Laserfiche WebLink
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 />S u bf loor/Ve nVl ns u latio n <br />Roof Sheathinq <br />Shear Wall <br />Framinq <br />lnsu lation/Energy <br />-P/-lDrvwallt//1(lctuk/'tll//,1 I ffiExt./lnt. Lath <br />']lrY/U/0/t/Bfldru ruBrown Coat <br />J\Iasonry I <br />Pool Fence <br />T-Bar <br />Handicap Req. <br />Deputy Final Report <br />Enqineer Final Report <br />Flood Zone Certif <br />,'OtlIrt13y{au o(a/H{7WFINAL <br />Certificate of Occupancy <br />Notes, Remarks, Etc. <br />OIVN[,lR <br />I hcrchy aflirm undcr Fnalty of pcrjury lhrt I am cxcmpt fiom lhe Clontrackrm' Liccns [:w ti)r lhc li)lktwirg rcasrn (Scc.70Jl.5 <br />Busincss lrxt Protbssion Colc): Any City or County which rcquircs a Frmit k, conslrucl. .lter. improvc. dcmrlish or rcpair any <br />structurc, rbr to its issumcc. also rcquircs thc appticsnt tbr such lEmit t(t filc a signcd statemnt lhal hc or shc is liccnsd pmuanl <br />kr thc pn[isions of tlE Contmctor's Liccnscrl kw (Chapter 9, Conrmcncing with Sction 7fi)o of Division .J of lhc Busircss and <br />pR)f'cssions Codc) or that hc or shc is cxcmpt thcrcliom and lhc hnsis for thc allcgcd crcmptiotr. Any vi(]lati(tn of Scclitn ?0J I .5 hy any <br />lpplicrnt lirr a Frmir subjccts thc spplicant b a civil pcnalty of not morc than fivc hundrcd dollds ($5u)). <br />_1. as owncr of the proFrly. or my cmpk)yes with wagcs as tlEir $lc compcnstti(rn, will do tlrc work axl ttE strutm is not <br />irtnlc,t orollcrcdlirisdctSc.ZtX4,SusincssandPmfcssionsColc:'fhcContractor'sLicenseLawdocsnolapplytoa[owncrof <br />thcpn)Frty wlxrhuildsorimprcrcsthcrrn,iurlwlxrd<msuchqrfthimsclforhcrsclforthoughhisorhcrowncmployccs, <br />p.ruia"l rt or such imlhrwnEnts m fr)t intcndcr! orotfcEl lbr sk. ll, k)wcrcf, lhc huil.ling or imprcwmnl is $ll sithin orc )tu <br />of conrpbriru, rhc Owricr Buillcr will harc rhc ttrnlcn of pmving that hc or shc did nil build or itr[rcve thc prcFrly for ttE purlx)s of <br />sh). <br />_1, as owncr of thc prupcny, am crclusivcly c()ilracting with liccnscd conlracb6 k, srnslrucl thc p()jcct (Ss. 7O44, Business <br />anl pnrlssinCortc:ThiConrractor'sLicenscLawd(Esnolapplykranowncrofprolrcrtywhohuildsorimprovcslhcrcon. <br />and who contmcts for such pnrjccts with a C(nrtmcto(s) licen*d pursuanl lo lhc Contract()r's Liccns kw). <br />-l <br />anrcxcmpt undcr Sclion-. B. & P.C. litr this rcason. <br />}V() RKI.] RS' ('()N I I'I.]NSAI'I() N <br />DECI,ARA'I'ION <br />I hcrchy at'l'irnr under penalty of Jrcrjury onc of'thc tirllowing dcclarations: <br />_lhavcalrlwill maintainaCcnificatcofConscnttoSclt'-lnsurclirrwrlrkcrs'conrJrcnsation,as providcdtitrhyScctionST00ofthc <br />Lahrr Ctxlc. lirr thc Jrcrformancc ol'the work for which the Jrcrmit ls isstrctl. <br />-l <br />havc and will maintain wttrkcrs' comJrcnsalitltt insurancc, as hy Scction 17fi) of thc Labor Cildc. titr thc pcrlitrntancc tll' <br />thc work lirr which this pcrnrit is issucd.carricr and gllicy numbcr are: <br />Policy <br />_l ccrlily that in the perlilrmancc ol'thc work lilr which this pcrmit is issucrl. I shall not employ any lrcrson in any manncr <br />s6 as t11 bcconrc subjcct t<l tlrc workcrs' conrJrcnsation laws of Calitornia, and agrcc that if t stxruld bccomc subjcct to thc <br />workcrs' contlrcnsation pnlvisitlns 6t'scction 17fi) of thc Latxrr CrxJc, I shall. tirrthwith comply with thorc provisions' <br />IVARNIN(i: Failurc to securc wtlrkcrs' cttnrlrcnsalion covcraqc is urrlawlirl. and shall subject an cmploycr trt crimfutal Jrcnaltics and <br />civil lincs up to one hundred thousand rftrllars (sl00.u)0), in addit comJrcnsation. danugcs as prtlvidetl filr the <br />Scction 1076 of thc Latxrr Ctxle, htercst :rnrl atttlrlrcy's tbes. <br />I hcrchy al'lirm under Jrcnalty ol'pcrjury thal I am licensed provisurn ot'Chaptcr 9 lcommcncing with Scction 7firu) tlf Division .l <br />tul' thc Busincss anrl Prolbssions Codc, and tny licensc is in lirll lirrcc and cll'cct. <br />Nunrhcr:%qtoffiLiccnsc <br />I <br />CONSTRUCTION LENDING AGENCY <br />I hcrcby atfum unrlcr pemlry of pcrjury lhat thcrc is a snstructi('n lcnding aScncy for thc pcrlbmncc of the w(rrk tbr which this lrcmil Ls <br />issucd (Sec. .1097, Civ. C.). <br />lrndcr's Namc: <br />l.cndcr's Address: <br />APPLICANT DECLARATION <br />I hreby tllirm undcr penalty of Jrcrjury onc ol'thc lirllowing declarations: <br />Dcrrxrlit ion Pcrrnits-Asbestos Notificat ion Fcdcral Regulations (Titlc 40, Parl6) <br />-Rcquircd <br />Lettcr of Notilication <br />_l ccrtily that thc f'ederal rcgulalions rcgiuding ashcstos rcmoval arc nol applicahlc to tltis projcct. <br />_l ccilil.v lhat I have read this application antl stalc that the atxrvc inlirrntation <br />ordinarrccs arttl State Laws rclating to huilding conslructiorr. arxl <br />ahlvc nrcntioncd proJrcrty lirr inspclitln <br />Applicant or Agent <br />Penrrilee n$nle <br />(_ <br />is corrcct. I agrcc to comply with all City antl County <br />reprcscntativcs of this City and County ttt cntcr uJxrn thc <br />I <br />i <br />,,^,,, ll f llli8