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BUILDING. INSPECTOR RECORD
<br />COMMENTSSITE.WORK DATE ID/SIG.
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />SubfloorvenUl nsulation
<br />Roof Sheathing /2//shA-4.d
<br />Shear Wall
<br />Framing
<br />lnsulation/Energy
<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 ,t,/zt/lo .
<br />Certificate of Occupancy V
<br />Notes, Remarks, Etc
<br />O\{NIiR B!ILDER DET,CARATION
<br />I hscby amlo undd pMah! ol pdlu.y lhal I d €xctopt ion rh. Conlraclos Lic.ns. Law lor nr iollowils r.a{n (Ss 7011.s
<br />Bsin6s &d Profdion Codc): Any Cily or C.mrt $hi.h requn6 5 p6nn ro connrud. oh6. impreva .lGnolith or r.p€n v
<br />ntucru., pnor ro ils isu4., abo r€quns $c alplicd lor such p.trrii ro lilc t sisncd statd€nt thal hc or shc G licdscd p@dt
<br />kr th. trovisioG ollh. Conlrtrcloas L(ens.d lrs (Chaple 9, Corrmcncina v h s(rion 1000 of DirisN. I ol rh. Irtr\ind$nd
<br />Pmlsions aod.)or thar h€ o, shc is.x.npt rhdcionr and lhc tEsis for rhe alle8.d cxdnprion Anyviolarionofsalion 7011.5 bvanv
<br />applicanr for apennn subjd8lh. applicanlloacivilpoahyolnol.rrclhanlivchuodrcddoll s($500)
<br />l. s osncr of rh. proD.ny, or m, mploy6 with \uas6 s !h.n ek comFrsdioo, vill dc' rb. "ork dthcslEd@s nol
<br />inrer&t or ofrecd lor sale (5(.7044, Bsins dd Pmfsions Code 'l h. contrcioas Li.mc ljw do6 not applv 1o an o\Fcr of
<br />rhc propdy s,D buil& or iryrov6 $@r ud sho do6 such Nt,t hi,ns.lior h6.lf or rhmuPh his or hF ok.nphvs.
<br />provid.d rhd such imp.ovoE$ ft nor inoddi tr ofb.n lor el€. ,l how&6. lh€ buildins or inprovmdr is sld tr irhi..n. vs
<br />orcomplction. th. ow.d AuiEq *ill have $c hrd@ oaForing $d hc or dE dd nor t ild or nnprove lhepDpd,lorihc Pulposof
<br />-1.
<br />s osnE oarhc propsly. @ .r.lusi!cl, conti.clins $ilh licas.d .ontdo6 lo conslruc' rhe rojd (sd 7044. BEhs
<br />and |rDfdsu Codc: Th. Conlradoas t,iccnse La{ do6 nol .rPly to os.( olriololvwho builds or inoi.ld lhtrmn.
<br />and who.onlmcrsforsuchprcjcds*nhaConhdoirlkdsedp6uerrorhcConlra.lor'st,ictuch\v)
<br />l,n.rmd mdd sdron - B. & PC.lor rha r.4n
<br />Drt. Ownq:
<br />ug85c8[cou!!NsArg.N
<br />DECtAEAtt!2!
<br />I hs.b, arrh undd p.nallyolpcjuryone ofrh. followin8 d(lamlions
<br />-l
<br />halr ad Nill maifllain a Cen ifi.arc olconmr ro Scl nsuc ror trlrk.E coalpen3liio0,4 pmlidcdro!bvSsrion11700oithc
<br />Lab.r cod., foi lhe pc aonM.ce orlhc *oik aor shich lt. p€mril is sucd
<br />I havc and will rsi.r.in wotk.ri conD€nsalion i6rra.c.. d requted bySrlnJn rTooofthc l,alatr Cod., lor rhc pqfonnarc€ of
<br />rhe rvo* for *hich llG p.mrit is isu€d. My wo&6 .omt $ation imurec. cnia dd policy nu'nbs ec'
<br />Policy Numb..-ExPn6:
<br />I ccnitlhal in rhe pdaonnsce oalh. wort lo which lhis p.mil is issued. I shall nor cmplo, a.v p€6on in anv mener
<br />s s ro bcon. subj€r to the B0'16 Qnpdsrion laNs ofc.lifomia. md ase rh.l ifl should b€oD. slbj*i ro lh.
<br />M|t6.Dnp.rsalnrnprovirioNofSdion1700oarh.t?b.rCodc.Ish!11.lonh\rithcomplylvilhlho€provisions
<br />WARNINC railur€ Io sue worlcd conpmsorion covdasc is unla{tu|, tud shall subid an mPlovd to siminalpobki6 md
<br />.nil nnca op ro on€ hundErl lhousd dollc (Sl0{,000). in addirion ro $c cosl ol comFr*rion. dm's6 6 Im"nl.n r'r rlr
<br />sdtion 1076 olthe l-abor Code inr.r6t &d allom.y s 16
<br />lt
<br />DICI.ABAIION
<br />I hrcby amm u.dcr poDlty. i p€rjury rhal I m licdsd undd pmvision ofchapld 9 (.ommmcins rvilh Sdtion 7000) 'Il)ithion 3
<br />ot rh. Busins md Prcf€$ions Co&. ml ,n, licok is h tull lore dd ellct.
<br />I -iceNe Cl6s:_l-ic.6. N unrbr
<br />,*..tt/tq/rz .-,*"*X-
<br />CONIIBIJCIIONTEIITNC.AGINCI
<br />I hcreb, afifln undd llnalry or pdjury rhal ih6. is a coflnrud ion lfldlns ,sc.cy for lhc psfom&c. of the woll t)r shi.h this p€rfln is
<br />issu.d (S*. 1097. Ci! C.)
<br />L.nd.''rName
<br />-
<br />Len,.lo ! Add6
<br />A.8IUC.ANTDECI,AMIIA!
<br />I harby aftun u.dr paahy of psjury onc ot thc followi,! &.ld.lions:
<br />Demolilion P{mns'Asbdos Nolifi€arion F€ddal R.*ulaliom (Tnb40. Pd6)
<br />-Requtcd
<br />Latd of Noiicalion
<br />-l
<br />cdiry that fi. f.dd"l r.sulalioB Eeddrng sb6tos rmoval {€ trol tppli.abh lo thls Prcj61
<br />I c.nify lhal I havc rdd thi! applictrion Md ar. rhd rh€ ahovc i.aomalion is cord. t .!ra lo complv wnh lll Citv md Counlv
<br />ordiMcd dd $ar. lis rclrm8 io boilding .ondrucliotr dd n@by .urhod- rc!n.$tdiv6 of lhis Cnv &d co@lv to flts upon rhc
<br />.L{vc nrotioned pr.p€n} ror iBpelion purpos6.
<br />a!, eR4ta- DL
<br />,,,", ,,f tr/rr
<br />vg
<br />^pprimnr
<br />or
<br />^senr
<br />stsnrt!re, tL
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