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ELECTRICAL.INSPECTOR RECORD <br />v. 08-07-201 <br />DATE ID/S!G COMMENTSAPPROVALS <br />Site-Work <br />Underqround <br />Pole Bases <br />Liqht Standards <br />Spas, Pool, Fountains <br />Siqns (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 />Ceilinos (Hard & Soffit Rouqh <br />Ceilinos (T-Bar Rouqh) <br />It/eter Release <br />Rouqh AService lVleter <br />*,w\0)F!NAL 6-10-7,0 <br />Notes Remarks Etc. <br />OWNIiR BIJII,DIiR I)T]I,CARATION <br />I hercby affirnr lDder pcrulty of perjury thal I iln cxenrpt from thc Contrrclos Liccnse Law for thc following r.apn (S(.70J1.5 <br />Busincss ard Prolcssion Codc): Any Cil), or County which rcquircs a [Emit to construct. allcr, improvc. demlish or rcpair my <br />struclure, prior () ils issuarce. aLso requires the applicaill tor such pcmil b filc a sigDed slatcmnl that lE or she is liccDsd pursuanl <br />ro rhc provisions ofthc Contrnctor's Liccnscd Iaw (Chaptcr 9. Commcncing with Scction 7Ux) ol Division 3 ofthc Busincss and <br />ProfessionsCodc)orthx(hcorsheisexenuttherefionrand(lcbasisfortlNallegedex.nrptiul. Ailyviolationofseclion?03l.5byaDy <br />ipplicnntforapcrmi!subjectsthc npplicanttoacivilpentrltyofnotrmrethunfivehundreddollars($5(n). <br />_1, as owncr ol'thc proJrny, or nry crnployccs with wagcs as thcir $le compcnsation, will do thc work ard thc stMtw is mt <br />iDteBlcd or olTerad for sle (Sr_.7(X4. Business anrl Profcssions Codc: Thc Conlraclor's Liccnsc law des not apply Io m owncr of <br />tlrc prcpeny wlxr builds or inproves therqnl drd wle does such work himself or lErself or thruugh his or her owo enuloy€es, <br />providcd lhat such impmvcrmnts ec mt inlcrdcd or ollcrcd for slc. Il. howcvtr, 0rc buiHing or irprorcmnt is sld within ore yca <br />ofconpleli(nr, the Owncr Buildcr will havc the burden ofprcvinS lhat hc or shc rlid not build or impmvc 0rc prcpaty for the purpo* of <br />ele). <br />_1. as owncr ofthe prop€iy, am cxclusiyely contractin8 with licc[*d conlrac(os to construct thc pmjcct (Scc. 7O{4. Businc$ <br />ard PE)ltssbnCodci'lheContrack,r'sLiceuseLawdoesndapplytranownerofpropenywhobuildsorinrprovesthereon. <br />and who contads lor such projccts with a Cortraclo(s) licc[ed pursuMl to thc Conrador's Licensc llv). <br />-l <br />anrexenrpt under Sectioil , B. & P.C. lbr tlis rea$[. <br />WORI(I'RS' COMPU,NSATION <br />DECLARATION <br />I lrcrcby alllrrn undcr pcnalty ofncrjury onc oflhc li)llowing dccltralions: <br />_lhavemdwillnraintairaCenilicatcofconsentrcSclf-lrNurcforworkcrs'conrpcnsation,as pmvid€dforbyScctionST0Oofthe <br />libor Codc, for fic Jrcrfornurcc of the work for which thc perdt is issucd. <br />_l have anrl will nrauilrnr wotkers coDrpensilltm insurxnec. as by Seclion 3700 of lhc bbor Code, for tlr lErfomuree of <br />thc work rhis is My cuicr nxl policy outrtrut <br />rp Q*CL c <br />Policy <br />4o I/tt <br />_l ccrify tlut i[ thc Frfornuncc of lhc work for which tlris pcrmil is issucd, I shall nd cnploy ily Frson in any manncr <br />s as to becorrc subjccl lo thc workcrs' conrpcnsation laws of Califomia. and agrcc that if I slnuld bccorc subjrcl to thc <br />*orkers' cotrpcnrution provirioDs of Secrion 1700 of the Labor Codc, I shall, fonhwilh comply wilh thoE provisions.. <br />WARNINC: Failurc lo surc workcrs'corrpcnsation covcruge is unlawful, and shall subjcct m cmploycr lo Fiminal pcmltics and <br />civil l'iiles ul) k) one hundred thousand dollars ($100.0!0). in ^%.,compensation, danuSes as provided for thc <br />t <br />Lahor Codc.l)o inlcrcsl and allork-y's lccs. <br />LICENSED CONTRACTOR <br />DECI"ARATION <br />I hercby affirm under pcDolty of perjury that I anr lic.nsed under pruvision ofChapt.r 9 (connrcocing with S{tion ?000) of Divisi-n J <br />of thc Business and Pmfcssi<rrs Codc. ard mv licensc is in full fore ard cffect. <br />LicenNe <br />tl <br />CONSTRUCTION LENDING AGENCY <br />I hcrcby all'irm undcr pcnalty ot pcrjury rhat thcrc is a construction lending aBcrcy for thc perlbrmance ofthc work ltrr which lhis pcrmit is <br />issued (Src. 3097. Civ. C.). <br />[.n,ler's Nanrc: <br />Lrndcr's Addres\: <br />APPI,ICANT DECI,ARATION <br />I lmtry irffrnr unclcr 1-.nalty of pcrjury one of thc foll(,wing declilati(,ns: <br />Dcnplition Pcrnlits-Ashcst)s Ndification Fcdcral Rcgulations (Titlc 40, PM6) <br />-Rcquircd <br />Lrttcr of No(ifi cation <br />_l cdily (hat lhc lcdcral rcgulations rcgdding $bcshs rcrmval uc not applicable to this projlEt. <br />6 mify tut t trr" rcad this application ard statc tlut inlirnEti(xl i5 coficct I agre rc conrply with all City and County <br />ordinanccs and Statc liws rclalin8 k) buildinB <br />abovc rrcntioncd prcpcny for inspcction <br />Applicstrt or Agml <br />CI'cmitcc nanrc <br />hcrcb), authorizc rcprcscntativcs ofthis City and <br />) <br />ent r upon thc <br />/D-