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ELECTRICAL.INSPECTOR RECORD APPROVALS DATE ID/SIG.COMMENTS Site-Work I -,4ttuthdUnderqround(4 Pole Bases Liqht Standards It ,:a: Spas, Pool, Fountains t,Y,a{wuua \{a Signs (monument) Life Safety /Low Voltage Fire Alarm / Dampers Communications Cable Buildinq Under SIab / Floor t/.,1 L =.J atl Bondinq I Groundins I UFER 'ql (// Transformers tl 7 Torqueino Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Roush) Ceilinqs (Hard & Soffit Rouqh Ceilinqs [-Bar Rouqh) Meter Release Rough Service Meter .^L hl t n FINAL IUIN[,V uKhn ildq Notes, Remarks, Etc.ll I I OTV N I.:,R II I' I I,I )I.]R I hereby affrnr under penalty of perjury that I am exenrpt from the Contractors' License [.aw for the following rtason (Sec.7031.5 Busincss and Prol'cssion Codc): Any City or County which requircs a pcrmit to construct, altcr. irnprove. denxtlish or rcpair any structure, prior to its issuance. also requires the applicart for such pernrit to fih a signed slaternent that lre or she is licenscd pursuant to the provisions of thc Contractor's l,iccnsed Iaw (Chapter 9. Commcncing with Section 7000 of Division 3 of thc Busincss and Professions Code) or that lrc or she is exempt therefrom and tlre basis for the alleged exentption. Any violation of Section 7031.5 by any applicant for a perrnit subjects the applicant to 0 civil penalty of not rnore than five hundred dollars ($5m). owncr ol'thc prolL-rly. or tny crnployccs with wages as their sole cornpcnsation, willdo the work and thc stlucture is not or offered frrr sale (Sec'.7(}f4. Business and Prufcssions Corlc: The Contractor's License Law tloes not apply to an owner of the pmperly wlxr builds or imprcve.s thereon, and wlxl does such work himself or lrcrself or through his or her own enrployees, providcd that such improvcmcnts arc not intendcd or olTered for sah. Il, howcvcr, the building or improverncnt is sold wilhin one ycar of comphtioq the Owner Buikler will lrave thc burden of pnrving ttrat he or she did not build or inrprove Orc property for thc purposc of sah). _1, as owner of the properly, am exclusively contracting with licensed contraclors to conslrucl tlrc prcject (Sec. 7044. Business and Prolesskrn Code: The Contractor's License Law dtrcs not apply to an owner of progrcrty who builds or improves lhereon. and who contracts for such projccts with a G)nlraclor(s) liccnsed pursuant to the Contractor's Liccnse Law). _l anr excnlpt under B. & P.C. ltrr this reason. I hcrcby aflirm undcr pcnalty of pcrjury onc of tltc fbllowing dcclarations: haveandwillntaintainaCertilicateofConsenttoSell-lnsureforworkers'cornJrensation,as providedforbySection3T00ofthe Codc, for the Jrcrfonruncc of thc work for which thc Jrcrntit is Lssued. _l have and will nuintain workers' conryrcnsation insurarrce, as required by Section 3700 of the l-abor Code, for the grcrfornunce of the work lbr which this pcrnrit is issuctl. My workcrs' conrJrcnsation insurance czurier arxl plicy numbcr arc: that in thc ;xrtirrnuncc of thc work f<rr which this 1rcrmit is issuc'd, I shall not cmploy any lrcrson in any manncr .so bccomc subjcct to thc workcrs' conrperrsation laws of Califonria. and agrcc that if I should bccolnc subjcct to the workers' conrpensation provisions of Section 3700 of the L:bor Cotle, I shall, forthwith comply with those provisions.. WARNING: Failure to secure workers'compcnsation coverdge is unlawful, and shall subjcct an employer to criminal penahies and civil fines up to one hurdred thousand rlollars ($100.000). in addition to the cost of compcnsation, danuges as provided for the Scction 3076 of thc Latnr Codc, interest and attorney's o^ru, /2,/o'Zo ?-â‚¬L I hereby affrnr under ;rcnalty of perjury that I anr licenscd under provision of Chapter 9 (conrnrncing with Section 7000) of Division 3 of the llusiness and Professions Code. arxl rny license is in full force arxi elTect. Licen.se Number: CONSTRUCTION LENDING AGENCY I hercby al'ljrrn undcr pcnalty o[ pcrjury that thcrc is a construction lcnding agency for thc pcrlbrmance of thc work lbr which this pcrmit is issued (Scc. 3097. Civ. C.). lrnder's Name: l.cnder's Address: APPI,ICANT DECI,ARATTON I tucby aflirm under pnalty of pcrjury onc of the following declarations: Demolition Pernrits-Asbestos Notification Fcdcral Rcgulations (Titlc 40, Part6) -Rcquircd lrtter of Notification ccrtily that thc fcdcral rcgulations rcgarding &shstos retnoval arc not to this projcct. tlrat I rcarl tlis that thc ahrvc is corrcct. I agrcc to conrply with all City and County and rclating to building of this City and County to cntcr upon thc above rrrcntioned Applicant or Agent lDcrmilcc namc inspection purposes. arxl 2 ./'d ?d a. 0w4fu//b{/,{rz/ P/>/4t r)ere: />. /C^'Ze.