20170083 - Permit - Laserfiche WebLink

Home Browse Search

ELECTRICAL-I NSPECTOR RECORD APPROVALS DATE ID/SIG-COMMENTS a_-Site-Work I Underqround -,U I Pole Bases Light Standards Spas, Pool, Fountains Signs (monument) Life Safety /Low Voltage Fire Alarm lDampers Communications Cable Buildinq Under SIab / Floor Bonding I GO-iihOin-d.I UFER /ZltrQ /La t try Transformers Torqueing Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Roush) Ceilings (Hard & Soffit Rough Ceilinss (T-Bar Rouqh) Meter Release /?4-/?Z.cft 7 Rouqh Service Meter FINAL /za/ -/ ?/Zc zt Notes, Remarks, Etc. OWNER BUTLDER DELCARATTON I h6cby aflirm unds pcnalty of pcrjury thar I m crcmpt ftom thc Contraclo6' LiceN t w for the following tron (Sc.7031.5 Businas and Profcssion Codc): Any City or County which rcquirc a pcrmil to omtruct. altc, imprcle dcmolish or rcpair uy structurq prior to its isumce, also rcquirB the applicant for such pcrmit to file a signcd stalmf,t that he cr !,r-'is liccnscd pursuet to the prcvisions of thc Contractor's Licenscd kw (Chaptq 9. Commcncing whh S$tion 7000 of Divis.on -l of the Bwins ud Prcfe$ions Codc) or that hc or she is qmpt thqcfrom md thc basis for thc allegcd ermption. Any violation of Scciion 7031.5 by any applicantforapemitsubjatsthe applicmttoacivilpcnaltyofnotmorclhilfivehundrcddollus($500). _1. as owner of the propâ‚¬rty. or my employees with wages as their solc compensation. rvilldo the work and the structue is not intended or offered for sale (Sec.7044, Business and hofessions Code: The Contractor's License Law does not apply to an owner of the propei'ty who builds or improves thereon, and who does such work himself or herself or through his or her own cmployees. provided that such improvanents are not intended or offered for sale. If,, horvever. the building or improvement is sold rvithin one )â‚¬ar of cornplaion. the Orvner Builder will have the burden of proving tha he or she did not build or improve the propoty for the purpose of sale). _1. as owner of the property. arn exclusively contracting rvith licensed contractors to construct the project (Sec. 7044. Business and Pncfcssion Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon. and who contracts for such projects with a Contracto(s) licensed pursuant to the Contractor's License Law). -IarnexetnptunderSection-.B.&P.C.forthisreason. Owner: WORKERS' COM PENSA'IION DECLARATION I hereby affrrrn under penalty of pojury one of the following declarations: -l have and will maintain a Certificate of Consent to Self-lnsure for workers' compensation. as provided for by Section 3700 of the Labor Code. for the performance of the work for which the po'rnit is issued. -l have and rvill maintain rvorkers' compensation insurance. as required by Section 3700 of the Labor Code. for the performance of the rvork for which this pennit is issued. My workers' compensation insurance carrier and policy number are: ('ar r icr . Policy Nurnber:-I: rpit cs _l certify that in the perfornrance of the work for rvhich this perrnit is issued. I shall not employ any person in any manner so astobecorncsubjecttothervorkers'compensationlarvsofCalifornia.andagreethatiflshouldbecomesubjecttothe workers' compensation provisions of Section 3700 of the l,abor Code. I shall. forthwith cornply with those provisions.. WARNING: Failure to secure n,orkers'coverage is unlarvful. and shall subject an anployer to criminal penalties and cir,il frnes up to one hundred dollars in addition to the cost of comgrnsation. damages as provided for the Section -j076 of the Code. interest fec.s. gttflL t)E('t,Att^'t't0N I hereby affirm under penalty of perjury that I arn licensed under provision of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect. License Class: I hereby alfirm under penalty of perjury that issued (Sec. .i097. Civ. C.). is a construction lcnding agency for the rvork for s'hich this pcnnit is I I I.cnder's Narne: APPLICANT DECLARATION I herâ‚¬b), aflirm under penalty of perjury one of the follorving declarations: Demolit ion Permits-Asbestos Notif-rcat ion Federal Regulat ions ('l'itle 40, Part6 ) -Required Letter of Notification _l ccrri& that the federal regulations regarding asbestos removal are not applicable to this project. _l have read this application and state that the above infrlrrnation is correct. I agrcre to cornply u,ith all City and County representatives of this City and County to enter upon theLarvs relating to abo"'e Applicrnt or Pu.nr;1\r,u for conslnrction. and aulhorize 1k - r,,", tt/d) lll n* ri-/ ?fi-t r:, L\O@ -LicenseNumber: q1 5-1 5k 1 Vivrc.rf &lffi Lender's Address: - ft