|
BUILDING. INSPECTOB RECORD
<br />SITE.WORK DATE IDiSIG.OIVNER 8T]II,D!]R DEI-CARA'TION
<br />I rtrrc$y,fltn! uid.r pdnlly.r t'crjury rh r I h cxcifl rn,n rhc cotrt{n)s- Licctrsc Lrw 6r rhc lnllo*ing rcas,n (sc.70ll5
<br />Busincss (M Prolls\ion Codc) Any Cily or Coutrly wht[ rcquirc\ a Fnnil r,, d,ndrud. rlrcr, i ln,vc, dcnFlilh o. rcP{n rn!
<br />dn'crurc, prirrn irs i\\umc. !l$ rcqrnc\ rhc rfnli.anr itr suchFnnirt, fil.r i8trcd n.hnf, lhd hcor sh. n licc.sc{t pu.n'onr
<br />to rh. pnlnioDs of rhc Contrrclors l,iccnscd l,s' (Chaptcr 9. Conn.cncins Iirh Secrn,n 70(x) of Divnn,n .l or rhj Busntss rtr,l
<br />Pr.lt$i{'n\ Codc) orrhrrhcorshc hcrcmfl rhercfromand rhc hr\ir ror rhc rllcsc crc'nfl n. Anyvn,hrn ofscclion70.1l5b,any
<br />rtrplic rli,rapcrn,ir \!bjcch rhc xp!licrirt, rcivilpcn!liyofior nor rhnn lnt hundrcd d.ll!6 ($500)
<br />L a\ ow.er or rh. pfl,Itny. or nry .nrk,r.s sirh rag.s * rhcir $k (,nlPderion. r'ill do rnc solt ad ltr dturh is tror
<br />nnc cd orofcrcn tur$L(Sa?t)44. Busirc$ a PmL$ion\(td. I'hc G'ntrctn ! l-ic.ns. bw do.r not 0rplyr. o.owrcrol
<br />rhc Im|Eny who hoilds or iNl'mvc\ rhc'sn- sd who lms skh *or* himsclfor hcisclfor rhmu8h his or h-r.wn cn'doyc.s,
<br />pr.vidcd rhrr su.h irnprulcnEnls !rc n.r irr. .tl or olTeEd lir \ilc. ll homrq. rlf, buikli.g or nlPrown. h $ld eirhm om ]qu
<br />orcomplcrbn- rtF O$n.r Brildd *illha\r rh. bdid.norpolins rh h.or\hcd{l n huin or impmrc lhc F)p.n, fo, rh. IlU tii{ or
<br />L sosncrofrhc p.lrrry. amcrulusivcly..nr crire wirh li.cnsl.d conrrrcn)F ro..nsrrucrrhc !fl,jecr(S*.7044. Busncss
<br />a l lhrl\sionCodc:'lhcCoorEclor'sl-iccnsel-!*.lmsnorrpplyrorn.wn.rolpiopcnywhotuilds.rnnprclcsrhcrcoi.
<br />rnd who .onracrs rd \x.h pn'l..rl wirh r Conhrtonr li...*al pusur Io rhc Conlrr.kn s l-iccn* L,w )
<br />I rm crc.rpr xnd.r Sftrtur
<br />!!!]S.tiEf,LrorlfENs rI!.}!
<br />DEIIA&IIIA!
<br />Ihc'.hynllr r udJcr rrtrrlryoft)cl,trrr unc ol rhc Ln[)*irx dc.hrrrirnr\
<br />I hrvcrtrxlwill nhin(rir rCcnllicrrcolConr n) Scli-lrsurc nn $orter'.ompcnsa!ion. pbvidcdfttrhyScctiu:17(X)ollh(
<br />ulDr C{xh, fff rhc Frl..nrn.corrh. work r(n shi.h rhc!.nn[ i\ isucd.
