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BUILDING. INSPECTOR RECORD
<br />ID/SIG.COMMENTSSITE.WORK DATE
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Rool Sheathino
<br />Shear Wall Aloq-lf Y-14jilFramino
<br />lnsulation/Enerqy v \J
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />It/asonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Reporl
<br />Flood Zone Certil.
<br />A
<br />FINAL lo -zo-t(
<br />Certificate ol Occupancy
<br />Notes, Remarks, Etc
<br />OWNAR $UILDER DEI,CARATION
<br />I hcrchy ,fi1fln undcr penrkr of p.rlury rhrr I rnr crcnrfl lmn rhc C.nk.clor' l-iccn{ bs ntr rhc lollo*inc rcx$n lscc 7(r.ll 5
<br />Bu\incss rnd Proac\sn Collc) Any Cily ot Counry whi.h rcquncs u Pcrnrir ro .otrsrlcr' lllcr- ituprolc. dcnFlkh or runJt rny
<br />ntudur. pri.r tr ! nsuatre. xho Equnc\ rhc dpdicint lnsuch pcrmir b lilc I sisncd irrcm r rhnt hco! shc i\ li.cn{J Durnr0d
<br />ro rhe pmrnion\ .fthc Conkrlois l.ic.nscd trw (Ch{tcr 9. Connncnci.S qirh Scclion ?000 of DivBi(,n 3 ollhc Burntss rDd
<br />Prnas\i,,r\Codc)orlhllh..!shc i\cxcnlr rhcrclromrnd rh. t'r\i\ ror rhcrllc8d.xcmPrn,n nyriolirionorsc.'Fn70lr 5hrlnv
<br />.tpli.rnl l'or a |Ennir s!hjlrr\ rh. apflicanl lo n.ivilpcn,xyornot rn.rclhan rivc hundEd d.lll6 (S5lx))
<br />L r\ oskrot rhcpmlcny. nrmyc'ntloycs wirh wucsa\rhcir n,lc.o rFn\.lion. silldd dr wort md rnc dtulm i\ mr
<br />imctrd&l or o0cleJ t(,r s!. ( se.7(,4. Ausincs ud Prokstunr C(d. Th. Contr(ttr \ Ldnse I is doc\ nor lpllv lo an o$ tu! or
<br />rhc fm!.ny who builds or imln,ks rhcon. ,nd wht d@s sk lr work hnhsclt or hcrrcll or rhn,ugh ht or hcr o*tr c rdoyccs.
<br />Irovidcd rhrr skh i'npovcmnrs m Nt inrcftl.d or oficftd f(tr *&. lt lxNc\rr. rh. huil]nl3 or inpo\ttrrnr h sld sthio om ]tr
<br />o, co.Dlclion.lhc Ostui tsu dn will hrvc rhc tud.n ol PnrnrS rlur l[ or shc dil nor huild.! lmnr!rc rlE fn)Pcnv fItr rh. lNrl.s o'
<br />t..sowncrolrhctep.ny, arcxclusilelrconrracrinB*irh licctrscd conl!&io^ ro conslrucl lhc puc.r (se 7Or4. Bn'in'*
<br />ant l\.fdsi'nConc Thc Conrrucln \ Li.cnsc L0w des n.lrnplyh atr.*ncrolnropcny*ho buildr or impovcs rh.rcoo-
<br />,nd qho conlmch for sxch poF-rs wilrr a G,nrrscr.r(s) li.ctred Fnrsunr b rh. C..r.cror's Li.cnsc Ltrw)
<br />I anr cxcmt,r!ndcr Sccr'.
