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APPROVALS DATE ID/SIG.COMMENTS Oqna.Build!. D.detim
<br />I hcrcby affm ud( pmdq oap.rlury $ar I d.xdpr fom r\l Conr-&ro6 Lic.nrc tlw fo. rhc followins rcEon Go 7oJLj Bujiiqr
<br />dd trcfslion Cod.): Aiy Cily d C.lity vhich EquiB . pmn ro coBEuci !Ila. inprov., d@oli5h or rcpar dy rtrucrw, rio, !o iB
<br />i55@@, aLo (quir6 ll1. +pli@l fd rld p6t io 6t. s sisn.! ,Ltmot rh.t hc or sh. is licascd puB t!o$cFoekioM ofdc
<br />ConE&tors Lic.ns.d L.w (Ch.t6 9, CoM6dn! wi$ S6tion 70oo of Divkio. I of $. Burinc$ sd Prot6iioir Codd q r\.t h. o
<br />sh. is q@pl td.fm &d tir bsi! rc $. .llc8.d cxmptrd Any violdion of S.dion 703 I 5 by My appl;@! ttr . p.mn 6!bjc.t thc
<br />applicul lo . civil pq.lty ol.ot m@ rt& fiv. huidr.,.t dolle (tsoo)
<br />_li d o*nn ol rhc Fol,.rtyi or my mploycq *irh *aAe d rhct 6olc .oEpc.6arion, will do rhc work ed rhc iLucrq. ii ror inr@dcd
<br />or otrn d lor !d? ( S@ 7044, Buiis ed PrcfqrioDi Cod! IIE Cdt &roC! Licosc Law d@ not .pply ro u wn.r of $. Fopqrywto buil& tr improvs li*6, Md vho doq trch wdt himclf or h6.lf or through hir tr hd oe! mploya!!, prcvid?<t rh.l ,!chimprovhda s. n.t in&nd.d o. olfdcd fd.al. Il how+d,lnc buildins tr inprdmhr i! sotd vithin on. ycr of @dptcrion, rnc
<br />Oh6'Buil<td pi ll hav. ln. buda oflroeinS lhs1 h. tr rhc ror blild o, ihprovo for tn. purpG. of r.l.).
<br />_1, { (M6 ol$q propaty, M cxcluiv.ly mn&$ns with liccnscd coir&loft ro.on5a!d $. projcn ( S.c 704,1, Bsin6 dd
<br />Prcf*ti@ Cod. Thc ConE&iorr Li.tuc kv do6 not apply 6 & oMlr of propqry vho buil6 r impror6 rh6.or , sd who
<br />@t &a for such prcjea wit I Coin..lo(, licofd puBuur r,o $. Coriacror,! Lic@. law )
<br />_I @.x.mpt u.d.r Scction
<br />Dar. Omd
<br />WORXERS COMPf, NSATION DECLARATION
<br />I hclcby affim un.ld pcn.lty oa plrjury onc oa th. aollowin8 d@lsations:
<br />_I iav. ed willhainlrin 5 Ccnili..lc of Consor to S.lltnsuE for work6i @nposali@, 6 providcd ftr by S@!o! lToo ofln.
<br />Llbq Co&, ttr 6. pcrf(narc. ot6. wo* fd which tl. p@i! ir is!u.d.
<br />_l havc &d will Faint{in wo*crr comp." rion insurscci s rquircd by Sanon rTOo of lh. L.bor Cod., for ihc p.rtmdcc of tn.poi( fd wht! this pmil i3 isu.d My wortqt' cmpatalim inrurucc cei.r &d policy numb6 uc
<br />(TnG s€tion n.d nor b! c@plclcd if thc p@n il for On. hur&cd dottd ltrool or t4)
<br />_l cdiry $al in $. pafomu@ of thc wdk ld *hich rhis pmit is i$ucd, I shatl nor cmploy My p..son in My murd !o s robadc subjat to r.h. wqtd ' conpd3lrio, l.w of C..lifonia. dd arr. rhd ir I shoutd b.conc subjd ro tc *drd,
<br />conpcNdioi prcvision! oiSqdon 3700 ollhc Lsbor Codc,I ih.ll, fonnwi$ cohply wirh rhs. proviijo.!
<br />WA&NING, rdluc to seur. edk?E' cmgc.stio. @vdas. i5 uol.wrul, ud rn.ll subj.d d .mptoyn ro oiniial pcialria ud cieiliii6 up to o.c hui.lrcd thousd dollu (S 100,000),in .dditioi ro $c co$ of @mFE.ri6, d.nssB s prceid.d fd 6. S@rio to?6 ot
<br />th. L.bor Codq inldBr ed ondncy'i f.q!
<br />LICFNSf,D CONTRACTORS DECLAX,{TION
<br />I hdcby aflim un&r pa.l9 of psjwy ftar I e lic4.d urdd prcvisioi of ch.pts 9 (@m...in8 wnh s.crion Tooo) of Divilion 3 of
<br />lh. Buirs! ed Profdios Cod6. ..d rry licdso t in full foM ed ciLct
<br />CONSARUCTTON LENNING AGENCY
<br />I h.r.by iffim unds pa.lty ofpajury $.1rhe! i!.@Etructid lddiuS rycncy fo. thc pdfm&c. oarho wdk fd whi.fi !ti5 pmlt irislcd (s.c 309?, Civ. C)
<br />AIITLICANT'S DECLAI'ATION
<br />Dmolition !.mil9Aib*lor Nolifiqlioi r.dcBl Rcsutadons Gitl. ,{0, }.n 6)
<br />_ Rcqut d Lctilr ofNodlicariot
<br />_I @niry rhlt !h. f.dq.l Ggul.rion! Essdi.s sb6ls r.Eoval d. not .pplioblc ro $is projcd
<br />_ I cciiry thr! I hsv. rcad rhir Aplicrrio ed rl.r. rhar $. .bovc inrom.io. k ffi*r r rtre lo c@dy wirt rl Ciry sd Cou.ryodi.$s ed Sl.L L5E-El.lj.A ro buildini c@rDcti6. Md hfthy .uthqia E Bot.liv6 of $k Ciry ud CMty io crta upo $c
<br />,bov. oatidcd propdry fd inrp@do plrpdat.
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Light Standards
<br />Spas, Pool, Fountains
<br />Signs (monument)
<br />L ife Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Communications Cable
<br />Building
<br />Under Slab / Floor
<br />Bonding / crounding / UFER
<br />Transformers
<br />Torquing
<br />Sub-Panels
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rough)
<br />Ceilings (Hard & Soffit Rough
<br />Ceilings (T-Bar Rough)
<br />Meter Release
<br />Rough I
<br />Service Meter
<br />FINAL r. o{o, zw, 5:7
<br />Notes, Remarks, Etc
<br />Air Conditioners
<br />EVait Fr Err
<br />FFR N ?l tq
<br />Li*ns. Clsr: LicdcNhb.r
<br />3--m,
<br />I -l
<br />L =
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