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ELECTRICAL.!NSPECTOR RECORD <br />I hcrcby affirm utrdcr penalty of per,ury that I iln exenrpl fronr the ContractoN' Liccnsc bw for thc following rea$n (Ss.7031.5 <br />Busincss and Profcssion Codc): Any Cily or County which rcquircs a pcr,nil h construcl, altcr, improvc. dcmlish or rcpair my <br />slructurc,priort)ils issunnce.ilsorequircsthcapplicailforsuchpemrittofileasignedslalenEill lhatlEorshcislicctrscd pursuaDl <br />to thc previsions of thc Contraclor's l,iccnscd law (Chapter 9. Cornmcncing wilh Scction ?000 of Division 3 of thc Business and <br />ProtessionsC()de)orthrtItorsheisexelrptthcreftonlaldtlEbasisfortlEallesedexenlplioo. AnyviolalionofSaclionT0Sl.5byaily <br />rpplicnnt[orupcrmilsubjectstlrc applicar(toacivilpenrltyofnotrrcrcthanfivchundreddollars($500). <br />_1. as owncr ol'th(' pro}trl!'. or my crnp klyecs with wagcs as thcir $lc compcnsation, will do thc work ard (hc stMuc is mt <br />irncnlcd orolleredforsalc(Se.7(ll4.BusinessandPrcfessionsCoda:ThcConlraclor'sLiccnscLawdocsnotapplyloaoowncrof <br />tlrepDpefly wlphuildsorin|p(,vcstltrqrl.drlwlndoessuchworkhimsclforlErselforthroughhisorlErownenFloy*s. <br />providcd that such improvcrrcnts {c not inlcndcd orollcrcd for sah. Il, howcvcr. tlrc building or improvemnt is mld within onc }eil <br />of .ompletim, tlE Owrrcr Buiuer will luvc the burrlcn of proving thd IE or she dirl mt buill or irpovc 0E prcpqty for lh. purtr)e of <br />*rle). <br />_1. 8s owner of the propeny, am exclusivcly contrdctin8 with liccNd contr&lors to conslruct tlE p,ojcct (Scc. 7044. Busincs <br />aill Prollssi[Code:Th€Contractor'sLicetrseLawdoestrotapplytoanownerofpropcnywhobuildsorimprovesthereon. <br />and who conlrncts for such p()jccts wilh a Conlmcto(s) liccnscd pursud to thc Conretor's LiccNe [2w). <br />_l anr excnpl under Section-, B. & P.C. l'or lhis reasn. <br />Ortrer:- <br />WORI(ERS'COMPENSATI_ <br />DEI]I.AEAIIgN <br />I hcrcby aflirm undcr pcmlry ofpcrjury one ofthc lbllowing declaratioN: <br />_IhaveandwillnuintahaCcnificatcofCorBentloSclf-lnsuGforworLds'comrBdion,as prcvidcdforbySetion3T0Oofth€ <br />labor Codc, for thc pcrfoflmcc of lhc work lbr which the pcnilt is issucd. <br />_l have and will nuintain work.rs' compcrEalion insuranc., as requiEd by Scclion 3700 of lhe kbor Codc, for thc perfomurcc of <br />thc work this ir My'trsurilncc cmrcl ilxl lrulicyr*(a vr /ato& <br />Policy <br />_l ccnili lhat in thc Frlbrnuncc of rhc work for which this lcrmil is issucd, I slull not cnrploy any ltrson in &y muncr <br />so as to becorrc suhjcct to thc workers' compensation laws of Cdlifomia, and agrce thut if I should becorre subjcct to (he <br />*orkers' conDensation prorisioru of Section l7Ltr of the hbor C'odc, I slull, fonhwith coriply with lhos prcvisioru.. <br />I{ARNING: Failure rc Nccura workars'compcnsation covcmgc is unlawful, and shall subject an cmployer to dminal pcnaltiqs and <br />dollrrs (S 100.000). <br />atrd atktrncy s lccs. <br />ol col|pcrtsaliur. dannges as providcd lor th€ <br />LICENSED CONTR CTOR <br />I)ECI,ARATION <br />I hercby affirm under lrcnnlty of pcrjury thilr I anr licen*d undcr prcviriotr ofChapter 9 (conurrncing with Section 7000) of Dirrsion <br />of the Busines! and l'mfcssions Codc. nRl rnv lice[* is in full [or@ dnl effcct. <br />civil fines up k) one luodrcd thousand <br />S!'ction 3076 oI tholrhor Codc. intcrcst <br />o",", a la/P <br />I addlio[ to ltE$ostG <br />-? q) 61€Liccose <br />W <br />I hcrcby allirm undcr pnalty ol pcrjury that thcrc is a construction bnding agcrcy for the pcrfo.rurcc ofthc work for which lhis Fflnil i{ <br />issucd (Scc. 3097. Civ. C.). <br />knJcr's Nanre: <br />- <br />[rndcr's Addrcss: <br />APPI,ICANT DECI.ARATION <br />I lEeby aflimundcr pcnalty of pcrjury one of thc folhwing delddions: <br />DcnDlition Pcrnils-Asbeslos Notification Fcdcral RcSulations (Titlc 40, Pm6) <br />_Requircd Lttcr of Ndificattun <br />_l ccrtili that thc tcdcral rcgulations rcg{ding &shcstos rcrnrval uc not applicablc to this proirt. <br />f,)l ccniti thar I hnvc rcild tlus apl)licutron drd sta(c that llrc ak)vc inlbrnulion is corcct. I agrcc to conply with all City and County <br />ordineccs and slalc Laws rcL!ing to building <br />sbove rncntioned prcpefly for inspcction <br />Aplrliceilt or ABml <br />I'cmrilcc tranrc <br />hcrcby autlpria rcprc*nlatives oflhis City and Couav to cntk umn tht/3/k <br />ID/S!G.COMMENTSAPPROVALSDATE <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 />Buildinq <br />Under Slab / Floor <br />Bondinq / Groundinq / UFER <br />Transformers <br />Torqueing <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rouqh) <br />Ceilinqs (Hard & Soffit Rough <br />Ceilings (T-Bar Rough) <br />[Vleter Release <br />Rough <br />Service [Vleter r\ <br />FINAL G_10_71 y.vLVt <br />Notes Remarks Etc. <br />,On <br />Rev.08-07-2015 <br />t <br />'o^rt