20172784 - Permit - Laserfiche WebLink

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APPROVALS DATE ID/SIG.COMMENTS Site-Work Underground Pole Bases Liqht Standards Spas, Pool, Fountains Siqns (monument) Life Safetv /Low Voltaqe Fire Alarm / Dampers Communications Cable Building Under Slab / Floor Bonding I Groundi ns I UFER Transformers Torqueinq Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Roush) Ceilinss (Hard & Soffit Rouqh Ceilinqs (T-Bar Rouqh) N/eter Release Rouqh Service lVleter \r A FINAL 0 ,WYA 5yff yl Notes, Remarks, Etc., I hereby affirm unrler penalty of perjury that I am exempt frcm the Contractors' License Law ftrr the following reason (SecI03l.5 Business arxl Profession Code): Any City or County which requires a permit to construct. alter, improve, dennlish or repair any structure, prkrr to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's Licensetl Law (Chapter 9, Commencing with Section 70OO of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not nxrre than five hundrerl dollars ($5OOl. _1. as owner of the property, or my empkryees with wages as their sole compensation. willdo the work and the structure is not intended or offered for sale (Sec.7M4, Business and Professions Code: The Contractor's License [:w does not apply to an owner of the pmperty who builds or impmves thereon, anl wtxr does such work himself or herself or through his or her own empkryees, provided that such improvenrcnts are not intended or ofbred fur sale. I[, hlwever. the building or inTlruvenrnt is sold wilhin one yâ‚¬ar of completion, the Owner Buikler will have the burden of proving thrt he or she did not buikl or improve the pmperty for the purynse of sale). _1. as owner of the pr()perty, am exclusively contracting with licensetl contractors lo construct the pnlject (Sec. 7M4, Business and Pnrfession Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a Contractorls) licensed pursuant to the Contractor's License Law). -l amexempt under Section-. B. & P.C. for this reason. WORKE,RS' COMI'ENSAI'ION DE,CI ARATION I hereby affirm under penalty of perjury one of the following declarations: -l have arxl will maintain a Certifrcate of Conscnt to Self-lnsure for workers' compensation, as provided for by Section 37fi) of the Labor Code, for the lrcrforrnance of the work for which the permil is issued. _l have and the work for will maintain workers' comgrcnsati<ln by Section 3700 of the L-ab<lr Code. for the lrcrformance of and grlicy number are:perrnit is issued.workers' Policy n -l certify that in the performance of the work for which this Srermit is issuetl. I shall not employ any person in any manner so as (o become subject to the workers' compensation laws of California, and agrce that if I should become subject to ttre workers' comgrcnsation provisions of Section 3700 of the Labor Crxle, I shall, frlrthwith comply with those pnrvisions.. WARNING: Failure to srcure workers'compensation coverage is unlawful,subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($addition of <Iamages as provided for the I hereby affirm under penalty of perjury that I arn licensed with Section 7UX)) of Division 3 of the Business Code. aml my license is in full force and effect. License Nurnher:r I hereby CONSTRUCI'ION LENIUNG AGENCY there is a construction lending agency for the perfrrrmance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: APPLICAN'I' DECLARA'I'ION I trrcby affirm under pnalty of perjury one of the following declarations: Demolition Permits-Asbestos Notification Federal Regulations (Title 40, Part6) -Requiretl lrtter of Notifrcation t certify tnar*{deralregulations rcganling asbestos rennvalare not applicable to this project. I have read this application and state that the ahrve infurmation is correct. I agree to comply with all City and County Laws relating to building property for inspect ion Applicant or Agcnt Permitee nanle and of this City and County to ELECTRICAL-INSPECTOR RECORD D Rev. 08-07-2015 Date: