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ELECTRICAL.INSPECTOR RECORD <br />APPROVALS DATE ID/S!G.COMMENTS <br />Site-Work <br />Underqround <br />Pole Bases <br />Liqht Standards <br />Spas, Pool, Fountains <br />Siqns (monument) <br />Life Safetv /Low Voltaqe <br />Fire Alarm / Dampers <br />Communications Cable <br />Buildinq <br />Under Slab / Floor <br />Bondinq I Groundinq I UFER <br />Transformers <br />Torqueinq <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Wdls (Conduit) <br />Walls (Rouqh) <br />Ceilinos (Hard & Soffit Rouqh <br />Ceilinqs [-Bar Rouqh) <br />Meter Release <br />Rough <br />Service N/eter I ,l t^-o <br />FINAL a tl / fi'{Y auro / <br />urNotes, Remarks, Etc.I <br />OWNIiR B UILDI'R DI'LCARATION <br />I hereby affrnr under penalty of prjury that I anr exenrpt fronr the Cbntractors' License [.aw for the following reason (Sec.7031.5 <br />Busincss and Profession Codc): Any City or County which requires a pcrmit to construct, altcr. irnprove. dcmolish or rcpair any <br />structure, prior to its issuance. also requires the applicant for such Srernrit to file a sigrrcd statenEnl that lr or she is liccnscd pursuant <br />to the provisions of thc Contractor's Licensed l.aw (Chaptcr 9, Commencing with Section 7fi)0 of Division 3 of thc Busincss and <br />Professions Code) or tlrat lrc or slrc is exenpl therefrom and tlrc basis for tlre alleged exenrption. Any violation of Section 7031.5 by any <br />applicant for a pnnit subjects the applicant to a civil penalty of not more than five hundred dollars ($5Otl1. <br />_1. as owncr ol'the propcrty, or tny ctnployccs with wagcs as thcir solc compcnsation, will do the work and the stnrcture is not <br />interxlcd or offered for salc (Scc.7(Xa. Busincss antl Profcssions Ctxlc: The Contractor's Licensc [-aw docs not apply to an owncr of <br />the prugrcrty wlxr builds or inrproves tlxreoq arxl wlxr does such *ork himself or lrerself or through his or her own enrployees, <br />provided that such improvcrrrcnts arc not intcndcd or ollcrcd for sale. Il. however, thc building or improvcnrcnt is sold within onc )€ar <br />of completioru thc Owrrcr Buikler will have the burden of proving that lrc or she did not buikl or improve tlre propcrry for the purpose of <br />sale). <br />_1, as owner of the propefly, am exclusively contracting with licensctl conlractors to conslruct the project (Sec. 7(X4. Business <br />arxl Protessi<rn Code: The Contractor's License Law does not apply to an owner of proJrerty who buikJs or improves thereon. <br />and who contracts for such pr<rjccts with a Contractor(s) licensr:d pursuant to thc Conuaclor's Licen.sc taw). <br />-l <br />anr exempt under B. & P.C. lbr this reason. <br />WORKT' RS' COMPI1NSATTON <br />DECLARATION <br />I hcrcby affirm undcr grcnalty of perjury one of thc tbllowing declarations: <br />_l have and will nnintain a Certit'icate of Consent to Selt'-lnsure for workers' conrpensation, as provided for by Section 3700 of the <br />[-atnr Jrerformancc of thc work lbr which thc perrnit is issued. <br />and will nraintaitr workers'insurauce, as rcquired by Section 3700 of the Labor Code, for lhe;rcrfornunce of <br />r carricr aml plicy numbcr are:work frlr this lrcrrnit is issucd.conrJrcrrsation insurance <br />Policy / /zt <br />_l ccrtify that in the ;xrfornuncc of llrc work frrr which this prnrit is issucd, I .shall not <br />so as lo becomc subjcct to the workcrs'cornpcnsation laws of Califomia. and agrcc that if I "r*6 *{r^any manner <br />should become subject to the <br />worliers' conrpensation pnn,isions of Section 3700 of the l-abor Code, I slull, forrhwith conply with thosc provisions..l <br />WARNING: Failure lo secure workers' compensation coverage is unlawful, and shall and <br />civil fines up to one tlxrusand dollars (S addition cost of the <br />Scction thc intcrcst and <br />>D <br />I hereby affrnr under pnalty of perjury that I anr licensed 9 (cornnrcncing with Section 7000) of Division 3 <br />of the Business and Professions Code. and rny licensc is in full forcc and effect. <br />License S=tis <br />I hcrcby affirm undcr pcnalty of pcrjury that thcrc <br />issued (Sec. 3097. Civ. C.). <br />[rnder's Nanre: <br />agcncy thc pcrmit is <br />[-enrler's Address: <br />APPI,ICANT DECI,ARATION <br />I hcrcby affrnr undcr pcnalty of pcrjury onc of thc following dcclarations: <br />Denxllition Pcrnrits-Asbcstos Notification Fedcral Rcgulations (Titlc 40, Part6) <br />-Rcquired <br />l.cttcr of Notilication <br />with all City antl County <br />above rrrcntioned property for <br />Applicant or Agent <br />Pcrmilcc nanre <br />to this prolxt. <br />and thc <br />08-07-2015