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ELECTRICAL.INSPECTOR RECOR D <br />v. 08-07-201 5 <br />APPROVALS DATE ID/SIG.COMMENTS <br />Site-Work <br />Underqround <br />Pole Bases <br />Light Standards <br />Spas, Pool, Fountains <br />Signs (monument) <br />Life Safety /Low Voltaqe <br />Fire Alarm / Dampers <br />Communications Cable <br />Buildinq <br />Under Slab / Floor t I <br />N+^q#Bonding I Grounding I UFER t?7 'Ll 7 <br />Transformers I <br />Torqueinq <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment '7/l Dk#Xt <br />Factory Wired Unit v, <br />Walls (Conduit) <br />Walls (Rouoh) <br />Ceilings (Hard & Soffit Roush <br />Ceilinss (T-Bar Rouqh)I I <br />l>kw)N/eter Release tl-2t 7 7tl <br />Rouqh <br />Service [/eter I I fa <br />FINAL I'7-/I lr(DKY Yl <br />Notes, Remarks, Etc.It <br />\ <br />OWNT'R BUII,I)I'R DIiI,CA RATION <br />I hereby afFrnr under pcnalty of ;rr.iury tlut I arn exenlpt frorn the Contraclors' License [.aw for the followirtg reason (Sec.7031.5 <br />llusiness and Prol'cssion Codc): Any City or Countv which rcquircs a pcrrnit to construct, alter. itnprovc, dcrnolish or rcpair any <br />structure. prior to its issuarrce. also requires the applicanl tirr such pernrit to fih a signed slatenrenl that lre or she ls licensed pursuant <br />to thc provisions ol'tlrc Contractor's l,iccnscd Iaw (Chapter 9. Comrncncing with Scction 7000 ol'l)ivision 3 ol'the Busincss and <br />Professions Codet or that lrc or slrc is exenrpt therefronr arrd tlrc basis frrr tlrc ulleged exentpti<llt. Any violatiott of Seclion T03 l .5 by any <br />applicant lbr a prrnit subjects the npplicunt to u civil penalty of not more thutt five hundred rJollars ($5m). <br />_1. as ()wncr ol'ttrc. prolL-rty. or lny ctnplovccs with wagcs as thcir solt' cornJrensation, will drl thc work and thc stnrcture is not <br />interxled or offeretl ftrr sale (Sec.7(].14. Business alrd Professiorrs Cotle: The Clorrtractor's License Law rloes nol apply ltl an owner of <br />the property wlxr builds or intprove.s llrterrn, ard wlxr does suclr wrlrk lrinrself or lrcrself or througlt his or her owtt enployees, <br />prol'idcd that such improvcrncnts arc not intcndcd or olTcrc'd for sak'. Il. howcver, thc buikJing or funprovctncnt is sold within one yr-'ar <br />of conrpletiorl the Owrrcr Builder will have the burden of provirrg thut he or slrc did not build or improve the ploperry ftlr the purprse of <br />s:rle). <br />_1. as owner of the ptotrctly, anr exclusively contracting with licensed conlraclors to consuucl the project (Sec. 70++. Busines.s <br />arxJ Pnrh:rsiou Code: The Contractor's License Law dtxs not apply to an owner of proJrrty who buikls or intproves tlrereon. <br />and who contracts for such projects with a Contracto(s) licenscd pursuant to the Contraclor's Liccnsc Law). <br />-IantexemptuttderSection-'B.&P.C.forthisreason. <br />WORKtr]RS' COMPENSATION <br />DECLARATION <br />I hcrcby aflirm undcr Jrcnalty of pcrjury one of thc t'ollowing dcclarations: <br />_l trave and will nmintain a Certilicate of Consent to Self-lrusure for workers' conlpetxation, as provided for by Section 3700 of the <br />L^ahor Codc, for thc perforrnancc of thc work lbr which thc pernrit is issued. <br />WOrrrand will nuintain workers' conrpensation insurarrce, as required by Section 3700 of the t-abor Code, for lhe Jrrfornunc'e of <br />tlrc work for wlrich this lrcrnrit is issucd. My workcrs' conqrcnsation insurance carrier arxl gnlicy numhcr iue:-Ahz-rica^Q-rtf r Cl-t, <br />Policy <br />_l ccrrily that in tlrc pcrlirrnnncc o[thc work lirr which tlris pcrrnit is issuctl, I shall ttot cntltloy any l)crson itt atty nlanncr <br />so astobccoltrcsubjccttothcworkL'rs'cornpcrrsaliorrlawsofCalifornia.andagrccthatiflshouldbccotncsubjccttothe <br />workers' conrpensation provisiulrs of Sectiorr 1700 of the Labor Cbde, I slmll, forthwith conrply with those provi.sions.. <br />WARNING: Failure lo secure workers' cornlrcrrsution coverirge is unlawful. irnd shal! <br />the cost of <br />subject an ernployer to criminal penaltics antl <br />compertsatirxt, danuges as provided lbr the <br />c I Var4c4 \ <br />lrGnsur coNTIrAcroR <br />I a.r lice.sc.f r. ChapterI hereby affrrtr under ltnalty of ;rcrjury that <br />of the liusiness and Professiorrs Code. arxl rny license is in lull force and effect. <br />9 (conrnrncing with Section 7000) of Division 3 <br />a)]7tc{License <br />(c, <br />I f..v Vr <br />CONSTRUCTION LENDING AGENCY <br />I hcrcby al'lirrn undcr pnalty ol'pcrjury that thcrc is a construction lcnding agc'ncy for thc pcrlbrtnancc ol'thc work l'or which this pcrmit is <br />issued tSec. 3097. Civ. C.). <br />[-cnder's Nanrc: <br />l.cnder's Addrcss: <br />APPI,ICAN'T DECI,ARATION <br />I hcrcby aflirnr untlcr pcnalty of pcrjury onc of thc folklwing dcclarations: <br />Dcnxrlition Pernrits-Asbt'stos Notification Fctlcral Rcgulations (Titlc 40. Pur(r) <br />-Rcquircd <br />l,cttcr of Notification <br />_l ccrtily that thc l'ctlcral rcgulations rcgarding asbcstos rcmoval arc not applicablc to this projcct. o <br />ylcertili that I lnvc rcatl ttris appticatkrn iuxl statc tlut thc ahrvc infornurtiort is corrccl. I agrcc to conply witlr all Ciry and County <br />orclinanccs and Statc Laws rclating to constluction. and hcrcby authorizc <br />ah.rve rrrcntioned property for <br />Applirartt or Agtnt <br />l'crnritec nanle <br />rcprcsentativcs oI this City and County to cnter uprn thc <br />' <br />,r,o, Z-1"1 - (ct <br />c <br />Z <br />A <br />Nwn,y.r, /VC{OQ&/i.I? expires: <br />--!a