Laserfiche WebLink
BUILDING. INSPECTOR RECORD <br />SITE.WORK DATE ID/SIG COMMENTS <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />S u bf loo r/Ve nVI nsu lation <br />Roof Sheathing <br />Shear Wall <br />Framinq <br />lnsu !ation/Energy <br />Drywall <br />Ext./lnt. Lath <br />Brown Coat <br />ltlasonry <br />Pool Fence <br />T-Bar <br />Handicap Req <br />Deputy Final Report <br />Enqineer Final Report <br />Flood Zone Certif <br />,l <br />FINAL I to 1a DYY I <br />Certificate of Occupancy <br />Notes, Remarks, Etc. <br />OWNERBUILDERDELCARATION F <br />I hcrcby atlirm undcr lEnalty of Frjury lhal I am cxcmpl from thc Contraclom' Licrnrc Low lbr thc ftrllouing rcawn (Scc.70-!1.5 <br />Busincss arxl Profcssion Colc): Any City or County which rcquircs a Jrcmit k) clrnstruct. altcr. improvc, dcmrlish or rcpat any <br />struclurc, ltri(rr to its issuance, also rcquircs thc applic{nt for such Frmit kr filc a signcd st.tcmnt thal hc or shc is liccnsd pursuant <br />to thc pn)visions of thc Contrrcbr's Liccnsd llw (Chaptcr 9, Commcncing with Setion 7(Xx) of Division J of thc Busincss and <br />Prof'cssionsCodc)orthathcorshciscxcmptthcrcfromandthcbasisforthcallc8cdcxcmption. AnyvioldlionofScctbn?03l.5blany <br />applicant lirr a IErmil subjccts thc applicant to a civil pcnslty of n(rt morc thon tive hundrcd dollus ($5U)). <br />_1, as owncr of thc propcrty, or my cmployccs wilh wagcs as thcir solc conrpcnsation. will do thc work and thc struclurc is ttot <br />intcrxlcd or ollbred frlr salc (Scc.7044, Busincss and Pml'cssions Crxlc: Thc Conlractor's Liccltsc [-aw dtrcs not apply to att owner o[ <br />thc pn)Frcrty whr builds or impnrvcs thcrcrrn, and who drrcs such work himscll'or hcrsclf or through his or hcr own cmployces, <br />provirlcd that such improvcrncnts arc not intcnr.lcd or olfcrcd filr salc. I[ howcvcr, thc buildirtg or improvcnrcnt is sokl within onc ycar <br />ol'conrphtion, thc Owncr Builttcr will havc thc burdcn ol'proving that hc or she did mrt buikl or improvc the pnrperty lirr thc purJxrsc ol' <br />salc). <br />_1. as owncr ol'thc pn)lrcrty, am cxclusivcly crxrtracting with liccnscd contractom l(] conslruct thc projcct (Scc. 7M4, Busittcss <br />arxl Pnllbsskln Code: Thc Contraclor's Liccnsc Law docs not apply [o an owncr of propcrty who builds rtr improvcs lhcrcon, <br />and who contracts lirr such proiccts with a Contractor(s) liccnscd pursuanl to thc Contractor's Liccnsc Law). <br />-l <br />amcxcmpt under Scction-, B. & P.C. fbr this reason. <br />I)atc: <br />WORKERS' COTTTPENSATION <br />DECLARATION <br />I hercby affirm undcr Jrcnalty of pcrjury onc of the tolkrwing dcclarations: <br />_l havc and will maintah a Ccrtilicatc of Conscnt to Sclf-lnsurc frrr workcrs' compcnsation, as provided tirr by Scction 37UJ of thc <br />Latxrr Crxlc, lirr the lrcrformancc of thc work lbr which thc Jrcrmit Ls issucd, <br />t4fi^u"antl will maintain workcrs'comJrcnsation insurancc, as rcquircd by Section 37fi) of thc Labor Code, tor thc Jrcrftrrmancc of <br />thc work lirr this Jrcrmit is issucd. My workcrs' compcnsation insurancc carricr and Jxllicy numbcr are: <br />p.ricy*",rn', lbVgTKl-71 Expircs:Ao"r <br />_l ccrtity that in thc Jrcrklrmancc of thc work tilr which this;rcrmit is issucd, I shall not cmpkty any flcrson in any manncr <br />so as to bccomc suhjcct to thc workcrs' comyrcnsation laws of Calililntia, antl agrcc that if I should bccrlnrc subjcct to thc <br />workcrs' coml^-nsation provisions of Scction 3700 of thc Latxlr CrxJc, I shall, ftrrthwith comply with thr:rc pnrvisions. <br />WARNING: Failurc to sccurc workcrs'comJrcnsation coveragc is unlawlul, and shall suh.icct an cntploycr to criminal Jrcnaltics and <br />crvrl lincs up to onc hulrrJrcd thousand dollars ($lm,Uru), in arldition to thc cost of comJrcnsation, rlamagcs as providcd lirr thc <br />Scctkrtt thc l:txlr Crxlc, intcrcst and attrtrncy's <br />D <br />I hcrchy atlirm unrlcr pcnalty ot'pcrjury that I am licenrcd under provisiort of Chapter 9 (commcncing with Scctilrn 7m0) of Divisirln .l <br />of thc Busirrcss and Prolbssions Codc. uxl my liccnsc is in lull lilrcc and cll'cct. <br />Liccnse Class: Liccnsc Numbcr: <br />W <br />I hcrchy aflirm unilcr Fnalty of pcrjury lhat thcrc is a (rrnstruction lending agcncy for lhc lErlirrroncc of lhc work fi)r uhich this fEmit is <br />issucd (Scc. -1097, Civ. C.). <br />[rndcr's Nanrc:t <br />[rndcr's Atldrcss: <br />APPLICANT DECLARATION <br />I lrcr.-hy atlirm unrlcr pcnalty of prjury onc of thc lillbwing dcclarations: <br />Dcnrolition Pcrmits-Asbcstos Notitication Fcdcral Rcgulations (Titlc 40. Part6) <br />_Rcqu ircd lrttcr of Notilication <br />_l ccrtily that thc l'cdcral rcgulations rcgarding ashcstos rcmoval arc nol applicablc to this prljcct. <br />_l ccnify that I luvc rcad this applicati(rn arxl statc tlut thc ahrvc inf<rrroIi<lr is c(rtu-t. I agrc to qrmply wilh all City and County <br />ordinanccs and Statc liws rclating to huilding colsIrucIi(rn, and hcrcby authorizc rcprcscnlativcs oflhis Cily and County to cnts uF)n lhc <br />atxlve mcnlioncd pnrpcrty lor <br />Applicant or Agertt <br />? <br />Pernritcc n$nle <br />purF)ses,? <br />NR 201