Laserfiche WebLink
ELECTRICAL.INSPECTOR <br />Rev.08-07-2015 <br />APPROVALS DATE !D/S!G.COMMENTS <br />Site-Work <br />Underqround <br />Pole Bases <br />Liqht Standards <br />Spas, Pool, Fountains <br />Siqns (monument) <br />Life Safety /Low Voltage <br />Flre Alarm / Dampers <br />Communications Cable <br />Building <br />Under Slab / Floor <br />Bonding / Grounding / UFER <br />Transformers <br />Torqueino <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Roush) <br />Ceilinqs (Hard & Soffit Rough <br />Ceilinqs (T-Bar Rouqh) <br />l\Ieter Release <br />Rouqh <br />,Z-\Service lVeter (-?o-2e /?zrt / €,at L rlFINAL <br />Notes, Remarks, Etc. <br />OWNDR BUILDI:R DI.]I,CARATION <br />I hcreby aflrnr uDder pcnalty of pcrjury that I dn excmpt frum thc ContracloB Licensc law for the followhg rcaen (Scc.703 1.5 <br />Busincss and Prolcssion Codc): Any City or County which rcquircs a pcrmit to conslruct, alter. improve, dcmlish or rcpair eny <br />structure. prior to ils issuance. also rc<pires thc applicot for such lEmil to fih a si8ncd statcmnl lhat tE or shc is liccred pusant <br />lo the pmvisions of thc Contractor's Liccnscd law (Chaptcr 9, Comtncncing with Scction 7000 of Division 3 o[ thc Busiress and <br />Profes3ionsCode)orthatlrcorslxisexenrptlherefiomiudllEbdisfortlEallegedexcnplion. AnyviolatiooofsectionT03l.5byany <br />applicdnt for r pernit subjects the ro a civil pcnalty of not mrc than fivc hundrcd dolhrs ($500). <br />_1, as owncr ollhc with wagcs as thcir solc compcnsation, will do thc work and the strcturc is fr)t <br />irlcrxlcd oroflcred for Busincss and Pmfcsiom Codc: Thc Contractor's Liccn* l:w des not apply to m omd of <br />the prcpeny who thcrdnr, md wlD does such work himself or lErselfor tkough his or her own enpkryees, <br />providcd tha(dc ml iflcndcd or olfcrcd for sb. ll, hoscvcr, tlE huiHins or itrprovemDt is $ld withio om )rcd <br />ot Builder will lurve thc burden ofprcvinS lhat he or she did not build or imprcve thc prcpefly for thc purpos of <br />silc). <br />ofthc propcny, am exclusivcly contracling with liccnsrl conuacloB to construd th. pmjet (Scc. 7O14, Busircs <br />and holbsiDCodc:TheContrack)r'sLicenseLawdoesnotapplytoanowoerofptopenywhobuildsoriDprovesthereon. <br />and who conuacls for such projccls with a Cr)ntEchr(s) liccnsd pursumt b thc Conraclor's Liccnsc [jw). <br />-I <br />B .C. lbr this reason. <br />L I)}:CI-ARATIoN <br />I hcreby affirm undcr penahyofpajury one ofth. following decltratiom: <br />_l havc and will nuintain a Ccnificatc of Conscnt to Sclf-lnsc for porkds' @mpcnsatioq u trcvidcd for by Scction 3700 of thc <br />t bor Codq for thc Jrcrfonlrme of the work for which the psmit ii issued. <br />_l havc and will nuintain workc6' conrpcNation isursrec, as rcquiEd by Sstion 3700 of lhE Libor Codc, for thc pcrfomc of <br />thc work for which rhis Frmit is issucd. My workds' compeNdion iNuilce cmicr ald [Elicy numbcr @: <br />r-;-. <br />Policy <br />_l ccnify that in thc lNilbrnunce of thc w(,rk for which this pcrnlit is issucd, I shall not cnrploy my pcrxrn in aoy muncr <br />$ astobccorrcsubjcc(tothcworkcrs'coilrpcnsationlawsofcaliforilia.andasrccthatiflshouldbccorresubjccttolhe <br />workcrs conrpensationprovi\ionrofSection3?00ofthcLaborCorlc,lslull,fonhwithconplywilhlho*prcvisios.. <br />WARNTNG: Failure to secure workcrs'conrpensation coveroge is unlawful, rnd shall subjact qn employcr to criminal pcnalties {nd <br />civil t-lnes to orrc lrurrdrcd (housand dollars 100.000). in addition to tlE cosl of corpc[etion, dmEgcs 6 prcvidcd for thc <br />Sccli(ilr C<xlc, <br />I hcrcby afltrm under penahy of pcrjury that I anl liccnsd 9 (corlmncing with Setbn 7000) of Divisbn l <br />of the Busincss and PrcfcNsiors Codc. and my license is in lull force md elllct. <br />Licanse <br />I hcrcby allirm undcr frnalry ofpcr.iury thal thcrc <br />issued (Scc. 1097, Civ. C.). <br />kndcr's Nantc: <br />agcncy for pcrl-oflnarcc ofthc *ork ldr which this pcrmit i\ <br />kMrr's AilJres\: <br />I lrrchy allirilrundcr 1x[rlly of <br />E@NLPE&^RA'I!AN <br />of thc folkrwing dccluations: <br />l:cdcral Rcgulati(,ns (Tnlc 40, Pm6)Dcnbliti()n <br />_Rcquicd <br />_t thc rc84din8 strcstos rcrmval dc nol applicablc to fiis projet. <br />thill I with all City and County <br />and stale and to cnte( uFrn thc <br />ub()\'e trEntioncd <br />rbApplicant or Agmt <br />P.'milec nemc <br />afpllciltioD ilxl strtc that <br />) <br />Z 1n