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BUILDING. INSPECTOR RECORD
<br />SITE-WORK DATE ID/SIG.COMMENTS OWNER BUII,I}i)tr DFJI-CAI',ITION
<br />I hcEhy rfintr undcr pcmlry orFilury rh.r I mcrcnlPr rio rh. Cl, n.los !-i.cn\c ljw ior ihc r(nk,win! rc,!,n tsc(l!]r s
<br />Aosiic\\ xl Prof.sion C.dc): Any Cily or Gutrly whr.h rcquncs n lrcmir ro coi(tu.r. rltr, inrrmvc. dcmlilh q rcrD ony
<br />{fl.rurc. prirr b irs is\urtrcc.olso requn \ thc ofplic$l l'or \u([ pcnnirro i]lt a sigmd ( cnrtrr thal bcor shc h liccnscd purunr
<br />lo rhc nnvnnnrs oi llr Conrra.tr'r l-i.cntd ljt (Chrtr.r 9. connncn.ins sirh Secli.n 7()0O or Dilisn,n :l ol rhc Busirrc$ rn'l
<br />,I'rofcssi{'n\ Codc) or rhrr lr.rshc i\cxcnlpl rlrrcrromand rhehsn ior rhcallcscdcicmprion Anyvn rrnrnolScciion]l).ll56yut
<br />rmh.rtrr ror a lEi,nir {uhtcck thc 0rplic0nr lo rcivilpcnallyoinor m,rc rhrn fivc hu edd.lln^1S5r()).
<br />-r,
<br />tr\ o*ner of rhc !r,Itdy. .r ny rnDlorrcs wnhwig.sNrhct slc compcns ion. rill d. rht wo* nnd lh. nmlurc h mr
<br />icndul orolt rcd for slc (Sa.?04,{, Blsincssand fmrcssion\ Gis Th.C.nr,.rofr Liccns t w docs nor {p0ly lo o owkr or
<br />rh. nnD.ny who builds or i'nfmws rh.mn. md wh. des such so* hinself or hcrscli or rhrc Shhis or hcr own cnrlloyccr.
<br />lrovidcd rhai such impmrnxntaft mt inrerH oro0.E:d lorslc.lll ho*elci rh. hiHing or inpmttrrnl t sklwilhinonc )tr
<br />oi con{,trnrr. rtf, oqncr Builds will h.rc lhc burdcn ol pmviq rlnr lrorshcdid mt hdiBorim|'ok E pnrl.ny iar r]r puq$e ol
<br />-1.$otrcrolrhcnnJnny,amcxclusilclyconrracli'rs*irhlirunsed.oh.n,\t'con\rnrctttEl)ro,ccl{Scc70.44.Buqncl{aM Ptufs{bn C.d.: ThcContrcttr s Liccnsc Lrw docs nor.l)plylo nnowncrofprol)c y*ho huildsor inrproits lhcrr.n.
<br />and wio conrack ft, such prujcck wirh d Conr.idon, lkcned llNunt b rhc Gr rNlo rLiccn\cbw)
<br />_l,n.rcnrpt undcrSc.rn
<br />t1l)8ru&r:!a!lf!NlA1l!)N
<br />DICLAIAII9I!
<br />I hcrcbyrrr r uidcr t:nrlryorp.rjuryonc ofrhc rbll.wins dccl iiiotr\:
<br />I hav. uld sill ruinhin a Ccnincarc of CoDsctrr ro Scll lNurc l(n Norkcr' conl.nqdion. ,s pmvid.d rbr by Sccr i,)n .l7m or rht
<br />tjhf Gllc, ror rhc ,.domn.c .l rhc qort io!which rhc pcrnrir is issucd.
