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FACTOR PSF ADJ.AREANALUATION p� OWNER•61;I1DER DECLAHATION SFR/ADD/REM O p 1 NEREBV AFFIRAI UiDEP VENALTY OF PERAIRY THAT 1 MI E%EMPT FROM THE CONTRACTOqS L4 � Ggfegfl/CfirpOR ' W CENSEUWFOFiTHEfOLLOWINGREA50N(SEC.70.71.68USWESSMAPqOFE5S10NSCO0EANYCRYOR (n � � U COUNTYWHMlIpEOl11RE5AVERMIi7000NS7RUCi,ALTER�PA�.DEUOLISH,ORREDURANYS7AUp � W Pa�iolDeck � � �1 � �' Z TURE iRqR TO RS ISSUANCf.ALSO REOUIqfS THE APPLICANT FOR SUCH VENIAIT TO FiIE A SICNFO � • � . � STATEMENT THAT ME OR SHE IS UCENSED PURSUANT TO THE PROVISIONS OF THE CONTMCTO(i5 L4 � � � C CENSE UW(GUPTER Y�COMMENCNU'MiFI 5EG7pN 70001�DNISION]OF iHE BUSINE55 AhcD PHD� POOVSpB 7l FESSqNSCODE)ORTHATMEORSMEISE%EMPTTf7ER[FROA1�IVDTMEBA515FORiHEALLEGEDE%EMP• C7 V TqN.MIrYIOlAT10NOFSECTiON7071.66YANY1I�PLMJNfFOfiAPEPA�ITSUBJECTST1EMPl�CiWiTO Z Re-Root ACML VEWLLTY OF NOT MORE THAN iNE MINDREO DOIURS IS500�.1: � � ❑4ASOYMEHOFTHEPiqVERTV.ORYYEMPLOVEESWITHWAGESISiHEiR50lf[DMPENSATqN, � �mmerciel ' � Z YYILL DO THE WOPoC AND TNE STRUCTURE IS NOT INTENOED OR OFFEHED iOR SALE(SFC.7a�,BUSI� J � N NESS AND PROFESSIONS CODE:7HE CONTMCTORS LICENSE UW DOES NOT APPLV TO AN OWNEIi OF ? �� � PROPERTYN?IOBUILDSORMVROYESiHEREON.ANDMMODOESSUpiY/OqNMIYSELFqINCRSELFOR Q 7T1ROUf:HHI50RMEROWNEMPLOYEES.VHOVIDEDTMATSUCHMVROV[MENTSARENOTMENOEDOR m W OFFEREDFORS4EIF,HOY7EVERIMEBU0.DINGORIMPROVEMENTISSOIDWRWNONEYEMOFCOMPLE• 0 TpN,THE OWNER�BUILDEP NnLL HAYE THE BUHDEN OF iROVIN�THAT ME OR 6HE�ID NOT BUID Ofi Z NIFROYEFORTIEGIIRPO5EOF5ALEx - �,.,: �.��•� = 04�ON�NEHOFTHEVROPERTY.AME%CLUSNEIYfANTRACTWOWTTNUCENSEDCONTiUC70R5 ..W (= TO CONSTFUCT TME PRO.IECT(SEG 70a�,BUSINE55 AND PROFESSIONS COOE:THE CONTitACTORS LI� VdIU9ti0f1 AQI.AAEJ1� W CENSEUWOOESNOT�PPLYTOANOWNEROFAPROiERTYWHOBUL�SORMPROVE37HEREON,�NO ,, � N�MOGOMMGTSFORSUCHPRQIECTSYATHACONiMCfOR�S�LILENSEDVURSUANTTO7MECONTRAG QUANTITY DESCRIPTION � �E � TORSLICENSELAW.