Laserfiche WebLink
ELECTRICAL-! NSPECTOR R ECORD <br />APPROVALS DATE ID/SIG.COMMENTS <br />Site-Work <br />Underground <br />Pole Bases <br />Liqht Standards <br />Spas, Pool, Fountains <br />Siqns (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 />Torqueing <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 />Ceilinqs (T-Bar Rouqh) <br />Nleter Release <br />Rough g I8 .-7-(ruru <br />Service JMeter <br />FINAL ?-zA-?l /ZC/,,ub"ln <br />Notes, Remarks, Etc. <br />, "" ,'XT",I?ykl",["'J""fl#L[ns kw ror thc rorhwitrs**nf,l <br />Busincss and Pmfcssion Codc): Any City or County which rcqutcs a yrrmit to construcl. altcr. improvc, dcmolish or rcflu <br />structurc. prior to its issuancc, alm rcquircs the applicant for such lrc]mit to {ilc a sigrcd statcmnt lhat hc or shc is liccnscd pursudht <br />to thc pmvisions of thc Contractor's Liccn$d llw (Chaptcr 9, Comcncing with Scction 7000 of Division 3 of thc Busircss ud <br />Pmfcssions Codc) or that hc or shc is cxcmpl thcrcfrcm and the basis for thc alhgcd cxcmption. Any violslion of Scttion ?03 I.5 by iny <br />trpplicant for a Frmit subjccts lhc applicant to a civil pcmlty of not mrc than fivc hundred dolles (S5u)). <br />_1. as owrcr of lhc pro[Eriy, or my cmployccs with wagcs as thcir elc comlEnetion. willdo thc wtrk and thc slrE{N is mt <br />intcrdcd or ollcrcd for slc (Se.7O44. Busircss and Prcfcssions Codc: The Conractor's Liccns llw dGs not .pply to an owncr of <br />thc pmFny wln builds or irnpmrcs lhcmn. atd wlb d@s such mrk himself or hcr*lf o] threugh his or hcr own cmploycts. <br />providcd that such impmwmnts m rct intcrded or olfcrci for sh. lf. horcE, thc huilding or imJrercmnt is mld wilhin onc }rU <br />of complction. thc Owrcr Buildcr will haw thc burdcn of prcving that he or she di, rct buiH or impmw thc pDtEty for thc purF)s of <br />slc). <br />_1, as owncr of thc pmpcny, am cxclusivcly contmcting wilh licenscd contradom to onstrucl thc prcjcct (56. 7(X4, Busincss <br />and Pmf.ssionCode:ThcContractor'sLiccnscLrwdoesnotapplyloeownqofpmlEnywhobuildsorimprorcslhcrcon. <br />lnd who crrntmcls for such projccts with a Contmcto(s) liccnpd pursuant to thc Conlraclor's Liccnsc kw). <br />-l <br />am cxcmpl undcr Setion-, B. & P.C. for lhis rcasn. <br />l)tlc. <br />WORKERS' COMPENSATION <br />DECLARATION <br />I hcrcby afl'irrn undcr pcnalty of perjury onc of the following declarations: <br />_l have and will rnaintain a Certificatc of Conscnt to Sclf-lnsure for workers' compcnsation, as providcd for by Section 3700 of thc <br />Labor Codc, for thc pcrfornrancc of the work for which thc pcrmit is issucd. <br />-l <br />havc and will maintain workcrs' cornpcnsation insurance. as required by Scclion <br />for which this pcrmit is issugl My worf,crs' compcnsation insurancc carricra\^\q k,*t 3700 of thc Labor Codc. for thc pcrfornuncc of <br />thc work and prlicy numbcr arc: <br />Policy qz \7-71 <br />_l ccrtify that in thc Jrcrfornrancc of thc work for which this pcrmit is issucd. I shall not cnrploy any lrcrson in any manncr <br />so as to bccomc subjccl to thc workcrs' comlrcnsation laws of California. and agrce that if I should bccome subjecl to thc <br />workcrs' conrpcnsation provisions of Section 3700 of thc L:bor Code, I shall, forthwith comply with thosc provisions.. <br />WARNING: Failurc lo sccurc workcrs' <br />civil fincs up to one hundrcd thousand <br />comlrcnsation coverage is unlawful.^and shall subict an employer to criminal pcnaltics and <br />dollars (S100,000).\addition to ff cost of compcnsation. damagcs as provided for the <br />":j*:.s'icesScction 3076 of C<xlc. inlcrcst <br />? <br />LICT'NSED CONTRACTOR <br />DECLARATION <br />I hcrcby alfirnr undcr pcnalty of pcrjury that I am liccnscd under provision of Chaptcr 9 (comnrcncing with Section 7000) of Division 3 <br />of thc Busincss and Profcssions Code, rurd my license is in full force and cft'ect. <br />Licensc D Z-S\ <br />Z <br />W <br />I hcrcby affirm undcr Fnalty of pcrjury that thsc is a @nstruction lcnding {gercy for thc pcrformncc of the work for which this lEmit is <br />issucd (Sc.3097, Civ. C.). <br />[-crrdcr's Nanrc: <br />lrndcr's Addrcss: <br />APPI ICANT DECLARATION <br />I hcrcty affinn undcr pnalty of pcrjury one of the following dcclarations: <br />Demolition Pcrmils-Asbcstos Notitication Fedcral Regulations (Title 40, Part6) <br />_Rcquircd l.ctter of Notification <br />_l ccrtify that thc fcdcralrcgulations regarding asbcstos rcmovalarc nol applicablc to this projcct. <br />_l ccrtify that I havc rcad this application and stBte that thc above information is corrcct. I agrcrc to cornply with all City and County <br />ordinances and Statc l.aws rclating to and hcrcby authorizc reprcscnlativcs of this City and Itt ugln thc <br />abovc mcnti<lncd propcrty for <br />Applicant or Agent <br />Pernrilee n$nrc s <br />Y l./7 <br />no ont <br />3 @t