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BUILDING- INSPECTOR RECORD
<br />SITE-WORK DATE COMMENTS OWNER BUILDER DELCAR TION
<br />I hcEhy aalifln hd( ,.nrhy oi p.rjury th0l I m cxcmpl frcm llE Coniii.k,J Lic.ns tr$ fot tfic tollo*ins rcasn (scc 70ll 5
<br />Bu\ilcss ,lx] Pr.r.si.tr Codc): Any Ciry or Counry shich rcqutc\ a Fhrir k, .lnNrucl. oltcr. i'nPn,v., d.mlhh or rcPan !n,
<br />nrudurc. piff ro ts ksuance. aho rcqri(s lhc appli.anr rd \u.h lImnr b nt o \i-qncn (alc8n! rhd h. or slE h liccnsed pur{anr
<br />tr rhc F,vnions ofrtE conklclofs Liatr$n ttrw (ChPrct 9. Comnrrcirs wnh Scction ?U)O of Division I ofrhc Businc$ .nrl
<br />PofcssnN Codc) or rhar E(or\hc crcflpl rhcrcliomadlhc hrsN fo.lhc ullcacd qctrllrrion Any viohrnnrolsccrionT0-rl5 brrny
<br />rrplicdnr f.ral.nnir subjerlthc apllicotrl ro acivillcnolryofnol!to8rh fiv.lrundrcddolltrs(t5OO)
<br />-1,
<br />rs osrcr ot lhc pmrEny. o. fry cnDloyccs sirh w!9.1 N rhcir $lc cnnPcnsd ion, will do lhc solt .nd lhe slMl@ is n.r
<br />inrcndqt orolrcrd lbr el. (sd.70,14, Busircss d Pnlcssions Cdlc: Thc A,fl m.r.i's Li.cn* hw dms nol amly kJ d owtrd of
<br />rhc tn)ridy qh) blildc ur iiip,orcs lhcNn- aM who d@\ ssh wo* hi'ns.lr.r hcrcllo, rhnush hn ot hd ow6.mplolccs.
<br />providcd rhrr su.h Dpn,mnEnk m mr i' cddi or .rT.rd f(r ek. Il ho{crcr. rhc hliklins or in{,roltEnr is vtld wilh onc Fm
<br />.fcdnpLrirn. rhc Oencr Buikls willhls rhc budco ol povinr rhd hc or {hc did nor buikt nr i,rlDrc ff, PR,Pcny for rhc l)urlbr of
<br />-1.asowncrofrtcpmpcny.r
<br />crclu\ivcly.ontrlcrins$ilhlicctrrdcor.r.dsro.otrsrucrrh.Pft,jccr(Scc7(}.l,}.ausNss
<br />d Pnfssi,nQ)dc: Thc Conlraciitr's l-ic.ns.l-rw do.s nor nr)dy to atr ow.cr olpropeny $ho buildr or irnfrovcs rhcrton.
<br />utrd sho conrlach n, ru.h tojcch sith. Contflcnn(, liccn*d plr\urm r) rhc Contlcrois Liccns bw).
<br />I rrc\.n,|n un,l$sccrii'
<br />DII]LAEAIIOX
<br />I h.rchy rfitni uidcr r.nrhy ofDcrjuyonc olrh. li)lL]$ itrg lcchBri,n$
<br />I hnv. dd sill nriN{iniCcnilicdcofCoo\cnrh Sclflr\rrd for $.rkc$ comPcnsdion. rs providcd fdbyScclio l7(Dol rhc
<br />l,ahor Codc. r(, rhc tcrronnncc ol lhc aork,i, uhi(h rhc pcrn r n isx.d.
<br />lhrvcrodwillnninrrin$or[.rr.onf..slri('nin.uDrRc..s,cqutcdhySNrir,]7m.lrh.l-,horCodc.lorrhcp.rloflmn.cor
<br />thc *ork l'or *hich lhis pennit is i\\!cd. Mywork.is corDtN.tiotr insur!rcccaricr andFhcynunrhct irc:
<br />s ci)'7 -to a,-8 - t1
<br />-l.unifythrliothcpcn'o',umcofrh.workLrwhthrhhr-_rnririsissucd-Ishrllnorcltlbytrnyt'c6oninrnymrirErq, xs k, h.co'ft subi.d to rhc qorkcs' comrnv'l ion hss ol Cll ifornir, Nd rsN rhllill stx,uu h.$m subj.d h ttE
<br />*o*crr.o'nnnsdionprovhionsolSdionlT00ofrlthbo.C{xl..ldDll.lbnfi*irhqnnPl!wirhlk$Pmvisions.
<br />WARNING: failurc ro surc wor*.is .onD.ns,rion ovcnSc n unhwl'ul. ,nd shrll suhjd rn cn{'lorr lo omiml FM]ra\ rnd
<br />civil fincs up io onc hln.lrcd rhousand dollus (SIft).uD). rn nildilion lo lhc con or tomp.nsntion. damacs $ pmlidcd ror rhc
<br />::::4ryU:i
<br />Ihcrobtrlft !fd$ Ftrrlry o f tujry rhri I u licrnyd trfttcr otr.iChrlirer 9l.onnnc'kins wirh Sccrn'n 7t{x)l ol I)ivi\nnr.l
<br />q. 0- Crn ^cvl 4+'t-.5b1
<br />4:P +$ ."",,".,", Mk{6E4 €\qEIY !r"tv!
<br />(]{TNSTRTICTloN LENDINE AGITN(]Y
<br />Ihcrctryrlfii,nu'{t.rp.rlryol$rrythlltllErchaconslrclionlcndings!$.)forrhcpctlirrn ccolrh.*.rkiorshichrIi\Pc.nriris
<br />i$ucd iscc .l0r?. Civ C )
<br />Lrtr,l . q' rc$
<br />ATPUIAITDEgLAEAUAN
<br />I hcE-by afijm udcr p.nrlry ot pcrru.y orc ofrhc follosins daluariois.
<br />Dc Dlition Pcnnils Asbcsros N( iri.{ion Fcd.r0i RcEUlorions (Tillc40- Pnn6)
<br />-Rcquncd
<br />krlcr orM ifi.,ri,n
<br />l.cn'fyrhrr lhc ltdcralrc3ulalions rcgJrdio! r\h.{.s rNx,ulJc trorr!flic.blc t' ll,i\ Ix,Jc.r
<br />l .cd ily rhd l h,u rcM rht !!pliut ion dd nrrc rh3r rhc rh,vc infoa[tti.n n conccr l rgrR ro .onlt'ly wilh nll Ciry aid Counry
<br />ord rMcs and Shrc tjws nhrins lo huildins cnn{tucrt'.. and hdrchylulhoriz. rclrcsdrriv.\.frhi\ Ciry.trd Counry lo c cr UFD rhc
<br />rl$!. .nri,trrtlf(,rdyn)r
<br />#fulEWL
<br />-rz- tB
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />UFER Ground
<br />SLAB Floor
<br />S u bf loor/Ve nt/ ln s u lat ion
<br />Rool Sheathinq
<br />Shear Wall
<br />Framinq
<br />ln s u lation/E nerqy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif
<br />FINAL (2,1t1(6 -,<tztzt(
<br />Certificate of Occupancv
<br />Notes, Remarks, Etc
<br />tD/stG.
<br />Erection Pads
<br />oi rh. Bu\i',c\\ uiJ P6tu$n)ns Codc. $rlDy liccnse h in fulltrc dd cflt.r
<br />Letu].is N.nr'-
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