�. , , � � 0 O I AM IXEIAPT UNDER SEC. B.1 P.G FORTHIS REASdt O �� C �,Q^ S � . . . . �r�i�„���`^ ,. �� . . LL DATE ONTIER o �C)Z • �L. 1 A1�- � LICENSED CONTRACTORS DECLARATION Z , N TV � INEREBVAfFIRUUNOERPENALTIOFVE0.tt1RVTMAT1�uLICENSEDUNDERDROV15lONSOFCHAPTEA � ��r (� d Y(COYAtENCwUWITHSECTION7000)OFDmS10N1OFTliEBUSINE55ANDPROFESSqNSCODE,MA � � "'^ � �� S r14� X MY IICENSE IS N Fl1ll FOHCE AND EFFECT. Z �V�Q ��S W m _ 0 LICENSECUSS�� L-�L� LIC.NO. � y t��y�] a � U WDATE U�Z^Q1 COHTMCTOR��J�—L_� J 1� \�`J•7L`G �� v C , � WORKERS'COMPENSATION DECUlMTION �v J�/ V�♦,�L � IHEREBYIIiFIRAIUNDERVENALTY0FpE0.URYONEOF7HEFOLLOWRlGOECIAAATIONS: � 10 HOs.� t • � _IHAVEANDWILLMAINTAMACERTIiIUTEOfCONSENTTOSElFdNSUR[FORWORKERS' GOAIPENSATpN,AS PROVDED BY SECTION 7700 OF THE LMOR COOE,FOR TME PEH WRIMNCE OF TIE WORK FOR WMICH THIS VENIIIT IS ISSUED. � w ��I HAVE AND WILL YAIMAM WORKERS COMPENSA7ION INSURANCE,AS REOUIRED BY SECTION � p 97o00FTMELAfiORCOOE,FORTMEPERFORMANCEOF7HEWORKfOHWMIp1THI5VERMRIS ISSUED.I�fV WORKERS'COMPENSATION INSURANCE GRR:EN MA POLIGY NUMDER AA CONSTRUCTION � uaaEa ��TC �u� PL4NREVIEW Z POl1CV NUUDER Ls S � ��_.,e ELECTAIC �J.� •///"'A�� Q v � (1HSSECfIONNEmNOTBEC01.4tiETmOFT1fPEFMf6POROPEFLWqEDWIUASISf0070RL£55} UMBING_� a ��- Z ICERTIFVTMATNTHGPERFORAIANCEOFiHLYVORKFORWNICHTMISPERMR6155UE0,1 Iu1ECHANICAL (7 511ALLNOTEMPLOYANYPERSONNANYM/WNERSOASTOBECOMESU0.IECTTOTH[ � � WORKERSCOMGENSATqNUw50FCKIFORNIqANO�GRBEiNATIF151UUlDBE ME iNSPECTIONFEE S SU6JECTTOTHEM/ORKERSCOMVENSATIONPROVISqN50FSEC710N77000FT F COOE.I SNALL FORTM+AiH COMPLY NnM TH RONSiO �SSUANCE �' O p DATE: �2�� APPLICANT: . SMIP � � ' � , ENERGY P/C WARNIH4:FAIIURE TO SECUfiE WORI(ER5 COMCENSATqN CDYEMGE IS UNUN'FIA.AND SHALL BE �y SU&IECTANEUPIOYEHTOCRiuqIALFENALTIESANDCMLFWESUPNONEHUNDREDTNd15AN0 ENERGYPERMIT� DOIURS�f t00,000),IN ADDrt10N TO TH[C0.5T OF COMPENSATION,DAUA0E5 AS FROVOf D FOR M7 � SEGTION77DeOFiHELABORCOOE,INlERE57,MWATTORNEY5FEE5. RE7EN1lONFEE: � ' O ' CONSTRUCTIONLENDINGAGENCY PRE-ALTfEE://�� /�/�� � � � IHEREBVAFFIRMUNDERPENKTVOFPERAIRYTHATTHEREISAOONSTR'JCTIONIENDINQACENCY (�p� n �41M7 n- FORTHEOERiORUANCEOFTMEWOfUCFOi1NT11CJ1T115PEW.1ITI5155UE0(SEG]Dv7,pV.G). �TII-i's�J��i�+� � �ew�E �' � IENOER5NMIE � LENDERSIIDORE54 W ICERTFYi17AiIM�VEREhDT/15MPLIGTIONIWDSTATETMAT7TIEABOVEWFORMATqNISCORRECL TOTALFEES � � . -�� • � IAGREETOCOMPLYN7THALLGTYANDCOUNTYORDINANCESANDSTATEUWSREUTNGTOBURDiNC � . � ODNSTRUCTION.ANDNEREBYAIlT1qR2EREPNESEMATNE50FTWSCOUNTVTOEMERUPONME , Z ABOVF�Y[MqNEDVHOPEH7VFORINSVECT10N0URPO5E5. , COMMENTS ' � sa.A l S� o+ _ m ERWTTEE IN7) . . . . 