Laserfiche WebLink
ELECTRICAL.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS <br />Site-Work <br />Underground <br />Pole Bases <br />Light Standards <br />Spas, Pool, Fountains <br />Signs (monument) <br />Life Safety /Low Voltase <br />Fire Alarm I Dampers <br />Communications Cable <br />Building <br />Under Slab / Floor <br />Bonding I Grounding / UFER 1/o-ff -Z t ,>41 (n_ <br />Transformers <br />Torqueing <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilinqs (Hard & Soffit Rouqh <br />Ceilings (T-Bar Roush) <br />Meter Release /e-h-Zt ,a4 (v <br />Rough /O-/l-*t z.AO {+ <br />Service JVleter <br />FINAL l, -lC-z-t ,pl.-1ll'f r <br />Notes, Remarks, Etc. <br />I hmby allinn unda pcrulty of perjury that I m q@pt ftom ihc ContracloB' Lic€N t w for thc following lwn (Sc.?031.5 <br />Buins ad Profcsion Codc): Any City or Comty which rcquirc a ponit to mnsruct. alto. imprcvq danolish or rcpair uy <br />srucluq prbr to its isumcc. also rcquirc rhc opplicot for such pannit to filc 8 signcd statmat thst hc or 81rc b licsBcd pwuurt <br />to thc prcvisioro of thc Contractor's Liccnspd Law (Chaptq 9, Commcncing with Setion 7000 of Division 3 of thc BEirys ad <br />Prcfeions Codc) or thst hc or shc is cr@pt thacfrom ud thc b6is for thc allcgcd cxmpion. Any violation of Selion 7031.5 by my <br />applicutforaponitsubj*tsthc applicmttoacivilpcnaltyofnotmorcthmfivchundrcddollm($500). <br />-1. <br />6 oms of thc propcny, or my cmplolc with wag6 s their $lc compeNation, will do Oc wo* and thc gruc1rc is not <br />intadcd or oflqcd for slc (Se.7044, Buine ud Profeioro Codc: Thc Conraclor's Lictre taw do6 not apply to u oma of <br />thc prcpqly who buil& or improvc ttEa4 ard who do6 sEh rclt himsclf or hffilf or thrcugh his or hq oM cmploy6. <br />provided that such improvffits re mt irtodod or offqrd for sle. lf, holrc, thc hiuing or imprcvmt is $ld within one )an <br />ofomplaion, thc Owno Buiklr will tnrc tlrc hrda ofproving tha trc or shc did not build or improw 0rc prcpoty 6r thc purpos <if <br />sD. <br />-1. <br />I om6 of thc pmpsty. m qclBivcly conkacling with liccnscd contractoE to construct th€ projd (Se. 7044. Buin6 <br />ad Profusion Codc: Thc Contraclor's Lic6e Law do6 not spply to s owtrq of property who builds or imprcvB th6@n, <br />ud who contrrcls for such Fojels whh a Contracto(s) licqucd puEwt to thc CoDtraclor's Licce lrw). <br />-l <br />m cxmpt und6 SEtion-. B. & P.C. forthis r@n. <br />WORKER^S' COMPENSATION <br />DF'CLARATION <br />I hereby affrrm under penalty of perjury one of the following declarations: <br />_l have and will nraintain a Certificate ofConsent to Self-lnsure for workers' conrpensation. as provided for by Section 3700 of the <br />for the performance of the work for which the permit is issued. <br />I will maintain workers' compensation insurance, as requircd by Scction 3700 of the Labor Code, for the performance of <br />this permit is issued. My workers' compensation insurance carrier and policy number are: <br />ta}or Code. <br />)ff r,uu".na <br />APolicy <br />-l <br />ccrtify that in the perforrnance of the work for which this pennit is <br />so as to be<orne subject to the worters' cornpensation larvs of California. <br />workers' cornpensation provisions of Section 3700 of the labor Code, I <br />t'/ <br />issued, I shall not employ any person in any manner <br />and agree that if I should bccomc subject to the <br />shall, forthwith comply with thosc provisions.. <br />WARNING: F'ailure to secure workers' compensation coverage is unlarvful, and shall subject an eflrployer to crirninal penalties and <br />civil fines up to onc hundred thousand dollars ($100.000), in addition to cost of compensation, darnages as provided for the <br />attorney's fees. <br />DECI.ATTATION <br />I hereby affrrn under penalty of perjury that I am licensed under provision of Chapter 9 (commencing with Section 7000) of Division 3 <br />of the Busincss and Profcssions Code, and my licensc is in full force and effcct. <br />License <br />W <br />I hrcby affrm undr pcmlty of pqjury that thre is a mmtruction hnding agocy for thc pqfomce of the wort for which this psmit is <br />issued (Sc. 3097, Civ. C.). <br />kndfi's Nmc: <br />I-ender's Address: <br />APPLICANT DECLARATION <br />I hoety a(finn under penalty of perjury one of the following derlarations: <br />Demolition Permits-Asbcstos Notification Federal Regulations (Title 40, Part6) <br />-Required <br />Lctter of Notification <br />cenify that the federal regulations regarding asbestos removal are not applicable to this project. <br />I havc read this application and state that thc above infonnation is correct. I <br />ordinances and State Laws relating to building construction. and <br />above rnentioncd propcrty for <br />Applicant or Agent <br />Permitee nnrne <br />with allCity and County <br />and County to enter upon the <br />o,,",912-lLl <br />D rr.na n7 nna tr, <br />Expires: <br />\&\^Q-L'A