Laserfiche WebLink
MECHANICAL-INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION <br />I hercby smrm under rcmlty of Frjury thst I m exempt from the Contmclom' License lrw for the folloving rc&tr (Scc.7031.5 <br />Busincss and Prcfcssion Codc): Any City or County which rcquircs a lxmil to onstruct, sltr. imJrrcvc. dcmlish or epair an/ <br />structurc. Fior 1o its issure. als rcquires thc rpplbanl for sch pemit to fih a sigrcd stalercnt lhat lE or slE is lico$d puNanl <br />to thc Imvisions of the Contrctor's Liensd ljw (Chaptcr 9. Comrcing with Sstion 70fl) of Divisbn 3 of the Busircss and <br />PmfcssionsCodc)orthstheorshciicrcmptthcrcfrcmandtheb&sisforthesllegcdexcmption. AnyviolstionofSathnT03l.5byany <br />applicant for a pcmit subjccts the applicanl lo s civil pcnally of nol mrc than five hundrcd dollus ($50O). <br />_1. as owner of the or my cmPloyees wilh wages as thcir sole comlrcnsation. <br />and hofcssions Code: Thc Conlractor's <br />will do lhe work and the structure is nol <br />License Law docs not apply lo an owncr ofl0d{. Susinsss <br />thc propcrly who huikls or inqrrovcs lhcrsxr. an<l who docs such work hirttsclf or hcrscll'or lhrough his or hcr own clnployccs. <br />o[corrrpktion. ltrc Owncr Builder will havc thc hunlcn of proving thtt hc rlr shc ditl not huild or irttltrovc thc pnrJrcfly for thc purJxrscof <br />srlcl. <br />-1. <br />us owner of the propcrty. am exclusivcly contracting with liccnsed contraclors to conslruct lhc project (Scc. 7W, Busincss <br />and hofcsshn Code: Thc Contractor's Licensc Law does not apply to an owner of propcrty who builds or improvcs thcreon. <br />and who contracts for such pmjccts with a Contractor(s) liccnscd pursuant to thc Contractor's License taw). <br />-lamexemptunderSection-.B.&P'C.forthisrcason.l):rle Orr ner <br />IVORKERS' COI\I PENSAI'ION <br />DFCI ARATTON <br />I hcrchy alllrrn undcr pcnalty of pcrjury one of thc following dcclarations: <br />-lhavcandwill <br />nnintainaCcrtiticateo[CorrscrtlloScll'-lrrsurcforworkcrs'contpcnsalion.ils provicledforbyScctiolt3T(X)ofthc <br />Lrhrr Crxle. for thc Jrcrformancc ol'thc work ftrr which thc pcrnrit is issucd.YI I h:rvc alrd will nrnintain workcrs'compensatiorr insurancc. os rcquircd by Sc'ction 3700 ol'lhc Lahor Codc. frrr thc pcrt'orntattcc ol' <br />thc work which this pcrrnit is issucd. My carricr arrd Jxllicy numbcr arc: <br />0 IrluPolicy <br />-l <br />ccrtify that in thc Jrcrformance of the work for which this Jrcrnrit is issucd. I shall not cmpkry any person in any mnnner <br />lio as to hccome subpct to thc workcrs'compcnsation laws of California. and agrcc lhat if I should bccomc subjcct to thc <br />workcrs' compcnsslion provisions of Scction 37fi) of the l.abor Ccxlc. I shall. forthwilh cornply with thosc provisions.. <br />WARNING: Failurc to riccurc workcrs' comlrcnsation iutd <br />civil tincs lo onc hundred thousand dollars ($1ff).firu). in thc <br />.Sccl iorr lhc Codc. inlcrest and attorncy's fees. <br />LTCENSED CONTRAC'I'OR <br />IIECI .IRATION <br />I hcrcby al'llrrn undcr pcnalty of pcrjury that I arn liccrrscd undcr provision of Chaplcr 9 (corrrrncncing with Scction 7Uru) ol'Division .l <br />of lhc Busincss arrtl Prot'essiorts Codc. arrd my liccrtsc is irt lull lirrcc and ctTccl. <br />t_ <br />Liccnse ctors V Liccnse 45 & <br />CONS TRUC'ION LFNDING ACENCY <br />I hcrchy itfrm undcr lEmlty of pcrju]y lhat thcrc is a comtrcti([ lcfding {gcncy for thc pcrlinnarxr ofthc work l'or which lhis frrmil is <br />issucd (Scc. 3097. Civ. C.). <br />knder's Name: <br />Lcndcr's Addrcss: <br />,"LICAN,'.r.rrcl <br />I hcrcby atlinn undcr pnalty of pcrjury one of thc lirlkrwing dcclarations: <br />Dcrnolition Pcrmits-Asbcstos Nolil'icalion Fcdcral Regulations ('l'itlc 40. Parl6) <br />-Rcquircd <br />Lcttcr of Notification <br />_l certify that thc fcdcral rcgulations regarding asbcstos rcnxrvalare not applicable to this projcct. <br />_l ccrtify that I havc rcad this application and stale that thc ahrve inforrnation is correcl. I agrcc to comply with all City and County <br />ordinarrccs arrd Statc laws rclating lo <br />above nrcnlioned propcrly for inspction <br />Applicant or Agent <br />l)cnttilcc ltlrnc <br />and hcrchy authorizc rcpresentativcs <br />::Eriry'fi*"'. <br />Appliances <br />t\Ietal Fire Place <br />Evaporative Cooler <br />Furnace <br />Compressor <br />lVlisc. Equipment <br />Duct Work <br />Pre-lnsulation <br />lnsulation <br />Smoke Detectors lnstalled <br />Rouqh Ductwork <br />Vents <br />Toilet Room I Clothes Drver <br />Residential Ranqe <br />Other <br />Hood <br />Type I Hood <br />Type ll Hood <br />Grease Duct <br />Fire Damper <br />Openinqs <br />lnstallation <br />F.D. Drop Test <br />Above Hard Lid <br />Above T-Bar <br />Rouqh Mech. <br />Final Test <br />Meter Release I I t, <br />FINAL lnlbn-t I)|ff,,? <br />Notes, Remarks, Etc.t, <br />\ <br />-l:x;lircs: <br />- <br />Contractor: )L