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BUILDING. INSPECTOR RECORD SITE.WORK DATE ID/SIG.COMMENTS Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Rool Sheathino Zll/za Z.Z2 Shear Wall Framino lnsulation/Energy Drywall Exl.i lnt. Lalh Brown Coat lvlasonry Pool Fence T-Bar Handicap Req. Deputv Final Report Enqineer Final Report Flood Zone Certil (2"+-€zE ,?,FINAL /ft5/"2 , Certificate of Occupancy Notes, Bemarks, Etc I h.r.6y dltrn u*l.r p.nrlry of p.iury rbnr I o.r.hpr tom rh. Cont$ro6 Lic..s. L€w for (hc follo*ing rcaon (Sd.7011.5 tlusin.ss .nd Pr.lcsioi Cod.lr An, Cny or Couniy rhich rlqutcs a lErmir r. c.n{rucl alrcr i'npr.!., d.mlish or tpln .iy itocilr, prntr ro irs issu{rtr.. .L$ Eqli(s rh. oppti.a for su.h lEmir r. ,ile a sigxrl rddEnr ildr lr or .b. h lic.tre! I,urunt r. rh. rovi.ions ol l,E Conkacrols I-ic..s.d llw lchapr.r L Commcncin8 qnh S.dk'n 7($.lDivi\ion l olrtE B$i*s rnd Prlcseonr CoJ.) or rhar lE or rhc ir cx.ry)r rhstAon and rhe ba6 for tlE !ll.3.d cxen{,ton AnyeioltrriooofS.crbnT0ll.5byany nptlicanr for i p.mi(ubj.crs rh. imlic.nr ro rcivilp.nrhvormr mr. rhln fivc hundrcd dolhA (l5lx,) l, .s osncr oI rh. I'o[rny. or my empblte\ wnh wagcs .s rh.L rL oqtns.rh., will d. rh. r.rt &d rlr {urE ts mr inr.!-t d oroflcrcd for Mlc (Se 7Or4. Buiin4i od Pmrcsio.s Code: Th. c.dmcror's Lic.n$ liw d(Es nor.t0ly ro 3n ovn.t o, nE ptup.ny *ho hild! or iqroks rlrd( and {h. d,B seh tun bitult or lEBclf or rhou8h hi\ or h., oq.nr?lottes. prcri'le'l rhar su.h iq'owmih @ d idcnd.d orotlerd loreL.lli t rcri tII blitli.8.r inpNvem nsBsnhinoEyc{ of contbri4 rh. OwEr Built *ill tuE rh. buni.n dt povine rhd lr oi 9E did mr blitl or jnPn'w dE pDldy,urhe purFs oI I. N osn.rolrh. pop.ny. amcxclusivclyconuu.ring w(h ltrcncd conrebn h con{rcr rlE !rcFct (se ?o4,1. Bu(ne$ lnl PlDErsn (.on., Thc Colurcroa1Lic.nsc Law !o.s nor lpplyro an o*ncr ufIlIoptdy wk, buiLlr or mnov$ rh.Eon. ald wh. .o.rmdslor\uchrmic(qnhaconE ro(rlic.MdauAuMr roihcconkcroasLicu.sckw). I id excnu undd Sccrion-. B. & ? C nx (his caiotr. !!]8trn$:.cq!l!IE!!4roN DECIABdIIOX I hd.by nltirm ondn Jf,nakyofp.iuryonc ofrhc LlloainAdccl.rarions: Ih0v.onnwillnEi oh a C.ni,i.ar.ofcoN.ntro S.l 6uEfo'$ork.nrohp.tudiDn,.rt$vid.drorbysartn1700ofrh. Ldlsr CrrL. f.' rh. n 'rurnw. of rhclo'k for qhi(hrhctdmir i5 ir.ucd Z r,*. -,.r *rrr n.mrur *. L6' (omn 6ar 'nn rldrrn.c, !s EquiEd hy s.ur ion r70o or rh. bhor L-od., Lt rh. p.rlomm. ol Jc" le inruhra tu .! el policy otrrh.r .: _l dniryrhd i. rh( n rfoinur. ofrlt w(k for rhich rhis lEn r is nsucd. I slEll rct cmplo, any r.'$n in lny muEr $ A ro h.cor subl4d h rh€ ro.te6 conp.Narion laws oI Calitomia- rn,l agrcc rh{ if I shuld b.c.m subiccr ro rh. loA.rs co p.irdrion pbvsionsofS..rion ST(XIofrhe kbor Code,l sh.ll, ionhwirh !-mply*irh d$s pmviio.s. WARNING Fiilur ro $cm wDrk.6' oqrnsdion @vc.ige is nnla*tu1. ,od .hployd ro lnmd l.Mhis Md iotr, ddm8.r i\ p6vil.d fo. rh.ro oi. hundr.d Lhoos..d dolla( ($llxr,(Xl0), in addn s..ri(nr 10760Irh.tihtrcql.,inr.r.!indI t ) 1..( i_\krlt{)N I h.rcby afli..nundcr pc.rhy ot pcrjury rnd I !'.liccns-d nndcr pmvision olChtptt 9 (co'nmncina wnh Sccibn 7flr0)olDilisioi 3 of rhc BusiRs and Ptulcsiotu Co{c. arvl hy liccn* is in tull fore end cli!c(. qlNllll![1\u]]!-Y.il!l1]{-!2oo I fuchy aruo under Fnalry ot p.rjur, rh, 'hd is r connrucrion bDdiry rBd6-.y ro. rh. pedomnE. of rh. polk lor which rhis n mn b isslcd {Soc. 11097, Cir. C.). AIILICINLpECL1IjIIO! I ls.by nfllmr 0iJer rnrlrvoipcrju.y oDc ofrh.lollowog d-lr!rio.i: Denxnir'otr P.rmi(isb.nos Norif'drron F.ridal Resul.ri.ns (Til. J0. P!n6) Rc{ut.i lin.r of Notfi .arion hd rlE Ld.Bl rcgnltrrioN rtgding rstEnos rcn-nl are or rntlicabl. n) rlus prol..r ..niay rh6r I lEv. Ead lhis applicdioD and $aG rhar rh.3bov. infomarion n dordr I Ur€ ro.$mply wi h dllCiyarri Cou'ry ordtrN).cs .trd Sr!r. lj*s Eliin8 I rprcsddiv6 ol rhis cny and counryro c.rd up.n rh. $\r nrntn)n.d !(,t dy,nr Aoplicnnt.r Agcnl Sitnrl{r.m",Z-)3--2-Zt 2 Rev.0B'07-2015 Subf loor/VenVlnsulation t n,ie s AJ,lms - I