<br />, hNr.ndNillmii nir Norkcrr .onpcnsolion nr{uromc- rs rcquircd $yS..rn,n.l7mofrhc LrborCork. rorlhc 0qIr un..ol
<br />rhc work tu which lhislcnnil is isv'c,l Mywortcrl cornpcnsrri{nr i'rsufltu.. ri.r nM!.licy trtrmbcr rc
<br />(()NSlRt'cT()N t FNDIN(; A(;ENCY
<br />IhcNhy rflirmundcr NtrilrynltErjury rh lhcrcis!.on(ructionhndinga8cncyhrrhcp.rronnrtucorrhcworkr6twhichll'i!p.rmiris
<br />i\\ued rs.c 109? Civ C L
<br />L(ndci\ \anrc
<br />drulc NLD[cL$.trIlaN
<br />I hcrny lln'nundq p.nrhy ofpc{trry orc orrhc lnlh)eina dc.lrrrnns
<br />Dcnxniri,)n Pnnils Astt{or Norilicrri{n Fcd.n! llcgnhrii'ns rl iilc (). Pdn6)
<br />-Rcqutcd
<br />Lelrcr ol Noliricaii{,r
<br />l.ohlyrhrr rhc fcdcr0lrcBnlrriins rc! dirgrslic{nrrcN'v.lircnorlrpflirrhIt,rhi\IR,J..i
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />SLAB Floor
<br />I
<br />Roof Sheathinq (h,tl* t '1r/1,lrvlfu /5)..
<br />Shear Wall ------E
<br />Framing
<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 />Engineer Final Report
<br />FINAL 1lrI t,/14, [1)
<br />Certificate ol Occupancy
<br />Notes, Remarks, Etc
<br />COMMENTS
<br />UFER Ground
<br />Sublloor/VenVl nsu lation
<br />Flood Zone Certif .
<br />l .cn iry lhrt in th. p.rformmr oi thc work fu wh i.h lhi\ Fnnil h issued- I shlll n l enDloy ,ny l. on
<br />'n
<br />onymotrncr
<br />s ns b tf,.onr subjcl lo lhc voitcn'mmFnsalion hws ofcaliforni!- ud lgd rhd irI \thrld tr.om suhitt lo rhc
<br />$ortcn compcrsli.npmviions ofSccrnrn 37(x)oarhc L.hor Codc.I rhrll. r{,nh*irh snfly wirh rhoc Pmvhions.
<br />WARNING: Failrrc io {curc work.s ..mp.nrarion sv..,e. is unlr!tu|. nnd shall subjccl an cmplorr tn Gimhal pcMlrics.nd
<br />.ivil ,incs up r. onc hundr.d lhonsnnd dollar (SIftl.00O). itr rddilion to lhe con oi conrpcnrarion. drmsg.s os lrovid.d lor thc
<br />S..lion 1076 ofrhc tnbr Codc. inrcrcsr and lxorrcy s fNs
<br />D.l.r Applimnl:
<br />|.ICEIIID-CI}NINdEIOBpncr dn {TloN
<br />I hcrcby aiit utrdcr llcnallr of pcrjury rhlr I am li.uan !ndc! pmvisioo ot Chnpr.t 9 (..nrmftitr8 wilh S€lha 7Ol)O) ot l)iviri,,n .l
<br />or
<br />'hc
<br />Busin.ss a.d P$fcssions Codc. ud my Ikctrs n ir tull loE snd cfrccr
<br />lctrJc' . ,Il'r.
<br />-
<br />-l.cnify
<br />rhlt I h,rc Ead thn lppliarion dnd srsrc th,r rhc,tnvc infomrion h coftcl I a8s lo onrp, wnt allCirrand C.xnry
<br />ordiurcs lnd Srarc Llsr elaths ro hlilding .oostrucrao( ard h.ebFu(horn. EpEsntarircs oflhh City 8nd Colnryr. cord ulrn rlt
<br />abow .f,nriorcd pmrcny for i.spetiotr purposes.
<br />Appll.sl o. Asent SiBrlurc Dore
|