4 N C � (/� SNiNANNE Oi iERM�TiE . �.._.DATE � � � . � \"� • r.1 � RECPT.N0. PAID BY VALJDA .. .. . .WHITE—Departmenl Copy,YELLOW�inence Capy,PINK—Assessa Copy,GOLOENROD—File Copy,GHEEN—AppllcenCs Copy �_ ...... ._....._ .. ..... . .. v:r•:.,� , - .. , . � . „ ... , , ,. _.:..e... .�,.. ..�,.� �, ,'i .'r'-. , ^*'�^., . . , . ., . � �- ...r.. :.,, �.. .- .- .. :� CITY,OF DIAi�iOND BAR ' � .�,' �� � . : . . . INSPECTIO� RECORD � - . . . . : .:�� : . . �I`.�-�.;�.����1�►� ��'r'u� i(�������t�� .. �I�������I?�e.::1��'..l. • y�,��.y;,.�' = -;. a�i������'-'.-�"�'���'-. _ _W ♦a.:a�_L..0 ♦����:_:i9'i�r _���.�.�J��... _ _ _."�'�'_� .. �� ... . . .0 �.i��r-.�a.�� " ' ' - SET BACK.;. _ � . . . . , . FLOOR JOIST- °' - - ' � `. FTGS/FORhAS/STEEL-�--- - � ` ' FHA REQ�vITS � . _. . .� r�..---- . ' � ELECTRIC GROUND �_ ' • UNDER FLOOR DUCT ,;� �•��-,•�•<� ; �,;�:�, ! .. GROUND PLUF�iBING � �/ ls ��-- � . UNDER FLOOR�C�I�IDUIT '=�' -`�'` � '' �='�'r•`:�••,-� ` '' , ` - . .. . , SLAB GRADE--- - -- '' - - ' • FIREPLACE FOUNDATION - - �� -- -.... . -� ----- � � ' - •< r - �! c._,� ,•.t.: . . -TEMP POWER: . -:._�.-.-:__ ._ _ _ _ _-: _ := FIREPI.AC.E�BOND B�AM, -,-'-. '. . , ,., : WATER SERVICE __ , • /�� -� - " ' 'MID HL� . � � ! '. G. _j_�� BOND:BEAh1 '��•: :1- --••!ii.�".�l� i.r . _f .__ _ , f .. ROOF SHEATHING ' 8 FT.E30ND BEAh1 r. . „ l,.i'• r'� ! "' FRAMINGNENTIUATION ' �FINAL BOND 8EAti1 �, i;_; „i�,.•.; ::.� '; ,•�:t� � • •�. ( '. - --- - _ � . .. ' ROOFCOVER - . ._.. ....-- -- ------- - .- . _ ._ . . . PRE-G1�A�1�1..l'1•.) (f•. i�. ,. . .. . . h� '.lr :tJ �,.-; ROUGH HEATING- : -' � ' `-` � - - - � BENCHING � � I ' �ROUGH ELECTRIC - � --'�`-; -- �- - � ��-- '. ROUGH GRADING ..... . , ... ROUGH PLUMBING . --" ?i�' �- ,�_ - - FINISH GRA�ING . ' � ' 1�1_?- . - .�. .� • � � . SHOWERITUE3 TEST - -- --` - ,-� - -�-� - - POOL ELECTRIC � ' ' ' EXT.LATH/SIDING_ ._� --- - --- � - - -- POOL FENCING . , : .. . , � �. WALL INSULATION � POOL FiNAL � • � � -- CEILING INSULATION OFF SITE INIPS., . . ' � . i '•, DRYWALL NAILING ' � DEDICATIONS � : SEWER _- --- �. ._. �I�S��7 __ lr... FINAL EPJG. . ... ' � SEPTICTANK .