Laserfiche WebLink
Rev.08-07-2015 <br />DATE ID/SIG COMMENTSAPPROVALS <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 / Floor <br />Bonding / Grounding / 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 />Ceilings (Hard & Soffit Rough <br />Ceilinqs (T-Bar Rouqh) <br />Meter Release <br />Rouqh <br />Service Meter /a\ <br />,-2A,2a 9.ulr[J\FINAL <br />Notes Remarks Etc <br />I hqeby amnn unda poalty of psjury lhat I an exempt from the ContractoE' Licmse Law for the following r6on (56.7031.5 <br />Busincss md Profasion Code): Any City or County which rcquires a permit to coNtruct. alta, improve, dm6lish or rcpair my <br />structue, prior to its issuancc, also requirB the applicmt for such pemit to filc a signed statmmt that he or she is licosed puiumt <br />ro thc provisions of the Conlractor's Licensed Law (Chapts 9. Commencing with S*tion 7000 of Division 3 of the Bushs md <br />Profesions Code) or that he or she is excmpt thqefrom ud lhc b6is for the allcgcd cxmpion. Any violation of Section 7Ol1.5 by any <br />applicantforapamitsubjststhe applicanttoacivilpenallyofnotmorethafivchundreddollas($500). <br />l. s owner of the propqly, or my employe with wag6 I their sle comperoation, will do the work dd the structue is not <br />intmdcd or offqed lbr sale (Se.7044. Busins ild ProfessioN Codc: The Conlractor's Licme Lsw do6 nol apply lo m oMq of <br />thc prcpeny who builds or imprcva th6o[ ild who do6 sch wort himsclf or herclf or thrcugh his or her om cmploycs, <br />providcd that such imFovmts de rct intodcd or oflqed for slc. If. howd6. thc buiHing or improvmot is sld within onc )@ <br />ofcomplaion. the Orms BuikJs will have thc bud6 ofprcving thd he or she did not build or improvc the prcpaty for thc purpos of <br />sale). <br />I. m omo of lhc propqty. an €xclusively contracting with licc$cd contlacloG to coNtrucl the prcject (Se. 7044, Buins <br />od Profosion Code: The Conlraclor's Licensc Law do6 not apply to il owns ofpropeaty u,ho builds or improvd ths@n. <br />and who conlmcts for such projets rvith a Conlmcto(s) licemed pursuel to the Contraclor's Licmc Law). <br />I m cxcmDt unds S6tion-, B. & P.C. for this reson. <br />l)rtc: <br />WORI(ERS'COMPENSATION <br />I hscby affim under penalty of psjury one or,n" a,,o*,n*ffiU <br />_l have md will maintain a Certificatc of Coroot to SelfJnsure for work6' compffition, a provided for by Sction 3700 of the <br />Labor Codr. forlhe Efommce of the work for *hich the pemit is isued., <br />ltfavc and will maintain workm' comperoalion imuace, u required by Sction 3700 of the t bor Code, for thc pofomece of <br />ihc work for which this pmit is isued My workc' compouation imurucc cmio ad policy numbo uc: <br />Policy 4-l-DZa <br />_l cenify that in the psfonnance of the work for which this pmit is issued, I shall not mploy any permn in any mmno <br />s s to bccomc subjet lo thc workm' compcNation laws of Califomia. ild agE lhat if I should becornc subjrt to thc <br />worktrs'compmsalionprovisionsofSectionST00ofthetaborCode,lshall,fonhwithcomplywiththowprovisions.. <br />WARNINC: Failure to *cure workes'cornpeNalion covfra8e is unlawful. and shall subject d qnployq to oiminal pmaltia md <br />civil fines up to one hun&cd thoMd dollm ($100,000), in addition to cos of compemtion. dmags 6 provided for thc <br />Strtion 1076 of the tibor Code. inttret md f6. <br />Dta( 1,,\R,l'iloN <br />alIirrn undr ofperjury that I an licosed undr provision ofChapto 9 wilh Sdion 7000) of Division 3 <br />Code. ud my license is in full ol <br />CONSTRUCTION LENDINC AGENCY <br />I hereby allirm undo penalty of perjury lhat lh6c is a construction lmding agmcy for the pafommce of lhe work for which this pof,it is <br />issued (Sec. 3097. Civ. C.). <br />knder's Nanre: <br />lad6's Addrs: <br />APPLICANT DECLARAI]ON <br />I hqeby aflimr undq pqralty ofprjury one ofthe following delualions: <br />D€molition P@nits-Asb6los Nolification Fedqal Regulalions ( l itle 40. Pm6) <br />_Required <br />the fcdeal rcgulatiom regdding dbstos rernoval ile not applicable lo this prcjccl. <br />to comply with all City and County <br />of this City ad Countyto 616 upon the <br />Permi(e nsme <br />conrcl- I <br />znob <br />ELECTRICAL.INSPECTOR RECORD <br />c-r*,#tAb Cz,nrftr+alroo lrBtmnuc. funC