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ELECTRICAL.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG COMMENTS ()WNl.lR Btlll,l)ltR l)III,CARATION <br />I herchy afftrtrr under penalty of ltr.Iury thnl I am excmpt fronr lhe CutrractoB Licensc [jw for thc following Eaen (S(.?0J1.5 <br />Busincss and t,roltssir)n Codc)r Any Cily or Counly which rcquircs a lEnnil b construct, ahtr. irnprovc. dcmlish or rclair my <br />slructure.l[iut)its i\sunnce.rlsorequireslheapplicniltforsuchfernilbfileasignedslutentnt thatheorsheislicenFd pursuanl <br />ro thc pmvisions ol thr' Contrachr's l,iccnscd liw (Chaptcr 9. CohmcncinS wilh Scction 70UJ ol Division 3 of thc Busincss and <br />PrcfessionsCode)rtrthatlNor\heisereDilthcrelronlardtlEhalisli,rtlErllegerlexenrptid. AnyviolationofSectionT03l.5hyany <br />ilpplicnnl lbr x p€nnit subjecrN llE applicaDt lo d civil perully o[ trot rnore thrn five hundrcd dollars ($50{)). <br />_1. as owncr ol tlE prolErlv. or my crn0lovecs wilh wagcs ar lhcir sl!' cornlrcnsation, will do lhc wc,rk ard lhc stMurc i\ mt <br />irilcrrdcd orolTered tor ule (Sec.7lll.l. Busirrcss and Prufesskrrs Cqle: The Coilrnclor's Liccnsc Law d@s not npply to an owner o[ <br />the ffi4rrty who builds or imp(,vcs therslr, ard wlm docs such ul,rk himself or lerself or lln)ugh his or lEr own enlpl(,yecs, <br />pro\id('dthalsuch improvorcntsarcmtintcftlcdoroltcrcdforslc. ll.hucvcr.th(blildingorirnprovcrrcntissklwithinonc}'d <br />o[conpleli0r, tlrc Owner Builder will luvc lhe burdcn ol pr)vir8 lhat hc or she did not buiu or impnrve tlrc propeny for tlE puqDse of <br />sak). <br />_1. a\ owner of the p,rrl)eily. ilm exclusirely contractirlg with licenserl contruck)rs lo cu)slruct lhe pn).iect (Sec. 7044. Business <br />and t\olissiurCtxle:lheCotrtrac()r'sLiccnseLawdocsnotapplyl()ailownerofp()penywhobuildsorinrprrvesthercon. <br />and who conlrncls li,r such pn,i'cls with a Contrackr(s) liccnsd pursumt k) lhc Conlraclor's Liccnsc [rw). <br />-l <br />af,rexempt under Secti(trr-, B. & P.C. lirr this teason. <br />IY(}RK}:RS' CONIPENSA'TION <br />I)ECLARATION <br />I hcr.by illirDl un(lcr |cntrlly of pcrjury otrc (,1 lhc l()lhrwirlg (lc.l[at()ns: <br />[,alxx'Gxlc, f({ lhc lrrlinrnnncc ofthc work li,r which lhc pcnnil is isruc(|. <br />_lhuveurrdwillnrair{nilworkers c(nrrpetrsrltDiDsuraDcc.as requiredhySeclirrr3T00oftlrct horCi)de,lorthelrrforunce(,f <br />thc work li)r which this pcrilril is issuc(l. My urrkcrs' con4*nsalion insurmcc cffiicr axl lxrlicy nunrbcr uc: <br />Policy Nurlbcr: Fipires: <br />_l ccrily that iil rhc l{rlirn)ilncc ol lh('s(nk f(n which lhis Nrnlit is issucd, I shall not cn4rloy any lErson ln any nuilncr <br />so ds h tx'corrr ruhjccl lo thc qorkcrs' cornpcnsalion laws ol Calilbrnid. aild asrcc lhat if l should bccotrE sub.icct to thc <br />workcrs'cotrrpnulionpro\'i\iotrsofSeutioD.]700oflheLatx,r(bde,lshnll,fonhwithcotnplywilhlho*provisiuns.. <br />WARNINGT Failurc to scure workerr'conlxnsation covcrage is unhwful, nnd shall subjcct sn cmploycr to cyiminal lEnal(ics and <br />civil lil)es up lo oDe Inrndred tkrusand rlollars ($100.U10). in ddition t) the cost of cotrrperLsati(rl. dan)ages as providcd for lhe <br />Sccli()n -1076 of thc Lnlx)r Co(lc. inlcrcst and albrncy's lccs. <br />I,ICENSED CONTRACToR <br />I)ECT,ARA'TToN <br />I hereby rlfirnr uDder I)ctrrlty of pcr.iury thill I atrl Iicenscd under provision ofChupter 9 (coilurEncing wih Section 7000) of Division 3 <br />o[ the l]usincss and I'rofersions Code. ard lnv licensc is in full lbrce atrd cfttct. <br />License Clarr:-Liccn\e Nunlber: <br />- <br />CONSTRUCTTON LENDING AGENCY <br />I hcrcby allinn und!'r [inah!'of frjur! that Ihcrc is a conslruction lcnding agt'rcy frrr thc pcrl'oflmrcc ol lhc worl ltrr which lhis Filnil is <br />issucd (Sec.3097. ('iv. C.). <br />[4ililer's Nrnrc. _ <br />I-cndcr's Addrcs\: <br />APPT,ICAN'T DT:CI,ARd1'ION <br />I ll'nby allirnr undcr pnalty of l)cdury onc ol'lhc folk,winS dcclu'alions: <br />Dcnx,lilion Pcrnrils-Aslrsk)s Notificrti()n Fcdcrrl RcSuluti(,ns (l'illc 40, Pd6) <br />_Rcquircd lrncr ol Nolilicrli(trr <br />-l <br />ccnili that lhc fcdcral rcgulatirnN rcgtrding rsbcstos rcmrval arc nol applicablc lo this frojcct. <br />ordinanccs and Slatc Laws rclating (o huilding conslructir)n. and lrcrcby aulh)rizc rcprcscnlativcs o[ lhis City and County k1 eolcr ulnn thc <br />rbove nEnti(nBd propenv for iospccti(rr pu{rc$'s. <br />Appli(ant or Agrnl <br />P(mrilcc ntrnrc lprinl,: <br />Site-Work <br />Underqround <br />Pole Bases <br />Liqht Standards <br />Spas, Pool, Fountains <br />Siqns (monument) <br />Life Safetv /Low Voltaqe <br />Fire Alarm / Dampers <br />Communications Cable <br />Buildinq <br />Under Slab / Floor <br />Bondinq / Groundinq / UFER <br />Transformers <br />Torqueinq <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rouqh) <br />Ceilinos (Hard & Soffit Rouqh <br />Ceilinqs (T-Bar Rouqh) <br />lMeter Release <br />Rouqh <br />Service lMeter <br />F!NAL <br />Notes, Remarks, Etc <br />I <br />,