20270661 - Permit - Laserfiche WebLink

Home Browse Search

ELECTRICAL.I NSPECTOR RECORD C),rt nQ n7 ?n-, A APPROVALS DATE ID/SIG.COMMENTS Site-Work Underground Pole Bases Light Standards Spas, Pool, Fountains Signs (monument) Life Safety /Low Voltase Fire Alarm I Dampers Communications Cable Building Under SIab / Floor Bondins I Groundinq / UFER Transformers Torqueing Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Rough) Ceilinqs (Hard & Soffit Rouqh Ceilings (T-Bar Roush) Meter Release Rough Service Meter I I ) FINAL a t4 ?tt Dlfr/lr,wy"/ Notes, Remarks, Etc.It OWNER BUILDER DELCARATION I hecby affrm undo penalty of pojury that I m exempt from the ConlracloG' Licare [aw for thc following rwn (56.7031.5 Bmines md Prof*ion Codc): Any City or County which requirs a permit to @nstruct. alt6. improve. danolish or repairay struclurq prior to its issuilce, also requirB thc applicot for such pcnnit to file a signcd slalmol thst hc or slrc b licoscd p|Nat Ilusiness and 7031.5 by any _1. as o\\'ner of the or rvith rvages as their sole compensation. rvilldo the rvork and the ! structure ts not intended or offered for and hofessions Code: 'l'he Contraclor's License [-arv does not apply lo an orvner of the properry who builds and rvho does such w'ort hirnself or herself or through his or her lf. howev'er. the building or improvetnenl own employees. provided that such not intended or offered for sale.is sold within one year of cornpletion.Buildo rvill have the burden of proving tha he or she did not build or improve the prograty for the puryrose of sale). o\!'ner of the property. arn exclusively contracting rvith licensed contraclors to construct the project (Sec. 7044. Business builds or improves lhereon.and Profession Code: The Contractor's License Larv does not apply to an orvner of property who and rvho contracts for such projects with a Contractor(s) licensed pursuant to the Contractor's License [.arv). _l arn cxernpt under B. & P.C. for this reason. ort", / -- k,46fu I hereby alTirm under penalty of perjury one of the _l have and rvill maintain a Certificate of Consent to Self-lnsure for s'orkers' compensation. as provided for by Section -3700 of the Labor Code. for the performance of the work for which the perrnit is issued. _l have and rvill nraintain rvorkers as required by Section 3700 of the Labor Code. for the performance of the rvork for rvhich this pennit is issued.compensation insurance carrier and policy number are: ('an'ier: Policy that in the perforrnance of the rvork for s'hich this permit is issued. I shall not ernploy any person in any manner so as to become subject to the rvorkers' compensation lau's of California. and agree that if I should become subject to the rvorkers' compensation provisions of Section 3700 of the l.abor Code. I shall. forthrvith comply with those provisions.. \VARNING: Failure to secure n'orkers' cornpensation coverage is unlas'ful. and shall subject an ernployer to oiminal penalties and civil fines up to one hundred thousand dollars ($l in addition to the cost of compensation.as provided for the Section -j076 of the Labor Code. interest and """, f;%-26D I hereby affirm under penalty of perjury that I am licenscd under provision 9 (cornmencing rvith Section 7000) of Division -1 of the Business and Professions Code. and my license is in full force and effect. License Class: License Numbcr: ('otttrirclor. CONSTRUCTION LENDING AGENCY I hcby aflirm undo pcnalty of perjury thst thqc is a constructiotr bnding agocy for thc pcrfomcc of thc slrk for which this ponit is isucd (Ss. 3097, Civ. C.). Lender's Narne: Lender's Address: APPLICANT DECLARATION I hereby aflinn under penalty of perjury one of the follorving declarations: Dernolition Permits-Asbestos Notification Federal Regulations (Title 40. Parl6) _Required _l federal regulations regarding asbestos removal are not applicable to this project. that I have application and state that the above infonnation is correct. I agree to cornply rvith all City and County and to building construction. and hereby authorize representatives of this City and County lo enter upon the above mentioned Applicant or l'ernrilee ntrme for purposes. """,/-JS-tgL 0 Expires: I o il )'t4vt 4JJtt