<br />I hrvc.nd willminrlain wortcr\'c.mpcosrriotr insuErcc. r\ r.+ncd hy sNr ion 17u) oi rhe Labor Codc. ntr rh. Frrornun.c.r
<br />lhcworkforwhi.hthnFirDitis'$ucdMysorkcscofl]pcn{li{{in\rrrnc..rmcrdtdpolicyntrnrtcraic
<br />",,,",,
<br />\ <in7y' fzr,t A
<br />P"txyN*,t ,: 4c 5 /02-? €c'\ tA ? r
<br />I t -z--/4:\tntsr."t
<br />I ccrlity ihar inrhcr.rfo nak.ofrhcwurkLrshi.hrhi\pci,nI i\ isucd.l rhall n.r cn,Iloy any pc oni'lanynmnncr
<br />q, mht(oN \uhjc.ln'lhcwo.kcr.-nrpcnsarnu k$s oi Caliiornix. md +rccrh ifl drtrld t$nnE subJ.ct t,rhc
<br />sorkc ompcnsrrin 0rorisions ofSccrion:17fi)ofrhc lnhrr C(rtr,lsh.ll. f.nh$irh.otrDly *irh ItoE prorisionl
<br />WARNINC Frilu,c r. {.rc r.rkcr( c.nrtEn{rion .orc[gc ir nnhsfu
<br />.'ril fi1c\ up k, onc hutrdrcd rhousrtrd dollar\ ($l00.lXl)). in adiili{,n I mrgcs r\ fnvidod ,r, rh.
<br />Sc.rnr 1or6.r rlr l.rhr (ixl.. ificrt\r rnd
<br />7- 1,''rq 7)
<br />DticLaxallo!
<br />I hcEhy {liirm umrcr pcnrlryolpcrjury lhrr I !m liccn\cd dhdcr pmvi\n,n orchrPrs 9 (c-nr.Ercins *irh S.crion 7000) oiOivnin:l
<br />ol rh. Burimss,nd Phrc$ions Codc..nd nN liccnsc t h full turcc !trd cltdci
<br /><a 4 zo3
<br />?-2" t Q 4"v 4aBEt
<br />(aNsIBllcIIANl[NllMiLGrNlr
<br />I hcEhy rfltn uodc. pcNhyorFrjury rhtrr rhcrc rs..ondfl.thtr lcndins.scncy tr rhc p.rtuilmit orrhc work r(tr rhich rhi\ r--nnir n
<br />issucd (S(. 1097, Civ. C.)
<br />L.ndca\ ALldi.\si
<br />-
<br />!lrqo\,.nn,vrlru r.r i
<br />I ccnilvnrr llr\( 'crd rhi\rrrli.ari,r I trN! intuirndiur t.or.\r. l.gre io comply trirh lll Cirrrtul Courry
<br />urdin.n.c( rnd Shrc bws rclrr
<br />iliovc nEnr ionc,l !rcFny i(tr i
<br />ht aurhfiizc rcprc{fltarivcs oflhn Ciry{.d Co! y k,.nrn uFotr rhc
<br />Appli.{nl.rAlcnr SigNt
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />Subf loor/Venl/lnsulation
<br />Rool Sheathing
<br />Shear Wall
<br />Framing //- t -14 J/,("-/?€)
<br />lnsulation/Enerqy
<br />Drywall
<br />Ext.i lnt. Lath
<br />Brown Coat
<br />It/asonry
<br />Pool Fence
<br />Handicap Req
<br />Deputy Final Report
<br />Engineer Final Report
<br />FINAL //- t -/,t/d c Ja:'Dk?
<br />Certilicate of Occupancy
<br />Notes, Remarks, Etc
<br />SLAB Floor
<br />T-Bar
<br />Flood Zone Certif .
<br />A.EEUCANLDECIABAI]O!
<br />I lf,arh) llltrm uodcr pcnully Drpc,jxryonc.rrh. r.lbwing dcchrdiotr\:
<br />D.rmlirion Pcrnrir+Ash.sros Norilic{rion Fedcal RcEubrions (Tirlc 40. P,n6)
<br />Rcqni,cd kucr oi Noliflc{rion
<br />_lccdilyrhxr rhcf.d.ralrctuldioncrgdd rB
<br />I
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