__. -- _ ' UINDSCAPE/1RRIG. - � : SEEP_F1T/L.L: .�...._-• -- - _ i_.... -- ---. . . ON SITE IMPS. � - GAS AIR TEST•-- :-- -- ���.'J^ ' � �' FINAL 7_ONING ' . ,. . ; . - . ; ..�. , ; r�:. � ., � FINAI-CONST. .--;' . _.. . __. .. `. - •.�: FIRE DEPT. FINAL FINAL-HEATING� __ �, '•� - . •. . , , . HEALTH DEPT. FINAL _ : ; , . .. FINAL ELECTRIC-. . _ - ;., „ ::.;� - •�, DEV. FEES PAID • . • . � . � r. • �i,• � FINAL PLUMBING -. - :,� ;�, : �� •�- •;!1 � ENERGY - ' � i , -�4 i t 7 j a• .:i7 � �7�,• i �,--!; _� � ��: •., • 1J. � � _ rt ,�,: , � . _ ;, .i ,r;�,•� : . �s R �rr �'�: ���.� _____._..: ' � � , _, , •. . . � r . • , � . , _ ' .. _- _ - . �. ,�.✓•�._.�r .... � ._. . --- .._.__.._.__. _ .... .. _ . . _ . . � . . _....__.. .-�---._. � COMMENTS r_.�,�f) _ :•��� _ �..�i ; . . . . . .. . _. - ----- - _ -- - - --- - _ . . . _�, .. - - . .. _ _ . , ' ;:, 4,c. e�=! ^l.sr:.: ,, � - --- — . .. - - - - � , . _t _. : . _ ;. . ... r _. . . .. .'�C. . _ ... 1�. � �i . ..." ' _ ._'_. . . ._ . .. � . �..+• . . 5 �l , � .�' , i � . . '. . � ... .. �. . .. , . . . . .. � ' • � � .._. .. . . . — _.... . ._ _.. . ..._ . . . ._ . ' , i , . . . . i . � � .,.`.� _ .. _ _' '_ . . . . .. - - �� . . . � I '� '�� . � . .. .. . .. � . . �� � i -. - - --_ .. - - - . ,. ; ' , . �S, ` -J; ��_ .. .:>> i�-s'J- . � : � + i �' '`.'_'. . . _ ; ' . - , � , , -.._. .. _ _. . ;:,.�,\����`�Y, I i , : . SEPTIC TANK SIZE -- - - � � , -- - --- - _. _.. ---. . . .. ._. __.. ... ---- - --- . . - . � ; . .. , _ _ = SEEP PIT/U SIZE .��,:, � f �.,,; . . .. ., , - - .. .. . . .... . ,. , „ �:t - . _ . . � . _ �.�.0 ; ! - = ...�� '�.. . • � i . - -- ._ .. ; � i . .__...- , . � - . : ; - ---. ._. _. ... . -- --- -. ..... _ .� . . . - _,: _ � -�i- � , . . . . . , '�►�:� _ _ _ !;... _.. . . _ � � . . , . .. : �.. . --- , . --- � � —� _. , � Ct.�;�, � jl C;�/�f..��C . y ... . ..... . ..... ; � __.�_._ . .\������-;� ' '\ � �`,;;` . , . .' , ., . '"� � * ,. , - - . � ��.�._ __. .. . .. _ - G6 - _.. ... . ,. _ : - . - ...-.- � - - ----- / oi�h. --/y