40134070 - Permit - Laserfiche WebLink

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APPROVALS DATE ID/SIG.COMMENTS Appliances Metal Fire Place Evaporative Cooler Furnace Compressor Misc. Equipment Duct Work Pre-lnsulation Insulation Smoke Detectors lnstalled Rough Ductwork Vents Toilet Room / Clothes Dryer Residential Ranqe Other Hood Type I Hood Type ll Hood Grease Duct Fire Damper Openings Installation F.D. Drop Test Above Hard Lid Above T-Bar Rough Mech. Final Test Meter Release lr'\^. .y' Lt t P)FINAL ,\dt\\ \A 1 ;lNotes, Remarks , Etc \ \c )t '; i'. {:l I , e - j OWNER BUILDER DELCARATION I hscby affm undr poalty of perjury tha I m cxonpt ftom thc Cortrac{on' Licre kw for thc following rcon (Se.7011.5 Buincs and Prcfsion Codc): Any City or County shich rcquie a pemh to construct. altc. improvc &mlish or rtpair my strucluc. prior to its isumcc, also rcquic thâ‚¬ applicant for such pcrmit to filq I signcd statmmt that hâ‚¬ or shc is licmscd pwant to thc previsioro of thc Contnctor's Licmscd Law (Chaptq 9. Commcncing with Setion 7000 of Division 3 of thc Buine ud Pmfcsions Codc) or that hc or shc b qmpt th@from ffd thc bosis for thc allcgcd ampion. Any violatioo of Selbn 7031.5 by my spplicant for a pcrmit subjcts thc applicant to a civil pmalty ofnot morc thff fivc hundred dollus (3500). _1. as owner of the property. or my employees rvith rvages as lheir sole compensation. willdo the work and the structtre is not intended or offered for sale (Sec.7044. Brsiness and hofessions Code: The Contractor's Licensc Law does not apply to an owner of the propeny rvho builds or improves therqrn, and rvho does such work himself or herself or through his or her own employees. provided that such improvanents are not intcnded or offtrcd for sale. If. horvever. the building or improvement is sold within one year of complaion. the Ourner Builder will have the burden of proving thd he or she did not build or improve the propcrty for the purposeof sale). _1. as owner of the propâ‚¬rty. arn exclusively contracting rvith licensed contractors to construct the project (Sec. 7M4. Business and hnftssion Code: "l'he Contractor's Licerse Law does not apply to an orvner of property who builds or improves thereon. and who contracts for such projects with a Contracto(s) licased pursuant to the Contractor's License L:w). I am exemot under Sfttion """, l/".tf ft- I hereby affrrm under poralty of perjury one ___lhavcandrvill rrraintainaCerlificaleof('onsenttoSelf-lnsureftrrrvorkcts'cotnpensation.as providedforbySection.lT00ofthc l,abor Cotle. for the po'fonnance of the s'ork for s'hich the po:nit is issued. I have and rvill ntairrtain rvorkers' cornpensation insurance. as recluired hy Section .1700 of the l.ahor ('ode. for the pcrfonnance of the u,ork frrr u'hich this pennit is issued. My u'orko's' cornpensation insurance carier and grlicy nutnber are: Policy lr r pir cs. _l cenify that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the workers'compensation larvs of California. and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code. I shall. forthw'ith cornply with those provisions.. WARNING: Failure to secure rvorkers' cotttpensation is unlau'ful. and shall subject an onployer to crirninal Fsralties and compensation. damages as provided for thecivil frnes up to one hundred thousand dollars to the cost of interest I hereby allirm under penalty of perjury that I am 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my licensc is in full force and effect. License Class: License Number: ('onlraclor: W I harby affm ud6 poalty of pgjury that thm b s sretruclion lcnding agey for thc pcfotlmcc of thc wrl &r which this p6mt b bsucd (Se. 3097. Civ. C.). Lender's Name: Lender's Address: A l'l'l,l('i\N'l' l)lt('l,AltA'l'l()N I hodry aftinn under penalty of pcrjury one of the following doclarations: Dernolition Permits-Asbestos Notification Federal Rcaulations (Title 40. Part6) -Required Letter o f Notification -l cenify that regulations rcgarding asbestos removalare not applicable to this project. I I read this Laws relating to " above Applicant or l'crrnitcc for inspc'ction M ECHANIGAL.I NSPECTOR RECORD Section -1076 of the laborfode. Dare: tt /ut ltlT