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E LECTRICAL.I NSPECTOR RECORD APPROVALS DATE ID/SIG.COMMENTS Site-Work Underground Pole Bases Light Standards Spas, Pool, Fountains Signs (monument) Life Safety /Low Voltage Fire Alarm I Dampers Communications Cable Building Under Slab / Floor t.l ^lr Bondins I Groundinq / UFER PlL /.tt (Lb{ g\ ) Transformers \-- Torqueing Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Rouqh) Ceilinss (Hard & Soffit Rouqh Ceilings (T-Bar Rough) Meter Release t/ 5614/f- â‚¬LaL.to l( lit gb B'l , Rough tI /^?:, Service l\Ieter lol6/c t ru;( fi) FINAL tb l1 /e-t tLum) Notes, Remarks, Etc.Ylt I hocby affirm uod6 poalty of pcrjury that I m cxmpt from thc Contreto6' Licmc law for rhc following rcn (Se.7031.5 Buins ard Profcssion Code): Any City or County which rcquira a pemit to coNtruct, allq, improvc. dcrnolish or rtpairQny structue, prior to its issumce. also require the applicet for such pcmit to filc 8 signcd staroat that hc or shc is licoscd pmuot to the provisions of the Conuactor's Licensed law (Chapts 9, Comencing vith Setion 7000 of Division 3 of thc Bwine md PrcfsionsCode)orthatheorshcisexemptthqcfromudthcbasisforthcallegcdqm6ion. AnyviolationofscrionT03l.5blany applicantforspemitsubjetsthc spplicanttoecivilpcmltyofnotmorcthofive hundrcddollus($500). -1. as owner of the properly, or my employees with wages as their sole cornpensation. will do thc work and the structure is not intended or offered for sale (Sec.7044. Business and Professions Code: The Contraclor's License law does not apply to an owner of the properry who builds or improves theron, and who does such wo* himself or hersclf or through his or her own employees, provided that such improvanents are not intended or offered for sale. I[, horvever. the building or improvement is sold within one year of completion, the Orvner Builder will have the hrden of proving tha he or she did not build or funprovc the propoty for the purposc of sale). -1. as owner of the properly, arn exclusively contracting with ticensed conlraclors to construct the projcct (Sec. 7U4, Business and Pnofession Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon. and who contracls for such projects with a Contracto(s) licensed pursuant to the Contractor's License taw). -l am exempt under Section-. B. & P.C. for this reason. Date:O*ner' WORIGRS'COMPENSATIM DECLARATION I hereby alTinn under penalty of perjury one of the following declarations: by Section 3700 of the for the perfonnance of ^C /tlzzPolicy(f _l certi& that in the performance of the rvork for which this perrnit is issued. I shall not employ any person in any manner so as to become subjcrt to the rvorkers'compensation laws of California. and agrec that if I should become subject to the workers' compensation provisions of Section 3700 of thc Labor Code. I shall. forrhwith comply with those provisions.. WARNTNC: Failure to se{ure u'orkers'cornpensation coverage dollars ($100.000). in is unlawful. and shall subject an to crirninal civil fines up to one hundred thousand addition to the of compensation, attorney's I hereby affrnn under penalty of perjury that I am licensed 9 (comnrencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force and efTect. License Number: I h@by affm undq pcnalty of pajury that th* is a @nsruclion lcnding agocy for thc pqfomcc of thc wrt for which this pqnh b issued (Sc. 3097, Civ. C.). Lender's Narne: -7 and for the with all City and County and County to entcr upon the Lendcr's Address: APPLICANT DECLARATION I her*ry alnrm under penalty of perjury onc of the following declarations: Dernolition Permits-Asbestos Notification Federal Regulations (Title 40, Part6) Later of Notihcation ccrrify that the federal regulations regarding asbestos removal are not that I have read this application and statc that the above and State laws relating to building construction. and above rnentioned Applicant or Permitee nAnre this project. ,,,",3lZafZt Dr'rr nQ 4tr, -I Codc, for the performance of the work for which the permit is issued. and rvill rnaintain rvorkers' work for pennit is and policy number are: _Expires: correct. I Qr