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ELECTRICAL-INSPECTOR RECORD Bev APPROVALS DATE ID/SIG.COMMENTS Site-Work Underground Pole Bases Light Standards Spas, Pool, Fountains Siqns (monument) Life Safety /Low Voltaqe Fire Alarm / Dampers Communications Cable Buildinq Under Slab / Floor Bonding I Grounding I UFER Transformers Torqueing Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Rough) Ceilinss (Hard & Soffit Roush Ceilinss (T-Bar Rouqh) N/eter Release Rouqh Service Meter I a FINAL /z/zz./zoot:<41f1;// I-rlNotes, Remarks, Etc. ( owNtiR BtrILt)t R I lrereby affrnr under penalty of perjury that I arn exenlpt fnrm the Clontractos' Licens'e law f<lr the following reason (Sec.7031.5 Busincss and Prolbssion Codc): Any City or County which rcquircs a permit to construct, alter. irnprovc. demolish or rcpair any structure, prior to its issuance. also requires tlre applicart for such pemrit to fih a signed statemenl that lr or she is licenscd Pursuanl to the provisions of the Contractor's [.iccnscd law (Chaptcr 9. Commcncing with Scction 7000 of Division 3 o[ thc Busincss and hofession.s Code) or that lrc or she is exenrpt therefrom and tlre basis for tlre alleged exenption. Any violation of Section 7031.5 by any npplicant for a permit subjects the applicant to a civil penalty of not morc than five hundred dollars ($stltt). _1. a.s owner ol'the' propcrty. or my crnployecs with wagcs as thcir solc cornpcnsation, intended or offeretl for sale (Sec'.7(X+. Business antl Prcfcssions Code: The Contractor's Licensc Law docs not apply to an owner of the pmpeny wlp builds or in{rrovqs there<ln, arxl wlro does such work himself or lrerself or through his or her own enrployees, providcd that such irnprovcrncnts are not intcndcd oroffercd for salc. If, howevcr, thc building or inprovcrnent is sold within one )aar of conpletioru thc Owner Buil&r will have the burdcn of proving th* hc or shc dirl not buill or inprove 0rc propaty for thc purposc of sale). _1. as owner of the properly, am exclusively contracting with licen.rcd contractors to construct tlr project (Sec. 7(X+. Business ard Prrotbssion Code: The Contractor's License Law dms not apply to an owner of property who builds or improves thereon. and who contracts for such projccts with a Contrachr(s) liccnsed pursuant to thc Conuaclor's License law). _l am exempt under Section-, B. & P.C. for this reason. Dale: WORKT]ITS' COM PT.:NSATION DECLARATION I hcrcby alf irm undcr pcnalty of pcrjury onc of the f'ollowing dcclarations: have and will nuintain a Certilicate of Con.sent to Self-ln.surc for workers' contyrcnsation, as provided for by Section 3700 of the Codc, for thc Jrcrforrrmncc of thc work lbr which thc perrnit is issucd. and will nraintain workers' conrpensaliorr insurarrce, as required by Section 3700 of tlrc Labor Code, for tlte yrcrfornunce of thc work for which this pcrmit issucd.comgrcnsation insurancc carricr arxl grolicy nunrbcr are: Policy _l ccrrity that irr thc lrcrlbrnuncc of tlrc work for whiclr this pcrnrit is issucd, I shall not cnploy any in any manncr so as to bcconrc subjcct to thc workcrs' corrrpcnsation laws of California. and agree that if I should beconrc subjcct to the workers' conrpensation provisions of Section 3700 of the Labor Code, I shall, forthwith comply with thosc provisions.. WARNING: Failure to sr:cure workers' compensation coverdge is unlawful, and shall subject an employer to criminal penalties and civil fines up to orrc hundretl thousand dollars ($100.0001. in addition to tlr cost of compensation, danrages as provided for lhe .Scction 3076 of L:bor Codc, intcrcst and attorrrcy's [ces. I hercby affrnr under penalty of perjury that I anr licensed under prcvision of Chapter 9 (comnrncing with Section 7000) of Division 3 of the Business and Professions Code. arxi rny license is in full force and effect. License Nurnber:I Date: V\fqLr-,v(r-\' \ CONSTRUCTION LENDING AGENCY I hercby al'lirm undcr pcnalty of perjury that thcrc is a construction lcnding agcncy for the performancc of the work l'or which this perrnit is issued (Sec. 3097, Civ. C.). lrnder's Name: A PPI,ICANT DECI,ARATION I hcrchy zrflirnr undcr pcnalty of pcrjury onc of thc folbwing dcclarations: Dcnxrlition Pcrnrits-Asbcstos Notification Fcdcral Rcgulations (Titlc 40, Part6) _Rcquircd Lcttcr of Notification _l ccrtily that the fedcral rcgulations rcgarding asbcstos rcmoval zuc not applicablc to this pro.iect. ccrtify that I havc rcad this application iuxl statc that lhc ahn'c infornution artd County abovc rncntioned property for inspection Applirant or Agent Ircrmitcc name and 1r upon thc 5 State laws rclating to of this