20171497 - Permit - Laserfiche WebLink

Home Browse Search

ELECTRICAL-INSPECTOR RECORD APPROVALS DATE ID/SIG COMMENTS Site-Work Underqround Pole Bases Light Standards Spas, Pool, Fountains Signs (monument) Life Safety /Low Voltage Fire Alarm / Dampers Communications Cable Buildinq Under Slab / Floor I Bondinq I Groundinq I UFER 1 Lt t7d 0rtTf)1utrT/ Transformers IU Torqueinq Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Roush) Ceilinqs (Hard & Soffit Rouqh Ceilinqs (T-Bar Rouqh)I I ,l D. lVleter Release I 'LLt\41 ) \)uYa 6/ I Rough I ,l t.) Service N/eter )Ttlw VrrYY c tft>/ FINAL t n,ll<t r )n4-rq Notes, Remarks, Etc.Ir > OWNIiR BUII,DER DI'I,CARATION I hereby afhrnr under penalty of prjury that I anr exenpt frcm the Contractors' License [:w for the following rcason (Sec.7031.5 Busincss and Prolb.ssion Code): Any City or County which rcquires a pcrmit to construct, altcr. irnprove. demolish or rcpair any structurc, prior to its issuance. also requires tlrc applicant for.such pernrit to file a signed slatement that lp or she is licensed purzuant to thc provisions of thc Contractor's l,iccnsed law (Chapter 9, Commcncing with Sccti<ln 7000 of Division 3 ol'the Bu.sincss and Professions Code) or that he or slre is exempt therefronr and the basis for tlrc alleged exenrption. Any violatiott of Section 7031.5 by any applicant for a pennit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). _1. as owner of the propcrty. or tny crnployccs with wagcs as their sole compcnsalion, will do lhe wcrk and thc structurc is not intentlerl or offeretl for sale (Sec.7H4. Business and Professions Ctxle: The Contractor's Licensc law does not apply to an owner of the property wllo builds or inprows tlrcreon, ald wlro doe.s such work himself <lr lrerself or ttuough his or her own enployees, providcd that such improvermnts are not intcnded or offcred for sah. Il. howcvcr, the building or improvcrncnt is sold within onc year of completkrq thc Owncr Buikhr will have thc burden of proving thu he or she did not buikl or improve thc propury for the purpose of sale). _1. as owner of the property, am exclusively contracting with licensed conlractors to construct tlre project (Sec. 7(X4. Busincss arxJ hotbssirxr Code: The Contractor's License Law does not apply to an owner of property who builds or intproves thereon. and who contracts for such projects with a Contractor(s) liccnscd pursuant to the Contraclor's License Law). -IanrexemptunderSectiott-,B.&P.C.lbrtlrisreason. WORKER^S' COM PT]N SATTON DECLARATION I hercby affirm undcr pcnalty of pcrjury one of thc following declarations: _I have arxl will nnintain a Certificate of Consent to Self-lnsure for workers' conrlrcnsation, as provided for by Section 3700 of the labor Code, for the pcrforrnance of the work for which the pcrmit is issued. * nur. arrd will maintain workers' conrpensalion insurance, as required by Section 3700 of thc l-abor Code, for the perfornunce of lhe work for which this 1rcrmit is issued. My workcrs' compensation insurance carricr ard policy nunrbcr arc: ! Poricy rtu,na"r, t O{Q%NLaL ' b? Expires:c _l ccrtify tlrat in thc lrcrlirrnrancc o[thc work for which tlris pcrmit is issucd, I shall not cmploy any lrcrson in any nlanncr so as to bcconrc .subjcct to thc workcrs' conrpensation laws of California, and agrec that if I should becomc subjcct to thc workers' conrlrcnsation provisions of Section 3700 of the Labor Code, I stull, forthwith conrply with thosc provisions.. WARNING: Failure lo secure workers' compensation coverag,e is unlaw[ul, and shall subject an employer to criminul pcnahies and civil fines up to one hurxtred thousand tlollars (5100.000). in adrtition to tlrc cost of compensation, danrages a.s provided for fttc attorney's [ces. a I hercby affirm under penalty of perjury tlut I anr licerrsed undcr provision of Chapter 9 (conrnrcncing with Sectbn 7Un) of Division 3 of the Business and Professiorrs Code. and my license is in full lorce and effect. Licensc lc Number: o o3s -Y7 7k1p CONSTRUCTION LENDING AGENCY I hereby afftrm undcr pcnalty of perjury that thcre is a construction hnding agency for thc pcrlbrrnancc of thc work lbr which this permit is issued (Sec. 3097. Civ. C.). [rnder's Nanre: lrnder's Address: APPI,ICANT DECLARATION I lueby affrm under penalty of pcrjury one of the following declarations: Denrolition Permits-Asbestos Notification Federal Regulations (Title 40, Pan6) Rcquired [.etter of Notification _l ccrtily thal thc federal regulations rcgarding a.shstos rermval arc not applicable to this pmject. Arccrtify tlrat I havc read this application and statc that the above informarion is correct. I agree to conrply with all City and County hrdinances and Statc laws relating to building constructiorl and hercby authorize rcpresentativcs of this City and County to enter upon the abovc rrrcntioned propeny for inspection purposes. Aplplicant or Pcrnrilee name O q Zo I a I ,\