Laserfiche WebLink
DATE COMMENTSAPPROVALSID/SIG. <br />Site-Work <br />Underqround <br />Pole Bases <br />Liqht Standards <br />Spas, Pool, Fountains <br />Signs (monument) <br />Life Safety /Low Voltage <br />Fire Alarm / Dampers <br />Communications Cable <br />Building <br />Under Slab /Jloor <br />Bondin / UFERIroundi ?11-70 c <br />TransformeV <br />Torqueinq <br />Sub-Panels <br />Air Conditioners \I <br />Roof Top Equipment 21? -20 I <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rouqh)I <br />Ceilings (Hard & Soffit Roush <br />Ceilings (T-Bar Rough)I <br />Meter Release rytq/2d\R-c2r7,t ) <br />Rouqh \-/ <br />Service Meter zls-w lLqe v <br />FINAL \\w.:zo i 4 <br />Notes Remarks Etc.t\ <br />1\I <br />v \-f <br />-) <br />Profe$ionsCode)orthalheorshciscrcrnpllhqefiomandthebasisforthcallegedercrnption. AnyriolationofSfrlionT{).ll.5byany <br />applicant for a pennil subjsts the applicant to a civil pen{lty ofnot rnore tha[ fi\'e htrndred dollars ($5(X)). <br />_1. m orvner of lhe propeny. or my empbye rvith rvage as their sole cotnpensation. rr ill rkr the Nork md lhe slnrdru-c Ls nol <br />intmdcd orofloedforslc(56.7044.Busin6sandProf6sionsCode'lhe('onnacbr'sl-iccnscL.\do6nolapplytoailoNntrof <br />lhepropeny shobuildsorimprovsth6on.trds'hodo6sucls'orthirnselforhoselforthft)ughhisorherosnerrpkrlecs. <br />providedthatsuch imp.ovonenlsdenotimorclsloroffaedforsle. If,ho\revtrthehrildirrgorinprorenrntiss:kl*ithirronelw <br />ofcornplelion. thc Owner Buildo uill have the trrrdo ofpoving lhat he or shc did nol build or irnprove the pr4u1!, for tllc purlFse of <br />ule). <br />_1. a owno of the properly. am erclusivcly contracting rvilh licmed conlraclos kr conslrucl the Dojccl (Ss. 7(H{. I}usiil6s <br />and ProfesionCode:'l'heContractor'sLicensc[-arvdo6not.pplylo[nownerofpropotys'hobuildsorirnprol'cslhcrcon. <br />and who conlrads for such projects wilh a Contractor(s) Iicensed pursu.nl lo the Conlraclor's License l,a*'). <br />Drte,_ Otner: _ _ <br />WO RKERS' COIIIPI]NSATION <br />DECLARATION <br />I hoeby aflirrn under penalty ofpajury onc ofthe following drlrations: <br />_l havc md will mintain a Certificalc of CoNent to Self-lnsure for rvorkos conrpmrtion. as trof idql for by Selion -1700 of thc <br />Labor Codc. for the pcrfomancc o f thc rvort for which thc pmit is issucd. <br />-lmexemptundersetion-.t].&P'C,forIhisreason. <br />PolicyNumtrer:g <br />_lhaveandrvillmainlainworkss'conlpensalioninsurnncc.as requiredbySeclioillT00oflheLabor(bde.forthepof(nlnmceof <br />the *ork for whichLhis pcnnit is i$ued. My workqs' cornpensation insurance can iq ord Jx)licy nunrbcr a e: <br />,^**,-, EvCe:.arff <br />h \[tn cs: <br />I cenify thal in lhe prforlrance ofthe s'ork for rvhich this permit is issred. I shall not onploy aD) person in anl nlanilcr <br />s as to becomc subjccl to lhc s'orkqs' contpcnsation las s o f ('ali fomia. snd asrce lhal i f I should becorne sutriet to thc <br />workfrs'con)pensationprovisionsofSeclionlT00ofthel.atxrrCode.lshall.forth$ithconrplyr!iththoscl)rovisions.. <br />WARNINC: Faifure to scure $'orkcrs'coflrpcnsalion coleragc is unlasful. and shall subicct an enplorcr k) (Tinliral laratis and <br />civil finesuptoonehundredthouwnddollars($100.000).ifiadditionlolhccoslofcon4rcnsalion.danragesasl)ro\i(ledforthe <br />nnLl allorneJ s fccs. <br />LICENSED CONTRAC'TOR <br />DECLARA'TION <br />I hmeby allirm under penalty of perjury that I an licensed unda pro!ision ofChaptq 9 (conilnenciilg with Sccti(rn 7000) of Division l <br />of the Rusinss md Profssions Code, ild my license is in full force mdeff<t. <br />Setion 3076 dlhe Labor ( ode. int(61,?-zb /b <br />t"*.rruu. ' -4G: LicenscNumber: ' 74q O? <br />,^r",.%-rz--@) <br />CONS'I'RUC ION LENDING ACENCY <br />I h6eby amrm und6 penally ofpgjury that thec is a construction hnding agmcy for thc;nfonrance oflhe sork ftr *hich this pqmit b <br />issued (Sa. 1097. Civ. C.). <br />Lcndtr's Narne: <br />APPLICANI' DECLARATION <br />I haeby allim under penalty of perjury one ofthe follorving declaations: <br />Demolition Permits-Asbeslos Notification Fcderal Regulalions (Title 40. I'an6) <br />-Required <br />Lelts of Notifi cation <br />_l certify lhat the fcderal rcgulations rcguding mbestos rcrnoval are nol applicable lo this projret. <br />furotify Lutl have rear! this application md slate that lhe f,hle infonnalt)n is coral. I sgre to conrply <br />ordinmce and State lrws rchting to brilding conslruclion. md hereby authorize rggr6cDtatirs oIthis ( il\ <br />above mentioned propeny ftrr insJmtic <br />AppticrntorAgents rrrr"r", s< Yr-+n7,,& r)sre:' <br />permire nrme ( prin r' x U.,4oIZ{.*C<AJ <br />$ ith all ('il\ nnd ( ounty <br />nild (irunl) lo ontr upon the <br />/-zb r{ <br />ELECTRICAL.INSPECTOR RECORD <br />D^,, no n7 <br />I <br />t\ <br />/\ <br />(.L1 <br />.t- <br />F\. <br />._-,,-^-....rt(- <br />Lcndtr s Addr6s: