20172171 - Permit - Laserfiche WebLink

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ELECTRICAL-I NSPECTOR RECORD APPROVALS DATE ID/S!G.COMMENTS Site-Work Underqround Pole Bases Light Standards Spas, Pool, Fountains Signs (monument) Life Safety /Low Voltase Fire Alarm lDampers Communications Cable Building Under Slab / Floor Bonding I Groundins / UFER Transformers Torqueing Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Rouqh) Ceilinss (Hard & Soffit Rough Ceilinqs [-Bar Rouqh) Meter Release I ^I Rouqh /l /n ltlM?O ,/"Y*,a;/-tlService Meter t V FINAL Z 7l-h)Wftg Notes, Remarks, Etc I I hseby alfm undc pcnalty of pcrjury th8t I m qempt ftom the ContmcloB' Licme Law for thc followirg r.en (Sc.7031.5 Buinos md Profeion Codc): Any City or County which rcquiB I pqmit lo coNtrucl. alta, improvq &rnolish or rtpair oy struc1uc. prior to its issumcc, also rcquire thc applicut for such pcrmit to lile a signsd statmot that hc or shc Ls licmcd pwuot to thc provisiom of the Contractor's Liccnscd Law (Chapt6 9, Commcing with Sction 7000 of Divisiou 3 of the BwinN ild ProfsioN Codc) or that hc or shâ‚¬ is qcmpr thGcfrom ed the basis for thc allegcd cxoFion. Any violatiotr of Setion 703 I .5 by ey applicantforapetmitsubjetsthc applicanttoacivilpcnaltyofnotmorcthmfivchun&cddollus($500). -1. as owner of the property. or my employees with wages as their sole compensalion, will do the work and the struclure is not L intended or offered for sale (Sec.7044, Business and hofessions Code: The Contraclor's License l-aw does not apply to an owner of the property who builds or improves theron. and who does such work himself or hersclf or through his or her own employees. provided that such improvanents are not intended or offered for sale. If, howwer. the building or improvanent is sold within one )aar of complaioru the Orvner Builder rvill have the hrden of proving that he or she did not build or irnprove the propcrty for the purposcof sale). _1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7A4, Business and hofession Code: The Contractor's Licensc Law does nol apply to an owner of property who builds or improves thereon, and who contracts for such projects with a Contracto(s) licersed pursuant to the Contractor's Licensc law). -I B. & P.C. for this reason. I hereby affrrm under penalty of pojury one of the WORKERS' COMPENSATION DECLARA'TION following declaralions: _l have and will maintain a Certificate of Consent to Self-lnsure for workers'compensationt as provided for by Section 3700 of the Labor Code. for the pcrformance of the work for which the permit is issued. -l have thc work and rvill maintain workers'as rcquire<l by Sc<tion 3700 of the Labor Codc, for the performance of issued.insurance carrier and policy number are: Policy 0 -l certify that in work for which this permit is issued, I shall not employ pcrson in any manner so as to bccome subject to the workers'compensation laws of California and agree that if I should become subject to thc workers' compensation provisions of Section 3700 of thc Labor Code, I shall, forrhwilh comply with thosc provisions.. WARNING: Failure to secure workers' compensalion coverage is unlawful. and shall subject an onployer to criminal penalties and thousand dollars ($100.000). in addition to the cost of compensation, damages as provided for thecivil fines onc Section and attorncy's fccs. 0 I,ICENS[D (:ONTRACTOR DECLARATION I hereby affrrm under penalty of perjury that I arn licensed under provision of Chapter 9 (commencing with Scction 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Number: 0 W I hmby aflirm unda pcnalty of pfijury thst thqa is a @nstruc{ion krding sgqcy for thc pqfomuce of thc work for which this p6mit is issued (Se. 3097, Civ. C.). Lender's Narne: Lcnder's Address: APPLICANT DECLARATION I hereby alfinn under pcnalty of perjury one of the following declarations: Demolition Permits-Asbestos Notification Federal Regulations (Title 40. Part6) _Required Letter of Notification _l certify that the federal regulations rcgarding asbestos removal are not applicable to this project. _l certiff that I have read this application and state that the information is correct. I agree to comply with all City and County ordinances and State Laws relating to building construction,representatives of this City and County to upon the above mentioned property for 201Applicant or Agent Pcrmitee nnme (print):o o Rev. 08-07-2015 Date: )