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ELECTRICAL-INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCAIIAI ION <br />I h€rcby aflirm und6 p€nahy ot pciury lhar I m €xcmpl from Ihc Conticiore' Licens Lrw fot $. tbllowinS r6on lS(.7031.: <br />BusiDBs and Prcfsion Codc): Any City or Couly *hi.h requir6 a ponir ro coBltu.l. aha, iml,love doolish or rcD€i y <br />3ttuclur., rior lo irs isuec., al5o r.quir6 fi. applicdi aor soch remir to liL a siBr.d stotdndr rhal h€ or sh. is licdcd lu6lanr <br />lo rh€ provisioE ofrh. Conra.b.s Lic.nsed b* (Chapl6 9. Conndcing snh Sdrion 7000 of Division I ollhc BNi.* od <br />PNfNions Cod.) or rhal he or sh. is.x.,npt lh6cf.on md rh. b65G for th..llc8€d ermprion AnyviolalionofsdionT0ll5 bre, <br />.ltli.ant for 0 p.nnit sobjds lh. ap!,licanltoacivilp..anyolnotmorcrh five hundlcd dollrs ($500). <br />-1, <br />6 oso orrhc Drcp.dy. or ny .mployr6 *irh $ae6 & their ole compeodion. I do lh. sork ad thc sloclu. E nor <br />inioddl or ord€d aor $lc (Se.70,14. Bsir6 sd ftoadioB Cod€r The Co.trcroas LiccG Llv do6 nor apply io m o*n6 of <br />rh. Ii)psry * h. hritis 6r nFo6 E6c rnd who do6 str h Mrk him.la or fiNlf or rnmugh his or id ou .mployd, <br />provid.d lhal such ioFovoErns rc nol nnddql or ofiecl lor eL li hosed, rh. b(illi6E or irProlt11d ie $ld * nhin onc yd <br />ofcompldion. dc O"md Buit6 s ill h!rc lhe hir&a oaprovios tha h. or she dtd mt build or iipn)!. rh. |)opdy for lh. porFF of <br />l. N owE of rh. Fop61y, o. sclurivcly contraclina {ith lictr.d conrra.roB ro @dtud rh. ,rojd (S(. ?044. Bsre <br />.nd ADislJo Codc: TheCotulclols Lic.6. lls do6 nor appl, ro o own6 oaFoFnyNho builds or improv6 rho@n, <br />.nd qho co mcts lorsuchFljars wnh a ConrBclo(, lic.6cd pu6wr rorhc conra.rois Lic@ tl*). <br />I ncrcnrpt und6 Ssrion-. B & P.C. for this r.dd. <br />tlrre: own.r: <br />l(aarEBrloltrENtAlla! <br />DECLAEAUA! <br />I h6cby amrh undr ,qtlry olFjury or. olthc aollo*ing dela.rioN: <br />I hr!. dd will msinrain . C61ificsl. of Const ro S.lf-lEur. for srk6t @mp.nsrion, d FoviLd for b, Selion 1700 oflhc <br />hbor Coi.. fo.lt Faoroc.of th.wrk for wnicn lh. pmn b iscd. <br />-l havc and will mrinrain oork.B .onpcadon iBeoc.. G rcquiral b, serion 3700 oaln. t bor Codc. for th. paforll@c of <br />lh. wo lor phkh tht pmi i! iqr.d. My wortds coopoa.io. iNtm.. cai6 dd p.lky numb6 e.:Mt fixvl t{ <br />,\ ,... <br />\(C s Lt-t <br />li rhar inrhctcrfor ancc!lrhcwork for $hrh rhispcirn is issucd.l sh.ll Ml c Dloy.nypcrson ir iDyn,anne' <br />so 6 to lEo,n. s"bj€d lo rh. mrk6s compmkrion Lws oacalifomio. md asr lhal il I should b..on. sobjel lo th. <br />wortm'comlmationprcvisioreolSstion3?00oflhekborCodelshall.fonhvith&nply*ilhlhoeprevilio.s.. <br />WARIING: Failur. (o sue workm compctralion covcm8e is unlawtul. d shall su u qntlold t1 dimind Frnie and <br />ro one hundred lhous d dollds ($100,000). in addnion lo lhe cosl of n. ddnagcs s provid.d fo, the <br />lxA\ <br />pr,:( r ',\R.\rl(r\Ihseby!fimu q p6ahy of F.jury lhat I m licds.d undd provisio. ofcha$q 9 (.omnacine silh S€ctior 7000) ol Dili.ion l <br />ol ih. aosins e PrcasioN Codc. ad ny licqs is in lull lore ed c,Icl. <br />19 \AFqZV <br />Ir /tqllfl .-**.kGc <br />CONIAUCIIONIENIIICACENCI <br />I h@by amm u!d( poahy of Fjury tha t@ 6 a oisrucri,n bndi.s agacy tur fi. psfo,rMc. of th. {oit fo, whkh rh6 Fdm( a <br />isu.d (Sa 109?, Civ. C ). <br />AIIIICANLDECI.AIAIIOA <br />I@aninnu d pqahy of p.rjury onc or lhc followins d{ldrion' <br />Dcmolnion Pd,nns-Astdros Norincarion Fcd6al R*ulalions (Tnb 40. Pano) <br />-Requte! <br />t,.tts of Norifi carion <br />I c6l iry $d rhc lcdeal r.rllotioG r.gedin8 ab.ros rmoval &. not applicablc lo this prcjcd <br />#;"'n',';*"ll I hav. rod lhisapolicarion dsrat.that lhc above ioniscorecl I!sr&r..omplysnhrllCilyandCoonly <br />.rc k$s Elati.B Io burldiqconstnrcrion. md authorne rctr*nlarivd ol rhi! Cny dd County to 6t6 upor lh. <br />abovc ,n6r i.n.d pmpdy lor inspetion -," l,/H( lY <br />,\pplicx r or aBdr SiAnnl0 <br />.u.r\r r Y tu- <br />Site-Work <br />Underground <br />Pole Bases <br />Light Standards <br />Spas, Pool, Fountains <br />Signs (monument) <br />Life Safety /Low Voltage <br />Fire Alarm / Dampers <br />Communicalions Cable <br />Building <br />Under Slab / Floor <br />Bonding / Grounding / 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 />Ceilings (Hard & Soffit Rouoh <br />Ceilings (T-Bar Rough) <br />Itileter Release <br />Rough <br />Service Meter <br />FINAL lUto/l(A\?rt <br />Notes, Remarks, Etc <br />Ldd.' I Addrd <br />I <br />I <br />=