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APPROVALS DATE tD/stG.COMMENTS Ow.cFBuildcr D.clsa @ <br />I hd.by dmm undd pcn.hy of pcrjury lh.r I m .xmfl fom lhc Conr.cioa Lico5c llw for lhc followin8 Eon (i.c 701 I 5 Buin6 <br />&d Prol6sion Codc): Any Cig o Couity whhh rcquits a ptmil |o co.s!'rcr, altcr, iBprov., ddolish or rcpBir dy sr.ucre. pnor ro irs <br />htudcc, also rcqutB rh..ppli@it for iucn pcmn io fiI.. sigicd slalmot dd h.or sh. is lic.nsd punudr ro dr. provisios offir <br />Conk.dmt LicdEd La* (Chaptr 9, Commacing wnh S.crion 7000 ofDivisior S olthc Bcins ed Profasions Cod.) or $at hc r <br />5h. is .r.mfl thd.arm od fi. ban fd fi. .ll.g.d .x.mption Any viol.ion oa Sarion 70.r I 5 by .ny appli.d ftr . p6n subj*E rh. <br />applicdr Io a ciril pcnalry or.d mor $e liv. hun&cd dolla(1500). <br />_I, a 6wn.r of thc prcpdt, d my mployG wnh q!86 $ lhcnsol. compcnllrion, qill do ihc work and thc rhcru. ir oot inrqd.d <br />o! of.rcd tor sllc ( S.c 70,14. Suin65 ud Prof6im Cod.r Th. Contrctor's Liccnic L.w d@s nd apply to a wn.r oi th. prop.ny <br />who buil4s or inp,ovcs thcr.on. dd vho do6 such wort hiruclf tr h6df or lhroqt his or hd own cmploycd, providcd lhat such <br />ihprov.nc.ri oc ior ii€nd.d d offccd ao' salc lf, howcv.r, rhc buildiir or inpoycmor is sold within onc yd of conpl.non, rh. <br />O*n.r-Buildfvill hay.lhcbudcn of provins thsr hc orsh. nol build or ihprovc lor thc purposc ofsalc) <br />_1, 6 ownd of thc prop.rty, m .rclsivcly conFacrins wnh lic.ns.d conlraciou to consrrud th. projei ( S.c 7044, Bwinds ad <br />Profsid Codc Thc Conlruror's Lic.n* L.w dG .or .pply ro a own.r of propary *ho blilds q improvG dq.o . ed who <br />conracs for $ch pror{B *nh acot &1o(,limscd rlBuar to th. conhcrors Lic.ns.,rw ) <br />_l 6 cx.mpl u.d6 Sccrion _,8 & PC fff rhis rc6on <br />IOBtrEBS-COIITEISA.III)N.DICIA IloN <br />I h.r.by ailim undcr p.nalty of pcrjury onc of thc followinE d.cleanons <br />_l hav. dd will tuin|ir a C.nifial. of Con@l lo S.lfin.ur. tor wort 6 .mp6satio, s prcvidcd for by Setio 3?00 of fi. <br />r:60r Cod., for ln. pc.f@.? of $. wod( ior whid thc pmn ir isru.d. <br />I h.r. md will mainbin *al6 @mpat.rid iNutucc! a rcqutcd b, Scciio. l7O0 of rhc tlbor Codc, for rhc pqfoms@ ol rh! <br />work aor which fit p.mir i5 i$u.d. My wok.6 cmpa!.!o in5u.{.. ..Fd ed policy iumbc, d.: <br />rTnr37'onnednotbt.mpldcdr($.pm R for Onc hundrcd dolloE ill00, o'16!, <br />y' c.nify iha' h rh. p.rfomu* orrhcsork ltr shkh $is pm, E rsu.d.l ehrll id cmploy sy p.6on <br />/.!d. subJN' <br />'o <br />fic *orl.8 'comp.ns4'on la$ ofCalifom!{ Md !8r.. rh* ift should baom. subj?.r ro <br />of$. kbor Codc. I shall, fonhwith <br />ro s.cuE work.6' conp.mation covaag. h :ubjccr an cnployd locnminal p.i.lri6 ed civil <br />fin6 up to on. hundr.d $ouMd dolln (Sl00,o0o),in addinoi to rhc.o!r of@np.nlaiotr, dMrg6 a provi.Ld for th! S.cdon 10?6 ol <br />fic Labor Codc, inl.rd Md.rlM.yk f.a. <br />LICENSED CONTiACTORS DECLANATION <br />I h.r.by lmm und.r po.lry ofpnjury thar I o lictu.d undq p,oeirio. ofchapts 9 (@mmacins wi6 S.ctid ?000) of Oivision I of <br />tfic Businds od Profsios Codc, and m, licas. is in full loEc and lffat. <br />pcDury lh.t fia. i! r consttucrior lchding.g.ncy fo! $c pcrfmanc. ofthc work tor which 6is Fmit n <br />isud (S8.3097, Civ. C.) <br />APPLICANT'S DECLARATION <br />D.holtion P@il$A5b6tos No lloro Fede3lR.sulaionr (Tnlc 40, P6n 6) <br />R.quir.d Lcncr of Noifi 6tid <br />-iv lta! ih. f.d...l r.gularions rclsdinS 6b<r6 ,ooval r. iol appli@blc lo lhis <br />I l€c lo c6pl, *iln dl Ciy -d Cootythal I hrrc rdd lhis agplicdion ud slrc thd rh. <br />ordindG ed Shrc Las El.ring lo building of$is City dd Courry lo otd <br />Site-Work <br />Underground <br />Light Standards <br />Spas, Pool, Fountarns <br />Signs (monument) <br />Life Safety /Low Voltage <br />Fire Alarm / Dampers <br />Communications Cable <br />Building <br />Under Slab / Floor <br />Bonding / Grounding / UFER <br />Transformers <br />Torquing <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilings (Hard & Soffit Rough <br />Ceilings (T-Bar Rough) <br />Meter Release E\/DID rh <br />Rough RRtr=l ?i:'j <br />Service Meter <br />FINAL rlvlu &.4ir, 290 gt6. ri67 <br />Notes, Remarks, Etc. <br />ELECTRICAL.INSPECTOR RECORD <br />Pole Bases <br />ab.v. h.nrion.d pr6p.ny for inry.cbon <br />I