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SITE.WORK DATE tD/stG.COMMENTS Set Backs Forms/Steel/Holdowns Erection Pads SLAB Floor Subf loor/VenVl nsulation lill llngRoof Sheathi 7 bi{t-4n P(a ,*Pr) Shear Wall r'I <-h '51l*,*, .,21( Framing lnsulation/Energy Drywall Ext./lnt. Lath Brown Coat Masonry Pool Fence T-Bar Handicap Req Deputy Final Report Engineer Final Report Flood Zone Certif FINAL It/'t /'l 1'Dt*,4U 1{5 Cert ificate of Occupancy Notes, Remarks, Etc. OlINTJR BIIILDI]R DI'LCARAl'ION I hcreby affirm under p.nrlty ol pglury lhat I m c(cmpl iiom th. Co raclon l-icEoe l-as lor rh. lollosins rcaq,n ls( 70ll 5 Btrsin*s and P(f<rion Cod.) Any City or C.u y trhich r.qut6 a tann ro ...ntuci. ah6. nnprola dGnolish or-?efli (rucntre priorr. ns isu ce- ol$ rcqun6 ihc rpplicMr ior sucn rnnii lo 61. a sisncd sraheor rhar hc or shc ii li.osdl tu' IrelessionsCodc)orlhal neorsh. nâ‚¬\cmpr rhdcliommd the b.s6 for lhc allcs.d .ronplion Anyvnnd'.nofSdrion70:rls appli(a.rtuap.f,hnsubje$th.al,ph.a.rroac'vilp.nahyorno"nor.rhnnnr.hui&.ddoll s($5001 h rhâ‚¬ InivGio.s.frh. conta.ro.s Lic.ns.d L.$ (c'haprr 9. co,nm.n.in! trnh S.crion ?000 of Dilision I orlhc B l.D â‚¬\empl underSslNn o,o,* 6'7o-l l.flif) rhrr in rhc pofomaic.oarhr$.rk itrNhichrhsp.nrn is issu.d.l shall nor .mploy .n! ps$n in.nynrann.r s, 6rob<oD.s'bjd to 'h. $ o! [m' comp.ns.rion lawsofCalifomia a8rce rhar ir I should b.com. subrdr ro rh. $ork6' conD.nstionpro\isio6ofS.clion]TOOorlh.lah)rCodâ‚¬.1 l. 6 oMtr ol thc proD.ny. or my cmployG $ilh vag6 s th.ir ele coDp6aton, rrll d. rh. \r.* md rh. slM$. is mt inroddl or ollocd for el. (Se 704,1. 86i.6 dd Proi6sio.s Cod.: Tn. Conhrctor s Licos. bw do6 nol ipply Io an 0*16 of lhc pNFly \rho ti'il(G or impror6 rhs@n. sd who do6 slch \Lo* hims.llo. hdElforrhmugh his or hnorn mplor.6 providcd rhar such inpre\ noc e ml inhd.d o! or6rd for sle I I ho$ 6'6. thc tlildina or inForEMl t $ld s'ithin .n. \tr ol.onddir( rh. Ov.d Buildd $ ill h,vc ft. hrlcn olrovins rha h. or sh. did ,ror build o. nq,ovc thc FoFty for lhâ‚¬ purros or L a ou nd olrnc prcpdy. dnelclusnc!co racriq qnh li.oscd conracroB ro connrud ih. Iroj{t (sr 7044. BG'nN and Aifdsirn Cod. 1h.Gr.t,croast-ic.nscL,Rdo6ndrdlplyro o$ns ofpropd!, trho buildsor improrcs rhssn. a rvho coitEcG ror such pror.ct Nnh a Conhdo(s) licascd puslant ro rh. ConrB.loi. t-rds. Las ) l)rrâ‚¬ osnrr:roaKlasllIfliNs -t!!)rUESnIAlllJ! I hoeb! amrm0trdd l)(aalryolnd 0r).ne.frhelollo$rn*ldl altns rz'I h .ed\illmamhmranrfirar.ofcomnrros.lf-lBur.lorsorl6 comFnslion. s lro dâ‚¬d lo bys(rio.1700ofrh./Qb.r ( od., tu rh. pcfnmr(. clrh. qn'l lcr {h(h rh. t6ntr F str.J I hai c .nd sill mainlain worl6 comp.Balion iNurance. s rcqunâ‚¬d by Sdro. 11700 orlhâ‚¬ I abor Cod., a.r rh. !dfomd.. of lhc s,ork for uhich rnis D.nnil is issu.d. My u,ort6 comp.6d ion insurmcc cui6 od rDlry numbd a. c*;., ar{(â‚¬ â‚¬O,J> eaxrr," * CtZl 43 OO 8,) y6 to orinnl p.n!hi6 andWARNINC: Failur. r. Rr. \orkds .onpmeri.n..!dag{ Ls ur .iil lin6 up ro o.. hundrcd rnousand dolld {1100.000), in addil inrddddaiiorc) s 16 males as lndâ‚¬J for rhr /o Io K 112V I hrâ‚¬b) afiinn undd p.na tyolpgjurylhal I dn licosrl undc' Forni d 9 (oinnh.r! \irh seloi 700{)ol l)Nhion l ol lhc lruslnsand Prel6sionsCod.. a.d mr liccnF is in lullrorcc 12/--{C-r 7qtrInr-r--- I hsrby rtfirm undr Falry o f pfjury lhal rhd. is . .o.no.r$n kndhg issucdlS( 1097. Civ. C ) AITIICANLDEI]dIAU(I! I hq.tr.lfim undr pâ‚¬nahy ofpcrjuq on. oflhc followins d(lmlions D.moltrion P.rm+^sb6rcc \.nncdion I.ddal R.Frldion\ r I r1..10. Puii5, 1R.qtrr.d L.lid of Nd'6calnn D lor ihclEloflnanc.ofrhcro* for\hrhlhxFm t I.d1Ll\ 11 1 rl,. fuJorl,r!trlxhf nic!asb.sr6 rmo\al e. nor artlicabl. ro ihis prej(r I cnil rhd I h.\c rad rhis appli.arion ordir.nc6 atrd Srare LaNs rclatiq ro hrildi.r abo\. nBlioncd pmpolr for iNpcdion DU ,{lplic.nl .r A8enl Signilu P.rmilft mn'.lprinl):I oS I agre ro cooply Nirh all cirya.d co my dtr6f,lrhtra ) Md Cou )roaidrxpon to lzzltTtu", I t UFER Ground BUILDING. INSPECTOR RECORD