />of th. Busins and Prci*sions Code, and ty lics. G in tull iotcc md €rtrl <br />ins wnhS{lion7000)orDivi! nl <br />(l)rsraucuor_tElDllc1cllcr <br />I hscbyalIflnu er p.n.h, ol lcdurr lhal thd€ is r consiruclDn knding t8d.y lor IIE prlonnancc ol the work aor wlrich $is p.nnit is <br />isucd (56.3097. Civ. C.). <br />Lnda B Na,n.: <br />- <br />ASELICANLDECLAEAIIA! <br />I heltry armuo&r poahy ofpdjuy6n of th. followiq d(ldalions: <br />D.Eolnion Pmns-Asb6ros NorrlicatD. F.<tdrl R.grLtions (TnE 40. Pan6) <br />Re{uncd Lals of Norific*ion <br />-l <br />.ol il, lhar Ihc lcddal resuiations rcssdins 6b.ska rmoval r€ not opplic.bl€ ro this prcjel <br />i.rrbr rJ{dcrhar rheah.\€ inr.Tdri.'r is.onar lJEre <br />and cotrnryro cn(Lr up()n d'c <br />7 <br />Qfrft <br />2-f- t <br />Set Backs <br />Forms/Steel/Holdowns <br />Erectron Pads <br />UFER Ground <br />Subf loor/VenVlnsulation <br />Roof Sheathinq <br />Shear Wall <br />Framino <br />lnsu lation/Energ y <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 7,-La-La <br />Certificate of Occupancy <br />Notes, Remarks, Etc. <br />SLAB Floor <br />41 <br />I