Laserfiche WebLink
BUILDING- INSPECTOR RECORD <br />SITE.WORK DATE ID/SIG.COMMENTS <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads 0-dz, <br />UFER Ground <br />SLAB Floor <br />Su bf loor/VenVl nsu lation t, <br />Roof Sheathing J,,6rlb <br />Shear Wall \-/t \ <br />Framing <br />lnsu lation/Enerqy I {w <br />Drywall <br />Ext./lnt. Lath <br />Brown Coat <br />[Vasonry <br />Pool Fence <br />T-Bar <br />Handicap Req <br />Deputy Final Report <br />Enqineer Final Report <br />Flood Zone Certif. <br />FINAL v*-Zt Yrr-'r dz-. <br />Certificate of Occupancy <br />Notes, Remarks, Etc <br />01VN1.,R BIJII,DI.,R )I hcrcby allirnr undcr lEnahy of Frjury lhal I am cxcmpt liom lhc Conlrrckrs' Liccnsc law for lhc folk)wing ]cdsn (SBc.?031.5 <br />IJusincss aftl Protbssion Culc): Any City or CouDty which rcquircs r lE]mit t(, construct, altcr. improvc. dcmlish or rclui any <br />slruclurc, lri)r b ils issuancc, also rcquires lhc apJrlicant tbr such lErmit k) tilc. signcd st.temnt that he or slE is liccnsd pusuant <br />k, the provisi()ns of thc C(nrlracbr's Liccnsrl hw (Chaptcr 9, Commncing with Sstion ?UX) of Division -l of thc Busircss and <br />Prufcssi(rns C(xlc) or that hc ()r shc is crempt thcrcfiom and thc hasis lbr thc allcgcd excmption. Any violation of Setion 7Ol 1.5 by any <br />lpplicanl for a pcrmit subjects thc applicant lo a civil pcnally of not mrc than fivc hundrcd dollus ($500). <br />-1, <br />as owncr ot'thc propcrty, or my employccs with wagcs as lhcir solc comJrcnsation, will do thc work arxl thc strutlure is not <br />intcndcd or oll'crcd ftrr salc (Scc.7M4, Ilusincss and Prol'cssit>ns Codc: Thc Contraclor's Licensc Law docs not apply to an owrrcr of <br />tlrc' pnrp-rty who huilds or improvcs lhcrcon, aml who drrcs strch work himsclf or hcrsclf or through his or hcr own cmployces. <br />prttvidcd that such intprovcnrcnts arc mrt mtcndcd orollbrcd lirr salc. Il, howcvcr, thc huilding or impnrvcnrcnt is sold within onc ycar <br />ol'complctiott, tltc Owncr Builtlcr will havc thc burdcn ol'proving that hc or shc did not buikl or inrprove thc propcrty lirr the purposc ol' <br />its ()wncr rll'thc Pft)perty,am cxclusivcly contracting wrth liccnsctl conlract()rs to construct thc pnrjcct (Scc.7M4,Busirtcss <br />and Pnrlbssion Codc: Thc Corttractor's Liccnsc Law docs not apply lo an owner ol'proJrcrty who buikls or impnrves thcrcon, <br />and who contracts ftlr such proiccts with a Contractor(s) liccnscd pursuant to lhc Conlractor's Licensc Law). <br />_l am B. & P.C. tor this <br />Ib o <br />I hcrchy aftirm undcr pcnalty of prjury onc of thc tblkrwing dcclarations: <br />-l <br />havc utd will maintain a Ccrtificatc of Conscnt to Sclt'-lnsurc lirr workcrs' compcnsation, as provitlcd lirr by Scction 3700 of thc <br />Latxrr Crxlc, lirr thc Jrcrtirrmancc of thc work ftrr which thc Jrcrmit Ls issued. <br />--l havc and will maintain workers' comJrcnsation insurancc, as rcquircd hy Scction .1700 of thc Labor Codc, fbr thc Jrcrfrrrmancc of <br />thc work for which this permit is issucd. My workcrs' comlrcnsation insurancc carricr antl Jnlicy numbcr arc: <br />Policy Numbcr: Expires: <br />ccrtity that in thc Jrcrtirrmancc of thc work tirr which this Jrcrmit is issucd, I shall not cmpkry any lrcrso]r in any manncr <br />as to hcconrc sub.jcct to thc workcrs'contpcnsation laws of Califilrnia, and agrcc that if'l should hccomc suhjcct to tlrc <br />workcrs' coml*-nsation pnlvisions ol'Scction 3700 of thc Lahrr CtxJc, I shall, tirrthwith comply with ttxrsc provisions. <br />WARNING: I;ailure to sccurc workcrs' comJrcnsation c:ovcragc is unlawlul, anrJ shall suhjcct an employcr to criminal Jrcnaltics and <br />civil lirrcs up lo onc hundrcd thousand dollars (Slffi,tXXt), in addition to thc cost of com;rcnsation, danrages as provirlcd firr the <br />Scction Ctxlc, intcrcst antl attrlrncy's l'ccs. <br />I)1.(].At{,\TION <br />I hcrcby allirm undcr pcnalty of Jrcrjury that I am liccnscd undcr prcvision ol'Chaptcr 9 (commcncing with Section 7firu) ol'Division -l <br />ol' thc Busittcss and Prol'cssions Codc, anr.l my liccnsc is in tull tirrcc arrl cl'fcct. <br />Licensc Class: Liccnsc Numbcr: <br />CONSTRUCIION LENDING AGENCY <br />I hcrchy allirm undcr Fnally of JErjury that thsc is a construction lcnding agcrey tbr thc lrcfformncc of thc wrnk for which this lErmit i1 <br />issucd (Ss. 3097, Civ. C.). <br />knder's Namc: <br />[.cndcr's Addrcss: <br />APPLICANT DECLARATION <br />I trcrcby all-rm under Jrcnalty of pcrjury onc of thc lirlkrwing declarations: <br />Dcmolition Pcrmits-Asbcstos Notillcation Fcdcral Rcgulations (Titlc 40, Part6) <br />_Rct1urcd lrttcr of Notilication <br />that thc l'cdcralrcgulalions rcgarding ashcstos rcmovalarc not applicahlc to this projcct. <br />ccrtil'y that I luve rcad this application and statc that lhc ahlvc inftrrmation is corrcct. I agrcc to comply with all City and County <br />and Statc [:ws rclating to construction. aml hcrehy authorizc rcprcscntativcs ol'this City and County to cntcr uJxrn thc <br />atxlvc mcntioncd proJrcrty for <br />Applicant or Agent <br />Pcnrritee nanre <br />o <br />Florr nP.-n7 -2n 1 6 <br />( <br />^ <br />z-17 1\ <br />t/trr/a <br />9lroht h{\4n <br />I