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APPROVALS DATE ID/SIG.COMMENTS <br />Site-Work <br />Underqround <br />Pole Bases <br />Liqht Standards <br />Spas, Pool, Fountains <br />Siqns (monument) <br />Life Safety /Low Voltaqe <br />Fire Alarm / Dampers <br />Communications Cable <br />Building <br />Under Slab / Floor <br />Bonding I Groundins I UFER <br />Transformers <br />Torqueinq <br />Sub-Panels <br />Air Conditioners r/ <br />Roof Top Equipment Yb q t/) <br />Factorv Wired Unit <br />Walls (Conduit) <br />Walls (Roush) <br />Ceilinss (Hard & Soffit Rouqh <br />Ceilinqs (T-Bar Rouqh)t I <br />lVleter Release \t (/7tr DX*tr <br />Rouqh <br />Service [Vleter I <br />1tr otv{trFINALt+q <br />Notes, Remarks, Etc.I <br />OWNIi,R IIUII,I)ER DIiI,CARATION <br />I lrereby affinrr under penalty of pr.iury that I anr exenrpt frorn the Contractoni' License law for the ftrllowing rea$n (Sec.7031.5 <br />lJusincss and Prol'cssion Codc): Any City or County which requires a pcrrnit to construct, alter, itnprove. dcrnolish or rcpair any <br />slruclure, prior to its issuarrce. also retluires the applicant lilr such penrit to file a signed slatenrcnl that lr or slrc is licerrsed pursuant <br />to thc provisions ol'thc. Contractor's l,icenscd law (Chapter 9. Cornrncncing with Scction 7(X)0 ol'Division 3 ol'thc Busincss and <br />Prot'essionsCode)orthatlrcorslreisexen4rttherefronrandthebasisfortheallegedexentptiott. AnyviolationofSectionT03l.5byarty <br />applicant for a pennit subjects the applicant to a civil penulty of not tnore thun llve hundred dollars ($5Ult. <br />_1. as owncr ol'thc protrcny. or tny crnpklyccs with wagc.s as thcir solc compensation, will do thc work and thc structurc is not <br />interrtlcd or offeretl for sale (Sec.7(X4. Business and Profcssions Ctxle: Thc Contraclor's Licensc [-aw tloes not apply to an owner of <br />tlre pnlJrcrly wlxr builds or inrproves thereorr, arxl wkr dtxs such wrlrk himself or lrerself or tluough his or her own entployees, <br />providcd that such improvctncnts arc not intcndcd or offercd for salc. ll. howcvcr, thc building or ilnprovcrncnt is sold wilhin one ycar <br />of conrpletkln, tlre Owner Buildcr will lrave the burden o[pnrving tha lrc or she tlid rct buikl or inprove thc propary for the purpose of <br />s:rle). <br />_1. as owner of the propeny. ant exclusively contracting with licensed contraclors to construct tlrc pmject (Sec. 7044. Business <br />and Prulbs.skrn Code: The Contractor's License Law dtrcs not apply to an owner of property who builds or intproves thereon. <br />and who contracts for such projccls with a C()ntraclor(s) liccnscd pursuant to thc Contraclor's License [:w). <br />-Iantexeml)tutlderSectitltl-,B.&P'C.lbrthisreasolt.l)ate: <br />WORKIERS' COM I'I'NSATION <br />DECLARATION <br />I hcrcby allrnr undcr pcnalty of pcrjury onc of thc lirllowing dcclarations: <br />_l have and will rrmilrtain a Certilicate o[Consent to Self-lnsure firr workers'contpensati()n, as provided for bySection 3700 of the <br />l,ahor Codc, for thc Jrcrfornrance of thc work lbr which thc pcrnilt ls Lssucd. <br />_l have and <br />tlrc work frlr <br />will nrtintuin 3700 of lhe l-abor Code, for lhe Jrcrfornutrce of <br />this :uxl lxrlicy uumbt'r arc: <br />l'olicy <br />_l ccrlily that irr thc 1^*rlirrnunr:c ol'tlrc work frrr which tlris pcrnrit is issucd, I slrall not cntploy any lrcrsolt in any manncl' <br />so as lo bcconrc suhjcct to thc workcrs' conrpcnsalion laws of California. and agrcc that if I should becomc subjcct to the <br />workers' con4rcnsution provisions of Section 3700 of tlrc Lahrr Cotle, I shall, forthwith conrply with tlmse provisions.. <br />WARNTNG: I;ailure to secure workers' conrlrcnsation coverdge i.s unlawful,subject an ernployer to critninal penalties arrd <br />civil l'irrcs up to one lrundred tlxrusand dollars in additiorr danuges as provided for lhe <br />Scction 3076 Ctxlc. <br />DECI.ARATION <br />I hereby affirnt under penalty of perjury that I aru licerrsed untler provision of Chapter 9 (contnrcncing with Section 7000) of Division 3 <br />of the Business and Professions Code. arxl rny license is in full force and effect. <br />D 11-License <br />I hcrcby al'linn undcr p'nalty of pcrjury that therc is a construction <br />issued (Scc. 3097. Civ. C.). <br />a8c'ncy pcrlbrrnancc of thc work l'or which this <br />Lender's Nanre: <br />APPI,ICANT DECI,ARATION <br />I trrctry aflirnr undcr Jrcnalty of pcrjury onc of thc following dcclarations: <br />Dcnxrlition Pcrmits-Ashc'stos Notification Ftdcral Rcgulations (Titlc 40, Pan6) <br />_Rcquircd Lcttcr of Notification <br />( _l ccrtity that thc fcdcralrcgulations rcgarding asbcstos rcmovalare not applicablc to this projc'ct. <br />_l ccrril.v that I lravc rcarlthis applicalion arxl statc tlrat llrc alxrvc irtlirnttaliott is corccl. I with all City and County <br />ordinances and Statc laws rclating to and County to cnter upon thc <br />above nrntioned prurperty for <br />Allplicant or Agtnt <br />I'crnrilcc nanle I rrrirrl l: <br />ELECTRICAL-!NSPECTOR RECORD <br />Y( <br />I <br />D*q8" <br />insurance. as <br />issucd. <br />a <br />1ev