Laserfiche WebLink
a t <br />ELECTRICAL.INSPECTOR RECORD <br />Rev. 08'07-201 5 <br />APPROVALS DATE ID/SIG.COMMENTS oWNIiR BUII,DER DIiI,CARATION <br />I hercby affrnr under penalty of periury that I iuD crempt fronl the C:ontractoN' License Law for thc following reaen (Scc.70Jl.5 <br />Busincss and Prol'cssion Cfilc): Any City or County which requircs a pcnnil to construct, altcr, irnprovc. dcmlish or rcpai any <br />structurc, prior to its issuance. also requires thc applicail for such lEmil lo fih a si8Dcd slatcnrol lhat lE or shc ir liccmd puoant <br />to thc pmvisions of lhc Contracklr's l,icenscd lrw (Chaptcr 9. CohmcncinS wilh Scction 70U) of Division 3 of the Busihcss and <br />Protessions Code) or (hat lp or slr is eien4rt therel'rom afld tlE bdis for tlE alleged exenption. Any violalion of Seclion 7031 .5 hy any <br />npplicontforapeflnitsubjcctsthc applicarttoncivilpennltyotnotmrethanfivehundreddollars($500). <br />_1. s owncr ol'lh('prolE(!. or rny crnployccs wilh wagcs as lhcir $le com[rnsathn, willdo the work and lhc stMtm is mt <br />intcnlql or offcrcrl for slc (Se.7(X,1, Busincss and Prcfcssions Crxlc: The Conltactor's Liccnc kw d@s nol apply to m owncr of <br />the pmlEdy wlm truilds or inqrrovcs tlrro[ and wl$ dNs such work hinrself or lrcrself or tfuou8h his or her own enrployfts, <br />providcd that such irnprovcmnls {c not intcndcd or ollcrcd for sh. lll howcvcr, OE building or ir{,roverrcnt is sold wi$i! onc )c{ <br />ofcompletirl thc Owner Builder will lmve the burden of provin8 that Irc or she did mt buill or ifiptuvc fie prcprxy fo. thc purpo* of <br />sr.lc ). <br />_1. as owncr of the propeny, am e^clusively conlructinS with liccnsd conlraclorr to construct tha prcject (Scc. 7{X4, Businc$ <br />aul ltr)tbssiol Code: The Coillracbr's License Law does not apply to ar owocr of propeny who builds or improves lhercon. <br />and who contracts for such prejccts with 0 Contractor(s) liccf,scd pursuMt lo thc Conurctor's Liccnse Law). <br />-l <br />mr erempt under Sstio[-, B. & P.C. fot this rcasn- <br />EQ8IESSS9MPJNSAII9N <br />DECLARATION <br />I hcrcby affrm undd pcnalty ofpajury ore oflhc lbllowitrg dccldatioN: <br />_l h.vc snd will nuinlaiD a Ccnifeatc of Consnt lo S.lf-lNurc for work6' @trrpcGdion, 8s prcvidcd for by Satioo 3700 of thc <br />tabor Code, for the Frforl,ffic of the work for which the pqmit is issued. <br />_l havc and will nraintain workcrs' conrpcNalion insuratrcc, as rcquircd by Selion 3700 of lhr kbor Codc, for thc pqfotlrrm. of <br />ttE work for which lhis lrcrnit i! is$ed My work6s' cotrlpcNtion iNure wier ud policy numbcr ac: <br />Policy Nutrrber: Expires: <br />_l ccnily lhal io thc [rrfotnuncc of lhc work for which rhis pcrnril is issucd, I shall not cnrploy fiy frrson in any muncr <br />$ as to bccorrc suhjcct to thc workcrs'cornpcnsalion laws ofCalifornia. and a8rcc that ifl should bccoE subjcct lo the <br />workers' compcnsatioD prc\'isions ofSection 3700 ofthc Labor Code, I shall, fonhwith conrply with lhos prcvisions.. <br />WARNING: Failure ro *curc worlers'mmp.nsalion coveEgc is unlawful, and shall subjcct an cmploycr to 6imin0l pcnahics and <br />civil r'incsuptourchundrcdlhousanddollars(3100.000).inaddiliontollEcostofcom{Erstion,dmugcsNprovidcdforlhc <br />Scction 3076 otthe llbor Cnlc, inlercs ed sttorrcy's [ces. <br />UCENSEP-CANTAASJQB <br />DDCI,ARATION <br />I hercby alftrm undcr peMhyof pcrjury that I am liGnsl undcr prcvision of Chapta 9 (conmncing wirh Sccticn 7000) of Division 3 <br />of th. Busincss and Pmfcssions Codc. ard mv liccnse is in full forcc ard cffcct. <br />Liccnsc Class:-Liccnsc Number: <br />Contmclor: <br />CONSTRUCTION LENDlNG AGENCY <br />I hercby alllrrn undcr frnalt),of pcrjury thal thcrc is a conrtruction hnding agcrcy Ior thc pcrlbrmarcc ofthc work lbr which this pcftnil is <br />issucd (Scc. 1097. Ci!. C.). <br />kndcr's Nailre: <br />ktrder's A,l,lrc'\: <br />APPLICANT DECLARATION <br />I hrcby afiirm undcr Fnalty of pcrjury onc of thc folk)wing dcclxations: <br />Dcnrclition Pernrits-Ashcsk)s Notification Fcdcral Rcgulations (Titlc 40, Pm6) <br />-Rcquircd <br />trllcr of Nuificalion <br />_l certify thar lhc fcdcralrcSulations rcgdding asbcshs rclmval tre not applicablc lo this prcj€1. <br />_l ccrtity llul I luvc rcad this application drl stsle llut the atx)vc inlbmElion is corcct. I aSre to conply with ull City and County <br />ordinances md Statc kws relating lo building construdiotr and hcrcby authorize rcprcsntatives oflhis City and County to ents upotr rhc <br />obovc rrcntioncd prcpeny for inspection purpoEs. <br />Appli(rrrt or Agflt <br />l,crmi(cc nantc (pritrl)l <br />Site-Work <br />Underqround <br />Pole Bases <br />Liqht Standards <br />Spas, Pool, Fountains <br />Siqns (monument) <br />Life Safety /Low Voltaqe <br />Fire Alarm / Dampers <br />Communications Cable <br />Building <br />Under Slab / Floor t/ <br />Bondinq / Groundinq / UFER 7/%/1/U Wt/dt</rrd <br />Transformers t I <br />Torqueinq <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rouqh) <br />Ceilinqs (Hard & Soffit Rouqh <br />Ceilinqs (T-Bar Rouqh)I .O- <br />lvleter Release 4D//r/U Pturn ' <br />nrf <br />T <br />Rouqh r2 <br />Service Meter r/?afidu #.fr./m 6{O <br />FINAL VA/r/?2 (+iW@ M,S6 <br />Notes, Remarks, Etc.