Laserfiche WebLink
ELECTRICAL-INSPECTOR RECORD <br />APPROVALS DATE ID/SIG COMMENTS OWNER BUILDER DELCARATION <br />I hcrcby alfrm under penalty of Frjury thal I m cxcmpt fmm lhc Contractors' Licens Law for Ihe following rcarcn (SN.7031.5 ' <br />Busincss ard Profcssion Code): Any Cily or Counly which rcquircs a Jrcrmil to conslruct, altq, imprcre. demlish or rcp8ir any , <br />structure, prior to its issuece, al$ rcquircs thc applicant for such JErmit to filc r signed slalcmnt that he or shc is licensd pusill <br />ro the prcvisions of thc Conr.ctor's Licensed [:w (Chaptcr 9. Comncing uith Sction 7000 of Division 3 of the Busircss ud <br />PmfcssionsCodc)orthathcorshciscxcmptthscfromandlhcb&sisforthcalhgcdexcmJ,tion. AnyviolationofSetionT03l.5byany <br />applicant for a pemit sbirts lhc applicant to a civil pcnalty of nol mrc lhan livc hundrcd dollus ($50O). <br />_1. as owncr of thc propcrty, or my cmployccs with wagcs as thcir solc comlrcnsation. willdo thc work ard thc structure is not <br />intcndcd or offered for salc (Scrc.7o44. Business and hofcssions Codc: Thc Contraclor's Licensc Law does not apply to an owner of <br />thc propcrty who builds or improves thcreon. and who docs such work himself or hcrsclf or through his or her own employccs. <br />providcd that such improvenrnts are not interdcd or offcrcd for salc. If. however. thc buikling or improvenrcnt is sold within onc )rcar <br />of comphtion. ttrc Owncr Buildcr will have thc burden of proving that hc or she did ncrt build or improvc thc propcrty for tirc purpse of <br />salc). <br />_1. as owncr of the propcrty, am cxclusivcly contracting with liccnscd contraclors lo construct thc projcct (Sec. 7W, Business <br />and Profcssion Code: Thc Contractor's Licensc Law does not apply lo en owncr of prolrcrty who builds or improves thereon. <br />and who contracts for such proicls with a Contraclo(s) liccnscd pursuant to thc Contractor's Liccnsc kw). <br />-IamexemptunderSection-.B.&P.C.forthisrcarcn.Date: Owner: <br />EQ85E8IiTOMTENSATXON <br />DEqLA8AUQN <br />I hercby afftrm under pemlty of pcrjury orc of thc following dclarations: <br />_t hsrc atd will mintain I Ccilficatc of Consnt to Self-lnsurc for workc6' smJrcnsstion, as pmvidcd for by Setion 3700 of thc <br />k}r Code. for the pcrforue of the mrk for whhh the pcrmit is issucd. <br />Tmr"unawittmintainworkcrs'compcnsationimur&ncc,&r rcquircdbysetion3Tmofrh€bborCodc,fortheperfomof <br />the work for which this permit is is$cd. My workss' @mpensrlion insumc cmicr urd policy number rc: <br />poricy N" b"r, PRU)e Lo'Ll ll'l Expircs: lf,- ec.- ?L <br />_l ccrtify that in thc performancc of thc work for which this perrnit is issued. I shall not employ any pcrson in any manner <br />so as to bccome subject to the workers' compensation laws of California, and agrcc thal if I should beconrc subject to the <br />workcrs' compensation provisions of Section 3700 of thc [:bor Code. I shall. forthwith comply with thosc provisions.. <br />WARNING: Failure to secure workers' comlrcnsalion covcragc is unlawful, and shall subjcct an cmploycr to criminal penalties and <br />civil fines up to one hundred thousand dollars ($100.0001, in addition to lhc cost of compcnsation. damages as providcd for thc <br />Scction 3076 of thc l-abor Code. intcrcsl and attorrrcy's fccs. <br />erp. OCI-04 -21 <br />LICENSED CONTRACTOR <br />D.FCI AITATION <br />I hcrcby affrm under pcnalty of pcrjury that I am licenscd under provision of Chapter 9 (comnrcncing with Section 7000) of Division 3 <br />of the Business and Professions Code, and my liccnse is in full forcc urd effcct. <br />Liccnsc Class:re _l-iccnsc Nurrtbcr:loo*oCt4 <br />-7 <br />W <br />I hcrcby alfirm undcr pcmlty of perjury thal thcrc is a @nstructk n bnding agency for thc pdfomnce of thc work for which this permil is <br />issucd (Se. 3097, Civ. C.). <br />I-ender's Name: <br />knder's Address: <br />APPLICANT DECI ARATION <br />I hcrcby affrrm undcr penalty of pcrjury onc of thc following declarations: <br />Demolition Permits-Asbcstos Notification Fcdcral Rcgulations (Title 40, Part6) <br />_Rcqu ircd Lcttcr of Notification <br />_l certify that the federal regulations rcgarding asbcslos rcmoval arc nol applicablc to this projcct. <br />f,rccnify that I have read this application and statc that thc abovc information is correct. I agrcre to comply with all City and Counry <br />ordinanccs and State [:ws rclating to building and hcrcby authorizc reprcscnlalivcs of this City and County to cntcr upon the <br />abovc mcntioncd proprty for insgrcction <br />Applicant or Agent <br />Permitee name <br />soP, C4 -O ?-21 <br />Site-Work <br />Underground <br />Pole Bases <br />Light Standards <br />Spas, Pool, Fountains <br />Signs (monument) <br />Life Safety /Low Voltaqe <br />Fire Alarm / Dampers <br />Communications Cable <br />Buildinq <br />Under Slab / Floor <br />Bonding I Grounding I UFER <br />Transformers <br />Torqueinq <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rouqh) <br />Ceilinqs (Hard & Soffit Rouqh <br />Ceilinss (T-Bar Roush) <br />[Vleter Release <br />a I <br />Rough I o/ t/t,{4{l 4 <br />Service N/eter I I V <br />FINAL to/t,, lr,,rl^{* <br />Remarks Etc. <br />, <br />Qn., nA n7 On1tr <br />An Guttrli)Carricr: