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ELECTRICAL.INSPECTOR RECOR D APPROVALS DATE ID/SIG.COMMENTS OWNIiR BU II,DIiR DI'I,CARATION t hcreby affirnr under penalty of prjury that I am exenrpt fnrnr the Contractos' License [:w for the following rcason (Sec.7031.5 Busincss and Prolbssion Codc): Any City or County which rcquircs a pcrrnit to construct, alter. itnprovc. demolish or repair any structure, prior to it.s issuance. also requires the applicant for such Srernrit to file a signed statemenl that he or she is liccnscd pursuant to thc provisions of thc Contractor's Licenscd t:w (Chaptcr 9. Commencing with Section 70fi) of Division 3 of thc Busincss and Professiorrs Code) or that lrc or she is exemgrt therefrom and tlrc basi.s for tlre alleged exentptiort. Any violation of Section 703 1.5 by any applicant for a pennit subjects the applicant to a civil penalty of not more than five hundred dollars ($5tXt1. _1. as owner ol'ttrc propctly. or tny ernployecs with wagcs as thcir sole comgrcnsation. will do the work and thc stnrcture is not intelxlcd or offered for sale (Sec.7tN+. Business and Profcssions Cotlc: The Contractor's License law tloes nol apply to an owner of the pmperty who builds or improves therm[ arxl who dors such work hinrself or herself or through his or her own entployees, providcd that such irnprovemcnts arc not intcndcd or olhrcd for salc. Il, howcvcr, Otc building or irtprovernnt is sold within onc year of completioru thc Owrrcr Buildcr will have the burden of pruving that hc or she ditl not buill or improve thc propary for thc purpose of sale) _1. as owner of the property, am exclusively contracting with liccnsed contractoni to construct thc pmjcct (Sec. 70+a, Business arrd hulbssion Code: The Contractor's License Law does not apply to an owner of property who builds or intproves thereon. and who contracts for such proi'cts with a Contractor(s) licenscd pursuant lo lhc Conuaclor's Liccn^se [:w). -l anr exempt under Sectiorr-, B. & P.C. lbr this reason. ll,,r^. W0 RK IiRS' u^OM PFN SATION DECLARATION I hcrcby al'l'irm undcr pcnalty of pcrjury onc of thc tirllowing dcclarations: _l have arxl will nnintain a Certilicate of Consent to Self-lnsure for workers' compen.sation, as provided for by Section 3700 of the Codc, for the Jrcrfornrancc of thc work for which thc perrnit is issucd. have and will nraintaitt workers'insurance, as required by Seclion 3700 of thc l.abor Code, for lhe perfornutrce of wlrich this pcrnrit is issucd.-W?"uf\*'"carricr :uxl plicy nunthcr are: v-.1C v t\JL- Policy I L _l ccrtify that in thc lrcrfornurncc of tlrc work for which this pcrmit is issuc'd, I shall not cmploy any pcrson in any manncr so astobecomcsubjccttothcworkers'cornpcn.satiorrlawsofCalifornia.andagrccthatiflshouldbecomcsubjecttothc workers' comlrnsation provisions of Section 3700 of the labor Code, I shall, forthwith conrply with thosc provisions.. WARNING: Failurc to secure workers' compensation ls and shall subject an employer to criminal penalties and civil lines up to one hundred thousand dollars llrc cost of compensalion, damages as provided for the attorney's fccs. I hcreby affirnr under penalty of perjury that I anr licensotl under provision of Chaptcr 9 (conrnrerrs*ing with Section 7000) of Division 3 of the Business and Professions Code. arxl my license is in ful! forcc and cffect. L 5e ?uLicense Class: License h,,r^. CONSTRUCTION LENDING AGENCY I hcrcby allirm undcr pcnalry of pcrjury that there is a construction hnding agcncy for thc performance of thc work l'or which this permit is issued (Sec. 3097. Civ. C.). Lrnder's Name: Lrnder's Address: APPI,ICANT DECI,ARATION I hrchy affrm untlcr pcnalty of pcrjury onc of thc folkrwing declarations: Dcmolition Pernrits-Asht'stos Notification Fcdcral Rcgulations (Tillc 40, Part6) _Required lrttcr of Ntxilication _l ccrtily that thc fcdcral rcgulations regarding asbcstos removal iue not applicablc to this projc.ct. infonrution is corccl. I agrcc to contply witlr all City and County rcprcscntativcs of this upon thc above rnentioned propny lor inspection purposes. Applicant or Agent Pcrnritec lhc O"''-A to 7/b Site-Work Underqround Pole Bases Liqht Standards Spas, Pool, Fountains Signs (monument) Life Safety /Low Voltage Fire Alarm / Dampers Communications Cable Buildinq Under Slab / Floor Bondinq I Groundinq I UFER Transformers Torqueinct Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Rouoh) Ceilinqs (Hard & Soffit Rouoh Ceilinqs [-Bar Rouqh)rl Meter Release 5lul7t bI4iH-l 7 ,I Rouqh , -[I rl t- Service [/eter LUI Wl'4 wrft1 >,/ FINAL t;l blZ(t\ne+ry Notes, Remarks, Etc. Flev. 08-07-201 5 I luvc rcad tlus applicalion and