20171459 - Permit - Laserfiche WebLink

Home Browse Search

NSPECTOR RECORD APPROVALS DATE ID/SIG.COMMENTS Site-Work Underground Pole Bases Liqht Standards Spas, Pool, Fountains Siqns (monument) Life Safetv /Low Voltaqe Fire Alarrn / Dampers Communications Cable Buildinq Under Slab / Floor I Bondins I Groundins I UFER lz lo Dkffi a Transformers l Torqueing Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Roush) Ceilinqs (Hard & Soffit Rouoh Ceilinss [-Bar Rouqh)I I , Meter Release Ot 7t t /) lT-tr fl-l II Rough tl Service N/eter ll-(,/1)) l)frv -y/ FINAL L d D*a -yl Notes, Remarks, Etc./t I OWNI,R BUII,DI'R DI'I,CARATTON I hereby affrm under penalty of perjury that I am exenrpt fronr the Contractos' License l-aw for ttrc following reaxln (Sec.7031.5 Busincss and Prol'cssion Code): Any City or County which requires a permit to construct, alter, irnprovc, demolish or rcpair any structure, pior to its issuance. also requires the appliciurt for such pernril to file a signed staternent that lrc or she is liccrrsed pursuanl to the pmvisions of the Contractor's l,iccnsed L-aw (Chaptcr 9. Commcncing with Section 70O0 of Division 3 of the Busincss and Professions Code) or that he or she is exempt therefrom and tlre basis for the alleged exemption. Any violation of Seclion 7031.5 by any applicant for a pennit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). _1. as owncr of the propcrty. or my cmployees with wages as thcir solc compcnsation, willdo ttrc work ard thc stnrclurc is not interded or offered frrr sale (Sec.7(}l4. Business and Prcfcssions Crxle: Thc Contraclor's Licensc l-aw does not apply to an owncr of thc prcperty wlro builds or inqroves ttrrmn urd wlro does such work himself or lrerself or through his or her own enployees, provided that such improverrnts arc not intcndcd orofhred for sah. Il. hnwever, thc building or irprovenrcnt is sold within onc year of completion, the Owrrcr Buil&r will havc the burden of proving ttrat he or shc did rrct buikl or improve tlrc propcrty for thc purposc of sah). _1. as owner of thc propeny, am exclusively contracting with liccn.sed contraclors to construct thc prujcct (Sec. 7044, Business arxl hottssion Code: The Contractor's License Law dtres not apply to an owner of property wtro builds or improves thereorL and who contracts for such projccts with a Contractor(s) licenscd pursuant to thc Conuactor's Liccnse hw). -IantexemptunderSectit,n-,B.&P.C.tbrtl$sreason. WORKtsIIS' COMPENSATION DECLARATION I hcreby affirm undcr penalty of perjury one of thc tbllowing declarations: _l have arxt will nrainlain a Ccrtilicate of Consent to Self-lnsure for workers' conqrcnsation, as provided for by Section 3700 of the Labor Code, for thc Jrcrfiormance of the work lbr which thc perrnit is issued. _l have and will nraintain workers' conrpensation insurance, as required by Secti<ln 3700 of the l-abor Code, for the perfornrance of thc work for which this pernrit is issued. My workers' compcnsation insurance carricr and grolicy numbcr are: PolicyV 7\l cerrify that ilr tlrc prlbrnuncc of tlrc work for which this pcrmit is issucd, I shall not cnrploy any pcrson in any manncr so i.s to bccome subjcct to the workcrs'compen.sation laws of California, and agrce that if I should beconrc subjcct to thc workers' conrpensation provisions of Section 3700 of the Labor C<xle, I shall, forthwith conrply wilh thosc provisions.. WARNING: Failure to sâ‚¬cure workers' compensation coverdge is unlawful, and shall subject an employcr to criminal penahies and civil lines up to one hundred thousand dollars ($100.000). in additiort to tlrc cost danuges as providcd for thc Scctkrn 3076 Lahor intcrest and attorncy's l'ccs. 1 I hercby affirrn under penalty of perjury that I anr of the Business and Professions Code. aml my I LICENSED CONTRACTOR DIiCI,ARATION , licenserl under pruvision of Chapter license is in full lbrce und cl'fect. 9 (conrnrncing with Section 7000) of Division 3 License to Number:LotbtA\Fr; CONSTRUCTION LENDING AGENCY I hcrcby al'lirrn undcr penalty of perjury that thcrc is a construction lcnding agency for the pcrlbrmancc of thc work for which this permit is issued (Sec. 3097. Civ. C.). I:nder's Name: I*ndcr's Addrcss: APPI,ICANT DECI,ARATION I hcrcby aflirnr undcr pnalty of pcrjury one of thc folkrwing dcclarations: Dc nlo lit io n Pcrnrit s- A strc'sl us Noti ficat ion Fctlcral (rirb 40, Part6) -Required l,cttcr of Notification _l ccrtily that thc fcderal rcgulations to this project. -[.ccrrity that I havc rcarl tlus ap;rlicaliort corrccl. I agrtlc to conrply w itlr all City and County ordinances and Statc Laws rclating to abr;r'c mentioned pruperly for inspection Applicant or Agent I'crnrilcc nanrc ( represcntativcs of this City and ugrn thc Rev. 08-07-201 5 I'[/L I)ate: Io