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-BUIi-DING. INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDER DEI,CARAITON D
<br />I hcrchy nl,]iln utrder pcmlry ol pcrjur! lhlr l .n cxu.rpr ln,m rhc Cont o^ Li..n\. ttrw lor rhc tullowin! rcJ$n (Scc?0.11.5
<br />Businc* lnd PD[cs\tin Codc): Any Ciry or Counry which rcqun$ i t^-irnjl r) co.slnrcl. rlrs. i rrovc, dcn$lhh nr rcn.M Jn)
<br />slrucrurc. rior lo irs nsum.. also r.quins rlrappli.rnr t slchl]cnnirro filcd sisrcd sratcnEnr rhar tEorshc ir lir.n*d nururnr
<br />k, rhc pmvi\ions of lhe C.nlllckn s l,iccnscd tiw (Chq,tcr 9. CbnnrEtrcire wilh Sc.rio. TlxD of Divhnnr .l oi rhc Du\ine$ rnd .
<br />Pofc$bns cod.) or ihar hcorshc ncrcnfl rhcrclrom,nd rhc blsis lor rh€ lllcscdcxcmpiion. Any violari.nofSccrion 70ll5l,y rny
<br />rrplicanl lor a pcmil subj€Is rhc apphanrb tr.ivilp.nrlryufnot mr. rhrn lir. huided dolhrs ( S5m)
<br />l. rr own$ or ihc ptuIrny. or ny c'npbyes wirh wlscs ,s rhcn $t conwns iotr.$illd.rhc*o !'d rhe srurm i\ nor
<br />inlc,tsl or olt.r.d n)r $lc (Se ?(x-1. Busim$ and h.fcssiotri Cddc Thc ConhNofs l-i.cnsc ljw do.s nor omly Io.0 oqrcrof
<br />rh.pn,fdy *ho huilds or im0mrcr rhcNn. ard wtn dms such wolk hnnscllor hcrclior lhmush hn or hcr own cmplo)ccs.
<br />prolid.d rh such inDn)rcmms e nI inr.nddl or olIcrcd fo. sak I rl b$cki rhc tliHing or imprN.mnt is $ld {irhin onc ,tr
<br />ol conplcrhn. rlrolrncr auiud willhrvc rhc burdd ofpolinE rhd he or sh. did Bn tdild or i'qtr,v. ilf, pmpcdy fr rlr Nq!,.o1
<br />l. !sowncro, rhc,'rcncnr. amcxclu\irclyconrmclira sirh li.ctr{d ..irn.loN lo conslrud lhc pkiccr(Scc 7(!l.1. Bunne$
<br />a Phns\i,n Codc: Th. Conta.roas Lic.nsc tis docs nor lplly ro an o*ncr oipmpcnt rh,) blildr or i,nprovcs rh.rcoi.
<br />and who conrra.rs,nr such l,olccts with 3 (bntE.ror(r licctr*J pur\unnrrorh( Cofta.ror's Lic.trs Ll*1
<br />-l
<br />rcxcmDl u.dcr S<ion-.
<br />I hcrchyr,ltmu crF.tr.ltyolttrrlury.nc.f rlrlall,,*nr8d(lrrri,,n\:
<br />lhrvcr *ill rnrlri'rrCcd'fi.arcof(l,nscDrkiSclt:ln!rcnrworlcn.rnnpcsinn,.r\rrt,eidcdturbySc...trl7f)olrh.
<br />bhr C.d.. for rlf pcrtoirnan.cofrtu aork lin whichrhc pcnnn t isncd
<br />_lh0vc0ndwillnxnnrairw.rkctr conD.ns ion in\urafuc. ^ r.+ncdbtSc.ri.n.lTmofrh.t-rh.rCbdc.lorrhcpcrfoirroiccol
<br />ihc work rbr s[ich lhis pcmn is timd Myuo.kcs codpcn{rbn ihrutukc&trtr J B,lky mmbf r.
<br />I ccniryrhar in rhcn rrornEnccollhc wort lor whichlht pc it h isiucd.l sh.ll not cmtloyuny!'cnon ir anymarrc.
<br />s is lo b.{onf, subJ..r ro rhc woltns .omFnsario. hws.l Califuni!. ,nd tr8ft rhar ifI shoxld h.oft subjcd b rh.
<br />*orkc6 $nFnsarionpolnionsofScclion1700ollhcIjt,C.dr.I\hill.f(flhwirhompl,wirhrho$tmvhionr.
<br />WARNING: Fuilurc l. slrc workc6'co rcnsatior ovcm8c is unl'wtu1. md shrll subjccl rn cmploycr l,gimiMl p.nuhic\ und
<br />cilil fincs up ro onc rDndrcd riru\and dollus (Sloo,OxJ). in iddilion to rhc cosl of.onrDcnsalion- d0rruecs as polid.d ftr rhe
<br />s.L,'on ru7h.r rh. tibd corc. drcrq Md rormy . rh o/l (
<br />fr.te, Apprimn': ( U.t#
<br />L!( Ft\SEr) CON',tFlLl OR
<br />DF('t ARATI'N
<br />I hrrcbyafttr undcr r. rhy oi p.rjury rhar Ltn lien\d undcr l]rolisi{,n of Chaprcr I (L\rnnEking snh Sccrion 7m0) of Oivision l
<br />of lhc Businc$$d PnlcsbnsCodc. md nryliccnsc il in iull r(,.0,Njciti.t
<br />LiccD$ Numb€r:
<br />Contrelorl
<br />coNSraucII.(lrI[xDtNGlcENlr
<br />I h.r.by allirn u q pcnahy oi pqJUry rhrr rhcrc t a co.srucrio,r bndio8 qcncy 6! rhc l].rfonuncc af rhc *ork ror $ hth rhn Frnir i\
<br />is{r.l(Scc 3tYr7.Civ C )
<br />AITUIAILIIEI;LAEAII!]N
<br />, h.rcby anjnn utrd.r |).mx, ol tujury om or lh. n,lbwing d&lnark,.\
<br />Dcnn irion Pc.hirs Arbc{os Norificatn,n Fcdrhl Rcrlhrions flnt 40. trd6)
<br />Ruquir.dlxncrof Norifi.ar n
<br />-lccnitylhal
<br />lhc,cderal rcBul4ion\ qndin8 ashcslor rcDFvnl.rc mr {'flicrbk l. tht pn+ct
<br />lccnitrrhrr I hrv. lcrd rhi\ rpplicrri{,n a drrcrhrrrhcrho!.inturnuti.ni\cotrccrlrgrftroconDlywirhrllCiryandCrurl
<br />ordi'rnnccsrndSrrlcl:rwsrcbritrgl,,huildinrrcnsrrucliotr.ffilhcrchyrulhorizcrcpr$.nrnlivc\oilhnCilyxndCortrrrrornrc'uFnrhc
<br />rh.vc mctrridrcd prot)cny lnr im!(rir)
<br />^
<br />\nDlirh,'l nr \*rd \ixDrllJn
<br />r'.nnirr ns .r|ldnll: C.l ,2 ((/4art u1O
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads tt/trlt .&:)
<br />UFER Ground -/
<br />SLAB Floor
<br />Su bf loor/Vent/lnsu lation
<br />Roof Sheathinq
<br />r z/rt/tt .rHit)
<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 / /tf/q -tN-a,
<br />Certificate ol Occu pancy
<br />Notes, Remarks , EtC,
<br />Shear Wall
<br />Framinq
<br />f T------
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