<br />Doler oPner:
<br />ivoRKFI{s' airiumNs l IoN
<br />DI:CIABAIION
<br />I hcrcbyallirmund$r.nrkyort luryon .lln.n,&,sin!ddld!lbo$
<br />-lhdvcddsillruirrtrinaCcnificnre.rcon*rlloSclalnsurcl'orsorrcscomPcnsdion.dsF)vidcdrbrbrSccrionlTrx)'rrh'Uhor Code. aor thc Frformmc ofrhc work ror whkh $c Pmni is nldd
<br />-l
<br />hove and e ilt maimdin worrcG comPcn\aridn insuhm., !s rcqut€d hy sccrion .r7m of lhc ljtxn Codc. for lhc l].rfnrmn" 'rthc s.'l ,nr whiclr rl,^ ltrinr i{ h$cd My $orltcn ion in$trtri...nftin rtrd plicy nu.rbcr ml
<br />-l
<br />ccniiy rhtrr id rhc pcrLnnrnce olrhc tur rhi.h rhir |crnrir ir i\\ucd.I nrlln.r enrPl{iy ri, Nn. irrtry'mnrcr
<br />n, I ro t{.otrr su},Jccl ro rnc uorknt .oDrt'cn\alinn hws ot Calinnnia. Md agrcc rhii ifl nsuLl hN.nrc srhr.cr k,rlf,
<br />*oikcs' compc$alion pnli{ions of Ssriotr l7U) of rhc ljhtr Codc. I sh{ll bnhwirh .o.r v wilh rhot ln,visnnls
<br />WARNINC l,ilu . h e.urc q.'kc'. cnn'ncn\arintr .uvc is unlaRrul. ind shall suhicr an. fl.yc, to dminal Ftr,ki.s
<br />.ivil linc\ ut l().n. huMrcd rhousr dollar\ (5I(X).[XX h .d(liliu h rhc .os ofcollrPcn\lrn,n. drnl.llcr rs lniridod tnr rhc
<br />serion:1076 Dfrne ld$r Codc. inrcrcsl and
<br />^*-. 4h2)18 ^
<br />ffi
<br />ul'D !!! !-1\rl r!-Lr.lll
<br />DICI,AAAIIAN
<br />I h.rcby llrmu crrc.ullyorr.rjury lhrrI m liccna{uft1cr pn,!i\nr ol Ch!flcr 9 lco nrNirsqilhSccri.n7000)'fl)ivisio:l
<br />of $c auincss nnd Pmfc$iorr\ CoJc. fxl my li.cn$ is in lull lore rxl .ff(1
<br />a)
<br />Tz/e..,
<br />C(INS RIJC]'ION I FNDINC AGFNCY
<br />I hcrchy ifltnrundcr pc alr! or lcrjuty lhal rhcrc i\ d.on{ddion lcndinr n-qcnr, r{r rhc rcnnflroNe olrhc worllnr *hich rhn Fiini k
<br />n{kd ts& 1097. ('iv c r
<br />APILICANLDEIIABdfIO!
<br />I trl$y amnn udc, Fnally ofFrjury one ollhc lnln]ainB d&hdrions:
<br />ncmlri,n Pci,ni*.Asbc(osNoriri. io.F.dcr0l RcSulalionslTnt40.Pd6)
<br />-Rcqrir.d
<br />blrcr oi Nolifolion
<br />-l
<br />ccnilyihrr rhc litc nl ic8u lal ions rcgrding asb.sos rcnmvrl atc nor amli.ahlc to lh priccr
<br />l.crrilrrhrlll..Acrcr rhsx|)!licrtim nl drrc rhd rh rlirt irlnrmdi,rr is.onccr I ro compl, wirh all Cily rnd C.trnrY
<br />lrhis Cn, and Countylo cnlcr uron E
<br />*, f/zz/Le
<br />ordinrNcs rnd Slrr. l-rs\ rc!{in8 ildirE con\lrucrn,n. rid h.r.by rtrrhoriTc !ctrc\cihr
<br />rtxNr nrtrrnnrd pmlrrly tur in\
<br />/ <2 -y 14)IL
<br />I
<br />4
<br />Subf loor/Vent/l nsulation
<br />YIVJ.L{
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