0201-095 (RPL)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensedunder provisions of
Chapter 9 (commencing with Section 7000) of Division 3of the Business and
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
Date , Signature of Contractor
OWNER -BUILDER DECLARATION
I•hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:' -
( )' I, as owner "of the property, or my employees with wages as their sole
compensation, will, do the work, and the structure is not intended or offered for
sale (Sec.7044, Business & Professionals Code).
gas owne`r!,A the property, am exclusively contracting with licensed
contractors it . construct the project (Sec. 7044, Business & Professionals
Code). i
O `I am'exempt•under Section B&P.C. for this reason
Date Signature • of Owner
- WORKER'S COMPENSATION DECLARATION
I hereby affirm under. penalty .of perjury one of the following declarations:
O I have and will maintaina certificate of consent to self -insure for workers'
compensation,, as provided: for l y' Section 3700 of the Labor Code, for the
performance of the work for which'this permit is issued.
and will_4"maintairrworkers' compensation insurance, as required by
6
^ectlon. 37001 of':the Lali
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans 8 Controls
Party Wall insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
-
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
steel
Set Backs
Electric Bond _
Footings
Main Drain py,
Bond Beam
Approval to Cover �-
Equipment Location
Underground Electric i
Underground Plbg. Test
Final
Gas Piping I
PLUMBING APPROVALS
Test
E�ectric Final i
Waste Lines.
Heater Final ]
Water Piping
Plumbing Final J
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover i
Sewer Connection
Encapsulation
Gas Piping
i
Gas Test
Appliances
Final � I
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
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