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20461996 - Permit
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20461996 - Permit
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Last modified
6/2/2021 9:06:41 AM
Creation date
6/2/2021 9:06:41 AM
Metadata
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Permit
Permit Number
20461996
Full Address
121 E Washington Ave
Permit ID
224758
Master ID Number
2016-128828
Project Name
N/V Garcia 2016
Street Number
000121
Street Direction
E
Street Name
Washington
Street Suffix
Ave
Building Use Code
Office
Job Types
Tenant Improvement
Permit Type
Electrical
Applied Date
11/15/2016
Issued Date
11/15/2016
Finalized Date
1/9/2018
Flood Zone
X-0602320163J
Description of Work
Remove illegal demising wall that created Unit B. New partitions to create (2) new accessible restrooms, waiting area, & hallway on 1st Floor. New partitions to create storage, billing, & chart rooms on 2nd Floor.
Nature of Work
TI/Demo/Restrooms
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ELECTRICAL-INSPECTOR RECORD <br />APPROVALS DATE ID/SIG. COMMENTS OWNER llUILDER D ELCARATION <br />I hereby affirm under penalty of perjury that I mn exem pt from the Cont ractors· l..icen!-e Law fo r the following re:tson (S ec.703 1:1 <br />Site-Work Business and Professio n Code): Any City or Co un1 y which requires a permit to co nstruct. ahc1·. improve. demolish or repair any <br />structure, prior 10 its issuance, also req uires the applicant for such pcnnit to fi le a signed statement that he o r she is licensed pursuant <br />Underqround to the provisions of the Controctor·s Licensed Law (Chapter 9. Co mmencing with Section 7000 o f Divis ion 3 of the Business and <br />Pole Bases Professions Code) or that he or she is exempt therefrom and the ba.,;;is for the alleged exemptio n. An y violntion of Seclion 7031.5 by any <br />applicant for a pennit subjects the applicant to a ci vil penalty of not mo re than five hundred dollars ($500). • <br />Light Standards _I, as owner oflhc propcr1 y. or my employees with wngcs as their sole compcnsa1ion. will do the work and 1he structure is not <br />Spas, Pool, Fountains intended or orrcrcd for sale (Scc.7044, L3usiness and Profe5sions Code: The Contrac1 or's License Law does not apply to an o,,"ner of <br />tht! propt.i1y who bu il ds or improvt'S thc.:.,eon. and who does such work himself or herself or through his or her own e111ployees.- <br />Siqns (monument) provided that such improvt.incnts arc nol imcndetl or orrered for sale. If. however. the bu ild ing or irnprorement is sold wii't1i11 one year <br />of complet ion. 1hc Owner BuikJcr wil\ h.tvc the burden of proving that he or she d id not build or improve the propt11 y for tht puqXJsc of <br />sale). <br />Life Safety /Low Voltage _I. nsowncr of the propci1y. am exclusi vely contract ing wil h lict.'llScd contractors to constn1ct the project (Sec. 704 4. Business <br />Fire Alarm / Dampers <br />and Pmfess io n Code: The Conlrnctor·s License La w does not apply lo an owner ofp1·o perty who bui lds or improves tl~ereon. <br />and who con1rnc1s ror such projects with a Contrac101·(s) licensed pursuant 10 the Contraclor"s License Law). <br />Communications Cable _I am c;u.'.'mpt under Scrtion • B. & r.C. for th is reason. <br />Date: Owner: <br />Building WORKF.RS' !;O~IPENSATION <br />IJF.r LAl!ATION <br />Under Slab / Fl oor I hereby affirm under penalt y of pt"ljuryonc oflhe fo llowing declarations: <br />Bondinq / Grounding / UFER _I have and will ma inta in a Cc11 ifica1e of Consent lo Self-Insure for wo rkers ' compensatio n. as provided for by Section 3700 o f the <br />Labor Code. for the perfonnance of the work for which the pennit is iss ued <br />Transformers _I have and will ma intain workers' compensatio n insu rnn ee. as required by Sect ion 3700 of the Labo r Code. for the perfonnance or <br />Torqueing <br />~:T~:::k 6,~t:s;7; is ~i;;;vz· co1~n~1S;•~;;;a~•; po li?~~;e/? <br />Sub-Panels <br />• V? ,_ . ' -, \_ '> ,J, /I 7 Air Conditioners Polic y Number C s I 5_{)_~µ1_/ 8 fapires: a ~ '.,{6 . <br />Roof Too Equipment _I ce11ify that in t he performance of the work for wh ich 1his permi t is issued. I shall nol employ any pers on in any manner <br />Factory Wired Unit so as to become subject to the wu rkcrs· co mpensation laws of Cali fo rnia. and agree 1hat i fI shou ld become subject 10 the <br />workers' compensat ion provisions of Sect ion 3700 oflh c Labo r Code. I sha ll , fort hwit h comply with I hose provisio ns .. <br />Wal ls (Conduit) WARNING: Failure to secure workers' compensation coverage is unlawful. and shall subject an employer to criminal pt.."lm!tics and <br />Walls (Rouq h) civil fines up to one hundred thousand dollars ($100.000). in ad it ion to the cosl of compe11s,11ion. damngcs .t s provided for the <br />Ceilinqs (Hard & Soffit Rouqh Section 3076 of the Labor Code. in terest and attorng:cs. <br />I I 1,, -r;-. A,.... < <br />Ceilinqs (T-Bar Rough) /7.,,, 't:rll-=>-S-)b rv .l::;6)..1-~ </ Date: J/£ f __ '1,.6. Applica t: ~ LI E NS!l!J •~• NTRAf:TOll <br />Meter Release , r ' -UllCLARATION <br />I hereby affirm under penalty of perjury that I am licensed under pro vislon of Chapter 9 (commencing with Section 7000) of Divisi on 3 <br />of the Business and Professio ns Code. and my license is in full force and effect. <br />Rough License Class: .. 5 Licer1.sc N u 111 bcr : ~ .Q <br />Service Meter / I Date_;f.1_'/1J..-1c -.J._L Contracto;b --/.L ¥---/21 ch/ s· FINAL 1/vf '/q; <" ¥--1l..1 ~-0 <br />Notes, Remarks , Etc. ' CONSTRUCTION LEN DI NG AGENCY <br />I hereby affirm under pen.1\ty of perjury thilt tltt:re is a constnict ion lending agency for the perfonnance of the wo rk for which this pt"lln it is <br />issued (Sec. 3097, Civ. C.). <br />Lender's Name: <br />Lender's Address: <br />t;r r u r ANT Dll!;LARA TIQN <br />l hereby affinn umlcr pena lly of pc1jury 0 11c of the fol lowing. dcclaral ions: <br />Demolition Pennits-/\sbestos Not ilicat ion f ederal Regulations (Tit le 40, P.1116) <br />_Required Lett er of Notificat ion <br />_I ct.'Tt ify tha t the federal regubt ions regarding asbestos removal are not applicable to this project. <br />_I ceit ify th at I have read th is appli cmf ~i state that t he a bo\'e in fonnm ion is co1Tcct. I agree to comply with all City and County <br />ordinnnccs and State Laws relating to bu d 1g constmction. and hereby authorize representatives of this C'it y and County to entli upon tl1c <br />above ment ioned propelty for insp71io1 pu ses. G <br />A pplicant or Agent Sign a(n~ f-1;{' .. h l)a (c:_&i/i/---/ 5"" 1 - <br />Pcrn1itec n11111e(p r int): -d..---'L(, I) <br />f.:!,...,, ni:• c:-; ')f'H i~ J ✓
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