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APPROVALS DATE ID/SIG.COMMENTS <br />Appliances <br />tr/etal Fire Place <br />Evaporative Cooler <br />Furnace <br />Compressor <br />N/isc. Equipment <br />Duct Work <br />Pre-lnsulation <br />lnsulation <br />Smoke Detectors lnstalled <br />Rouqh Ductwork <br />Vents <br />Toilet Room / Clothes Dryer <br />Residential Ranqe <br />Other <br />Hood <br />Type I Hood <br />Type ll Hood <br />Grease Duct <br />Fire Damper <br />Openinqs <br />lnstallation <br />F.D. Drop Test <br />Above Hard Lid <br />Above T-Bar <br />Rouqh Mech.3l './t( q lz N-ont *( <br />FinalTest <br />Meter Release <br />FINAL /-02-l.E 5b-e?tP Sr@tt^) <br />Notes, Remarks, Etc. <br />lf ,iffi [li[****i*'*[]##fl ,ilt <br />to lhc provisions of llrc Conlmclor's Liccnscd kw (Chapicr 9. Commcncing with Scc(ion 7000 of Division 3 of the Busincss and <br />ProfcssionsCode)orlhslheotsheisexcmpllhcreliomandthehasisforthcallcgcdcxcmption. AnyviolationofScclk)n7031.5hyotry <br />applicantforapcrmitsuhjelslhc applicanttoacivilpen0ltyo[notmrcthanfivchundrcddollns(5500). <br />-1. <br />as owrcr of lhc proIErly. or my cmployccs wilh wagcs as lhcir slc cotrUEnsalk)n. will do lhc work aftl thc slrutm is fril <br />i[lcndcd or offcrcd for sslc (SN.7044. Busincss and hofcssions Codc: The Contractor's Liccnsc Law docs not apply to an owncr of <br />lhc pmfrcny who huilds or ir{rovcs thcrcn. and wlk) des such wrrk himsclf or hersclf or lhmugh his or hcr own cmployccs. <br />providcd lhat such Lnprovcnrnls m not intcMcd oroffcrcd for slc. ll howcvcr. thc building or rnprcvcrrcnl is sokl within onc yc{r <br />ofcomphlion. thc Owncr Buildcr will havc lhc hurdcn ofpmving tlurt hc or shc did nol hoikl or imJ,rcvc thc pfi,IErly for thc l,urlbs of <br />sh). <br />-1. <br />as owrcr of thc pmlrcrly. am exclusivcly contracting wilh liccnscd conlmctos to construct lhe pmjcl (Scc. 7044, Business <br />ild PrcfcssionCode:ThcContraclor'sLiccnscLdwdocsnolapplytoanowncrofpropcrtywhobuildsorimprovesthcrcon. <br />and who conlmcts for such pmjccts with I Contmcto(s) licenscd pursumt b lhe Conlractor's Liccnse Llw). <br />_l am excnrpt undcr Scction-. B. & P.C. for this rcason. <br />Ownrr: <br />IVoRK}'RS' C(UII PENSA'I]ON <br />NECLAR 'IiON <br />I hcrcby affirm undcr pcnalty of perjury one ofthe folbwing dcclarations: <br />Labrr Codc. li)r lhc l)crlitrilrrn.r ol lhc sork li)r shich lhc l)crtrril is i\\ur(l <br />-l <br />havc and will mainlain workc6' comlEnsalion insurarcc. as rcquircd by Strtion 3700 of thc tabor Codc, for the [Erforrorce of <br />the work for which this pcmit is issucd. My workers' compcnsation inrurance carier and policy numbcr uc: <br />Policy U rT />ty' ,q <br />T <br />-l <br />ccnify lhal in lhc pcrformncc of lhc work for which lhis pcrmit is issued. I shall nol employ any;rcrson in any manner <br />s astobccomsubjcrttotheworkcrs'compcnsutionlawsofCalifornia.&ndagrccthetiflshouldtEomsubjsttothe <br />workrs'compcnsalionprovisionsofScclion3T00ofthctatnrCode.lshall.forthwithotrplywilhthosprevisions.. <br />WARNING: Failurc kr rccurt workcrs'compcnsnlion covcrflgc is unlawful. und shall suhjcct an cmploycr to criminal fnaltics and <br />civil fincs up lo orc hundred lhousand dollors ($100.000), in addition lo lhc cost of for thc <br />fecs. <br />DT'CI ARATI(IN <br />I hcrcby allirm un(lcr pcnnlly ol pcrjury thal I arn liccn*\l undcr provision of Chrptcr 9 (comrrcncing with Scction 7fi)0) ol Division l <br />of thc Busincss rnd Prultssi(nrs Codc, {nd Dy licrJlse is i[ lull lorcc nnd cllcct <br />Liccn\c Nunrbcr: <br />CONSTRUCTION I PNDING A(;ENCY <br />I hcrcby allirm un<lcr ;nnrlly of perjury that thcrc is a couslruction lcndirg agcncy lbr thc pcrlormancc oflhc work for which this pcflnit is <br />issucd (Scc. 1097. Civ. C.). <br />[lndcr's Narrc: <br />[rntlcr's Adtlrcss: <br />APPLICAN'I' DIICI ARA'I]0N <br />I hrtby allinn untlcr g:nrlty of prjury onc of thc li)lk)wing (lcclarill i(il\: <br />Dcnx)lilion I'crmil\ A\hcslos N(ilificilliotr ltdcral Rcgulations (-l itlc.l0. I'arl6) <br />_Rcquircd I-cttcr ol Notilicilli(rl <br />_l certify that thc fcdcralrcgulalions rcgdding asbcstos rcmovul are not applicablc to lhis prcjcct. <br />0trevc informalion is corcct. I agre lo comply with all City and County <br />Cily and Counly to entcr ulmn thc <br />abovc nrcntioncd prcpcny for inspcction purfxrscs. <br />Applicant or Agenl <br />Pcrtrritcc nanE (pri[l <br />F MAR @7JgI8 <br />MECHANICAL.INSPECTOR RECORD <br />contoctor K 16.