20172230 - Permit - Laserfiche WebLink

Home Browse Search

ELECTRICAL-INSPECTOR RECORD APPROVALS DATE ID/SIG.COMMENTS Site-Work Underground Pole Bases Lisht Standards Spas, Pool, Fountains Signs (monument) Life Safety /Low Voltaqe Fire Alarm / Dampers Communications Cable Building Under Slab / Floor Bonding lGrounding I UFER Transformers Torqueing Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Roush) Ceilinqs (Hard & Soffit Rouqh Ceilinss (T-Bar Roush) l\Ieter Release Rouoh lService lVleter FINAL -11-4 h'tkw) Notes, Remarks, Etc.\-/ "l N t lrt?X'-l v OWNER BUILDER DI'I,CARATION I hereby affirnr under pcnalty of perjury that I un exenpt from the Contractors' License l-aw for the following rea$n (Scc.7031.5 Business and Prol'cssion Codc): Any City or County which requircs a pcrmit to c,onstruct, altcr. itnprovc, dcmolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that lrc or she is licensed pursuant to thc pmvisions of thc Contractor's l,icenscd hw (Chaptcr 9, Commencing with Section 7000 of Division 3 of the Busincss and Professions Code) or that hc or she is exempt therefrom arxl tlre basis for tlrc alleged exenption. fuiy violation of Section 7031.5 by any applicant for a perrnit subjects the applicont to o civil penalty of not more than five hundred dollars ($50ttl. _1. as owner of thc propcrty, or my ernployees with wagcs as thcir solc compensation, willdo the wcnk and the stnrture is mt intentled or offered for sule (Sec.7H+. Business and Prolessions CcxJc: The Contractor's License Law does not apply to an owner of the pruperty wlro builds or improves thereon, uxl wlxr doe.s such work himself or herself or through his or her own enrployees, providcd that such impmverrnnts arc rnt intcndcd orollerc'd for sah. Il, howcver, the building or improvcnrnt is sold within onc )ear of comphtion, tlr Owner Builder will have the burden of proving that he or she tlid not build or improvc thc pnrperty for thc purposc of sale). _1. as owner of the propefly, am exclusively contracting with licensed contraclors to construct thc project (Sec. 7(X4, Business arxl Pmtb:sbn Co<le: The Contractor's License Law does not apply to an owner of prope(y who builds or improves thereon. and who contracts for such projects with a Contractor(s) liccnsed pursuant to the Contractor's License t-aw). -l anr exempt under Section-, B. & P.C. for this reason. Owner:wonxprcffin DECLARATION I hcreby aflirm undcr grcnalty of prjury one of thc following dcclarations: _l have and will nraintain a Certilicate of Consent to Sclf-lnsure for workers' compen^sation, as provided for by Scction 3700 of the l-abor Codc, for thc grerforrnancc of thc work for which thc permit is issued. _l have and will nraintain workers' conrpensalion insurarrce, as required by Seclion 3700 of the labor Code, for the perfornunce of thc work for which this grcrnrit is issued. My workers'insurancc curicr arxl plicy nuntbcr arc: Policy _l ccrrity that in tlrc ;rrfornuncc'of lhc work f<rr this pcrmit is issucd, I shall not cnploy any l)crson in any manncr of California. and agrec that if I slnuld becorte subject to thcso as to bccomc subjcct to thc workers'cotnpcn.sation laws workers' conrlrnsation pruvisions of Section 3700 of the L-abor Code, I slull. forthwith conply with thosc provisions., WARNING: Failure to secure workers' compcnsation coverage is unlawful, and shall subject an employer to criminal penalties and compensalion, danrages as provided for thecivil fines up to one hurdred thousand dollars ($ I cost of Scction 3076 of thc Latxrr Ctxlc. intercst and o*,, Y(ol( 3 7o' \ I hereby affirrn under penalty of pcrjury that I anr licensctl under 9 7000) of Division 3 of the Business and Professions Code. arxl my license is in full force r 2,oLicense I hcrcby all'irrn undcr Jrcnalty of pcrjury that thcre is a construction lcnding agcncy for thc issued (Sec. 3097, Civ. C.). of thc work lbr which this pcrrnit i.s [,ender's Name: l.cnder's Address: APPI,ICANT DECI,ARATION I Mry aftirm under Jrenalty of pcrjury onc of thc folkrwing declarations: Dcnplition Pcrnrit.s-Asbcstos Notification Fedcral Rcgulations (Title 40, Pan6) _Rcquircd lrttcr of Notification _l certily that thc fcdcral(asbcstos removal are not applicablc to this projcct. _l ccnily thal I havc rcatl tlus statc tlul lhc ahrvc infornulion is corrcct. I agrcc to contply with all City and County ordinanccs and State Laws rclating and hcrcby authorizc rcprcscdelirs of this City and County to cnter upon thc above rncntioned propcrty for Applicant or Agent Pcrnrilcc nanlc *", ifn) 3- 7.0' v.08-07-2015 o,rc, ifi7 3. Z4t'