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BUILDING. INSPECTOR REGORD SITE.WORK DATE ID/SIG.COMMENTS O\lNER BTIILDER DEI,CARAT('N I h6eb lmrnr und6 poalry of p6jur,v rhar I fln ercftpr lroor lhc Contr.dou l,icos l,N lor lhc lolknvDs rd$n (s(70.115 Busn6s and Prol6!.n Cod.,: Any Ciry or ('ounr) shich rcqun6 a r6rn ro ...srtucr. ah6. ifrpro!.. dGnolish or rimn ml strucrur..,nnn b ns issutur.c. .le r.9ui,6 rlE amli.d lor strch t)mn ro file 0 siencd stat6n6l rhal hc or nre is licms.d puEtranl ro rh. fovirioN ol th. Conta.roas t-i..nscd b\ (Chafl- 9. (ifrn.ncin! rirh Sdrbn 7000 of Dilisiof, I oflh. BtrsinBs rnd Pft,fcsioosCod.)orrhar h.orsh. is.rcnrpl ihdcfton Md lh.trsis ror rhc nllqcd c\.mp{ion Anyviotaiionolsâ‚¬crDnT0ll5byan}- .pplicair for a pâ‚¬mil s'bjslsrh. apDlicanl lo ac'v,lp.nalryofnol nFr.thd fi!. hund(dddlles($5001 l. .s o\us of rhc lropdly. or mri .mphle \ irh sat6 0s rh.ir $1. .onrpNtion. \ ill do th. \ ort od ih. slnd,tr $ ('r inrdlnl or orTs.d for sl. (s< 7044. Busi6s and ltordsions Code Ih. (tnr&r.r\ l-i.d* Larv dJ* mr rpplt ro m o{n( ol llE r.orEny \rho buil& or inprov6 th@n. nnd $ho do6tuch \o hims.llorh.elforlhroushhho,herown. ploy.s. p.!iti.d rhar such imEo\ nrdG ft mr idad.d or olTa.rl ftr sk ll h.\v6 d. rh. h'l]{l]nr or nnr rmni is Fld wittin onc Jtr nfc6mpl.rion. rh. (\ nr Blild< Nill hav. lh. blrdd olrnying rhd hc or s}c did tur h'ild or i'npror. rh. pNr6, aor th. purfrs .f I. a o$nd olrhcrord!. ,n .r.lGircl, .onta.rins \nh li..ns.d .ofui.kr6 ro .oNrtrd rh. Fojd (Se 70,14, llrinKs ant PNa6irn Codâ‚¬: I hc Conrrrcxn s l.iccns. l-a{ do6 nor afp ly ro a! o\ n6 o l aropcd ) s h() huilds .r imptuy6 rh66n, and qho conlrads lor srch F/oids \nh a (-onrmdo(s) li.dsed pusranr ro rhe(-o.nadois Liccre.l-i*J lan erernpt trnds S(tion D.te: Orn.r: *ORY.ERS (OMPTNSA-IroN DECTAAAIIO! I h.r.by amrn u.dd Fnahyolpdjuryon.oarh. followin! daledio.s: lhorcond\vill m.n .insC.nificarcof(onsd lo selfln$trc lor s orkd s' comparsii.n. 0s proridcd ior bys$lion r7(x)ofrhc t bor Coni aor ihc pdaonnm.. of th. wort aor *hich rh. pnnr b issu.d Ihareaod\ill,naintaintrorles comrrnsarion iNurancc..( requircd b) Sslion l7(Xrofrhclibo.aodr- forrh.pr[,nn.n.cor lhc sork forrhichlhh pemrit is issudl My\rorkEs.ompdsarioninrrancc.ario dI'(,licynumhsarc: gl!jila!rfla!l,E!D!!clc.!r!(! I hfthy amrm un<ld rEf,ahy olprjury rhal rh6c ts a.onsrru(ion kndin! ar6cy forrh. r6aonn.... ofrh. $orh ior \tichlhis Fnnil is issu.d(ss lr0!7. Civ. C ) drfucaNlDtlltBAtll)! I @ aran trndcr pâ‚¬.ahf ofp6irn one oflhc aollo$inr d{laralioas: I)emolni.n I,amirs- sh6tosNorili.arion I.nd.l R+uhrn!ns(Iilc,l0. l'.n61 R.qun.d Ldl6 oa Nolific.lion I .dili r h.l rh. lcd<.1 rcsular ions eEedins 6b6ros rm.val e. nor atpli.rbL lo thi! p6jd I Ldit th l ha!. @d rhi! rpplic ion ..d nar. rh6r rhc ahrr. inlofuion is coE*t I a8E lo .onply wirh all Cny rnd County ordimn.s^nd srd.Irsrddi sm htri nr!rqlsnarn s of lhis ( il! and Cotrnlvlo ols trDon lh. rli,\r r.nrkrr.ll tn|cn\ n! ,\pDliNtrl or,tEent Sigtrslurr l'erri(â‚¬. n{n,â‚¬(prinr): y'--Vr r/ ra.4 pl>ltt Set Backs Erection Pads UFER Ground SLAB Floor Subf loor/VenVl nsulation Roof Sheathing Shear Wall Framing lnsulation/Energy Drywall Ext./lnt. Lath Brown Coat l\ila so n ry Pool Fence T-Bar Handicap Req Deputy Final Report Engineer Final Report Flood Zone Certif I .r--\ FINAL vlal2on ) vz) p"ncy T I urCertificate of Occu Noles, Remarks, Etc Policy Nunrb.r: lrttrcs I cdliar- lhar in rh. F lorninc. ofrhc rvo.k aor $nich rhk pdnit is issu.d. I shdll nor anployanyp6son in any ma.ncr $ arlo hccomc bjsi loih.Nolt6 comp.re.tion la$sofcalifolnia. andnlRrhat ifI should bccomc $bj6r loth. *orlisl compeN.lion pmyNions orSalion 1700ollhc L,tor Codc.l shal!.lonhs'tth complr \rilh lli* pmrilnrns WARNING: Failur. to kLtr. \r.rkn .onFtsdion c.\daE. 's unlaslul, dd sh.ll suhjd d an!1o!6 ro nnninalrs0lti6 md .i!il fin.s trp ro on. hundr.d rhousdd dolld (S100,00o). in addnion tu rlt con oa.omr.nstiotr dona86 d F{o\id.d for lh. s.crion 1076 ol rh. llbor Q)d., inldd md a(om.y s aa Drre Applionr: IICENIE!-g)NINACIAA DECIABtrIIOX I hftby amrn undo p..ohy otp.rjury thal I am lic.n*il !nd6 rro\ision of( hapls 9 (co'nmcncins *nh Sdtion 70001ofDnision l of lh.Bsin6s d ProtBsioNCod.. di my licdse is in tull forcc rnd efi(t Forms/Steel/Holdowns