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ELECTRICAL.!NSPECTOR RECORD DATE ID/SIG.COMMENTSAPPROVALS Site-Work Underground Pole Bases Lisht Standards Spas, Pool, Fountains Siqns (monument) Life Safety /Low Voltaqe Fire Alarm / Dampers Communications Cable Building Under Slab / Floor tl Bonding I Groundins I UFER tLl t lu Dtraf q Transformers Torqueing Sub-Panels Air Conditioners Roof Top Equipment lUt l-Lo uffrrn Factory Wired Unit Walls (Conduit) Walls (Roush) Ceilings (Hard & Soffit Rouqh Ceilinss (T-Bar Rouqh)I ,L Meter Release lTl t ln{)Snvg I Rouqh Service l\Ieter I I t2)|T1/)DftK67FINAL Notes, Remarks, Etc.I I OWNI'R BUII,DER DEI,CARATION I hereby affrnr under penalty of perjury that I anr exenpt from the Conkactors' License l-aw for the following reason (Sec.7031.5 Busincss and Profcssion Codc): Any City or County which requircs a Srcrmit to construct, attcr. itnprovc. dcmolish or rcpair any structure, prior to its issuance. afso requires the applicart for such Jrcrnrit to file a signed slaternenl that he or she is licenscd pursuanl to thc provisions of thc Contraclor's l.icenscd taw (Chapter 9. Commcncing with Scctinn 70fi) of Division 3 of thc Busincss and Professions Code) or that he or slrc is exempt tlrcrefrom and tlrc basis for the alleged exenption. Any violation of Section 7031.5 by any applicant for a pennit subjects thc applicant to a civil penalty of not more than five hundred dollars ($stttt). _1. as owncr ol'thc propcny. or my crnployccs with wagcs a.s their sole compcnsation, irrtended or offered for sale (Sec.7044. Business and Professions Code: Thc Conlractor's Liccnse Law tloes not apply to an owncr of the pruprerty wlxl builds or in4rroves tlrreorl arxl wlxr does such work himself or lrerself or through his or her own enrployees, provided that such improvcmcnts arc not intendcd or ollcrcd for sah. ll, howcvcr, thc building or inprovcrrrcnt is sold within onc year of completiorr, thc Owncr BuikJer will have the burdcn of proving ttra hc or she did nrt buikl or inprove thc propcty for the purposc of sale). _1, as owner of the pr'operty, am exclusively contracting with licensed conlraclors to construcl thc project (Sec. 7(X4. Business arxl hotbssion Code: The Contractor's License Law dcrs not apply to an owner of proSrcrty who builds or intproves thereon. and who contracts for such projccts with a Contractor(s) liccnscd pursuant to thc Contractor's Liccnse l-aw). -IantexemptuttderSectitltt-,B.&P.C.tbrtltisreas<ltt.Owner: WORKtr]RS' CO[}T PF]NSATION DECLARATION I hcrcby allirm undcr pcnalty of pcrjury one of thc ltrllowing dcclarations: _l have ard will nuintain a Certificate of Consent to Self-lnsure for workers' compensation, as provided for by Section 3700 of tlrc Labor Codc, for the pcrlormance of thc work for which thc perntit is issued. rrk have and will nraintain workers' conrpensalion insurance, as required by Section 3700 of the Labor Code, for lhe performance of work which this pernrit is issucd. My carricr numbcr are: Policy o.\ 2l I.&ccrrify that in tlrc I .shall not employ any [rcrson in any manner it I should bccornc subjcct to theto bccomc subjcct to thc workcrs'conrpcrrsation laws of California. and agrcc that workers' conrpensation provisioru of Section 3700 of the Labor Crxle, I shall, forthwilh comply wilh thosc provisions.. WARNING: Failure to secure workers' compensation coverdgc is unlawful, and shal! subject an employer to criminal pcnaltics and civil fines up to one hundred tlrousand tlollars ($in addition to llre cclst of contpensatiott, danrages a.s provided foillhe .Scction 3076 of thc l--ahor Co<lc-Itolzo intcrcst and attorncy's \r I hereby affirm under pnalty of perjury that I anr licensrd under provision of Chaptcr 9 (conunencing with Section 7000) of Division 3 of the Busincss and Professions Code. and rny license is in full force and effect.cro Number: q1b1 S(o VI VI L)AY CONSTRUCTION LENDING AGEN CY I hercby al'tirm undcr pcnalty of pcrjury that thcre is a constructkrn lending agency for thc perlbrmance of thc work lbr which this permit is issued (Sec. 3097. Civ. C.). [-cnder's Name: lrntler's Address: APPLICANT DECLARATION I lucby allirnr unrlcr pcnahy of perjury onc of the following dcclarations: Denxrlition Pcrmits-Asbcstos Notification Fcctcral Rcgulations (Tillc 40, Pan6) -Rcquired lrtter of Notification _l ccrtify that thc fcdcral rcgulations rcgarding asbcstos removal are not applicable to this projcct. LR"niry tlrat I navc rcad this and statc that thc ahrvc ittlirrnutiott ordinanccs and Statc laws rclating Aplllicant or I'crmilec nanrc construction. I so as above rrrcntioned property for