20172784 - Permit (2) - Laserfiche WebLink

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ELECTRICAL.I NSPECTOR RECORD APPROVALS DATE ID/SIG COMMENTS Site-Work Underqround Pole Bases Liqht Standards Spas, Pool, Fountains Siqns (monument) Life Safety /Low Voltage Fire Alarm / Dampers Communications Cable Buildinq Under SIab / Floor Ir Bondinq I Groundinq / UFER t8 a xt hild*Y4 Transformers Torqueinq Sub-Panels Air Conditioners I Roof Top Equipment t 'lp ?l DA.P&/ Factory Wired Unit I Walls (Conduit) Walls (Rouqh) Ceilinqs (Hard & Soffit Rouqh Ceilinqs [-Bar Rouqh)I I A N/eter Release 0 'ru A DWu-fl Rouqh -^. Service Nleter FINAL 'L0 t >444-81 ,, Notes, Remarks, Etc. l)ut,c"\RA'l'loN I hcrcby affrm undcr JEnalty of pcrjury that I m exempt f]om thc ContmctoN' Liccns hw for the following rc8lDn (Scc.7031.5 Busincss ord Prcfession Codc): Any City or County whbh rcquircs a pcmit lo construcl. ahcr. irprcvc. dcmlish or rcJuir airy structurc, prior to its issuma, als rcquircs thc applicont for such Frmit to tile a sigred statcrcnl that hc or slrc is lienscd pursant to thc pmvisions of thc Contractor's Licenmd taw (Chaptcr 9, Comncing uith Sslion 7000 of Division 3 of thc Busircss ild Prcfcssions Codc) or thal hc or shc is cxcmpt thcrcfrom and the basis for the allcgcd cxemption. Any violotioo of Scthn 703 1.5 by any 8pplicant for 8[rcmit subjects the applicant to a civil penrly of not mrc than fivc hurdEd dollds ($500). -1. as owner of thc propcrty. or my cmployccs with wagcs as their solc comJrcnsation, willdo thc work ard thc structurc is not intcndcd or offcrcd for salc (Sec.7044. Busincss and Profcssions Codc: The Contraclor's Licensc law docs not apply to an owncr of thc prof,crty who builds or improvcs thcrccln. and who docs such work hinrsclf or hcrsclf or through his or hcr own employees. providcd that such improvcnrcnts arc not intcnded or offcrcd for sah. If. howcvcr. thc building or improvcnrnt is sold within onc )rcar of comphtion. thc Owncr Buildcr will have ttre burden of proving that hc or she did not build or improve the propcrty for the pur;nsc of sah). -1. us owner of thc property. am exclusivcly contracting with licenscd contractors lo construct thc projcct (Scc. 7W, Busincss and hofession Codc: The Contractor's Liccnse Law does not apply to an owncr of propcrty who builds or improves thcreon. and who contracls for such projects with a Contracto(s) licenscd pursuant to thc Conlractor's Liccnsc l-aw). -lamcxcmptundcrSection-'B.&P.C.forthLsrcason. WORKERS' COMPENS{TION DECLAIIATION I hcrcby atfirrn under pcnalty of pcrjury onc of the following dcclarations: -l havc and will maintain a Ccrtificatc of Conscnt to Self-lnsurc tbr workers' compensation. as provided for by Scction 3700 of the Ccxlc, for the lrcrformancc of the work for which thc ;rrrnit is issucd. have and will maintain workers'Scction 3700 of the Labor Code, for the lrcrformance of carricr and policy number are:work tbr this pcrmit is Policy D _l ccrtily that in thc pcrformance of the work ltrr which this pcrnrit is issucd. I shall not cmploy any pcrson in any rnanncr so as to becomc subjcct to the workers' comJrcnsation laws of California. and agrcc that if I should becomc subjcct to thc workcrs' compcnsation provisions of Section 3700 of thc l-^abor Code. I shall. forthwith comply with thosc provisions.. WARNING: Failurc to sccure workers' compcnsalion covcragc is unlawful. and shall subict an cmploycr to criminal pcnaltics and civil fincs up to onc hundrcd thousand dollars ($100.000). in to thc cosl of compcnsation, damagcs as providcd for thc Scclion Codc. intcrcst and attorncy's fccs. I hcrcby affirm under pcnalty of pcrjury that I am licenscd Chaptcr 9 with Section 7000) of Division 3 of the Business and Code, and my licensc is in full forcc and effcct. Liccnsc o C0NS'I'RI.](] ION I,EN I)ING,\(; IINCY I hreby affum under pemhy of pcrjury that lhm is a snstruclbn lending agcncy for thc pgfot.lrwc of thc rcrk for which this permit is issucd (SG.3097, Civ. C.). lrndcr's Namc: lrnder's Address: APPI .TCANT DFCLARTilTION I trcrebyaffirmundcr pcnalty of prjury one of thc following dcclarations: Dernolition Permits-Asbestos Notification Fcderal Regulations (Title 40. Pan6) _Requircd lrtter of Notification _l ccrtity that thc fedcral regulations regarding asbcstos rcrnovalare not applicablc to this projcct. -I ccrtify that have rcad this applicution anrl statc that thc with all City and County ordinanccs and Statc [:ws rclating atxrvc nrcntioncd propcrly for Applicnnt or Agcnt I'errtritee nnme to building construction. atnvc infonrutiorr and to thc nv nA n7 On1 tr I t , -Expires: %