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ELECTRICAL.INSPECTOR RECORD <br />OWNDR AUILDER DELCATdATION <br />I ho.by arm !.d6 p@rl(y ol psjory lh,l I m .xonpi nom th. (bnlncroB' Lic.nse l-as for lhc aollowinS !.Mn (Sd 701 I s <br />BEin6s dd Profsion Codc): Any Cily or Counly which rqun6 a pdnit lo co.ntud, alra, improv., dmolish or Ep€t lny <br />strucruc. lrior lo its (su cc also r€qun6 rhc arplicdt tor such pdnh ro fiL r sign.d stalmdl thal lE or shc ii lico{d p6@r <br />ro lh. roli.iod offi. Colfacroas Lic.n*d tiw (Chort6 9. Comnrflcins {irh Scrio. 7000 of Division ] ofth€ B$in* d <br />Profsion! Cod.) or lhal hc or shc is cx.mpl lhgclion dlhcbastrorrhc.l4.n.r.mption.AnyviolalionofscdnnT0ll5hyan, <br />aptlicur for a Dsmn subjdr lhe applic&l ro . .iril p.n.ht o f nor mor. rte lir€ hunilrcd doll.6 ( $5C!) <br />l. c ownn of the propeny. or my cmplorG rvilh {as6 6 then sE comFd,rion, {ill do th. $ott ud lh. sln(lrc ts Nr <br />inrad€d or offdd lor slc (Sr.704.,,. BBind aod PN fsios Codc Thc Conlrucroi s Lic6s LlN do6 nol E ply ro m o(id oa <br />rh. pnFq who hril& or imprcBtfidon..nd who do6 srch *o't tims.llorhGlrorrhntrsh his or hd own cmploy6- <br />provid.d thdl such ihlrovdffiE m hor idadol or ollscd ao.eL.I[ hosBd, th. buikliq or n"pmvd*d i! $ld Nithto orc rqr <br />ofcompl.lion. lhc ol,nq Buildtr vill hat $. hrdd oaFovins rhll h. or sh. did nor build or i,Dpmve lhc popdy tor lh. porpos ol <br />-l, <br />sow.qolrheprotiy, an.xclusivcl).onth.rinu\inh liceBcd cont,acloE lo consl.u.l rhe rroj.ct (S( 7044. a6i,rN <br />ard thGssion Cod. The Conrracrors l.iccnse l.ax do6 n l anply to e owna o apropolJr {ho builds or improvcs thdon, <br />snd who morrmrs ftr luch rrojd6 *ith a Gnlmcro(s) li.em.n pu6uint to lhe conk,.roir 1-i.@. Las). <br />.u!aEEa5l!ulfls4!!ot!Drct &lljol <br />I hsrb annrutrdcrp.nlhyoitsjrrroncoi'heLllo$irAd(l .lions <br />-l <br />ha!€ ad s ill minlno a Cdi6car. of cocml lo sdfiNu. fo. work.s .on'p..er RJn, 6 provid.d for b, Sdion 1700 oflh. <br />ljbor Code for the Flotr@cc of lhe rort lor snich rh. Ff,i is i$u.d <br />ltuncr.'npr udnc SL\rion . Ll & P.( l'orrh6 r.a$n <br />D.r. o$n€r: <br />t) <br />ciril fin6 op ro one hundro] thousd <br />S<1rc.10T6oflhel-abor <br />I cdily th.i in lnc pqfomance o I lhc *ork for which lhis psnit G issu€d. I shall nol dploy any pcrson in uy mdnd <br />s d ro h6onc subjal lo lhe sorl6 conp.Mrion Lws oac.lifomia, and asr lh! il I should bc.om. s(5jcl lo th. <br />so*6' compGarion pDvi3ioc ofsdion I700 ofrh. tibor Co3e I slEll. lorlhwnt conply {ith lhoe PmvilioB.. <br />J#lr*6NPr'vrddrd.h' <br />-l <br />have and Nill nai.r!i. wolkcrs conpeBalior irsrra.cc. s rcqun.! by Serion 1700 of fic bbor (nd., tor th. pgaonnece of <br />is isud Myworters co idr iNuran!.cads dd Brliq- nu <br />L" <br />wARxlNCr raihrc lo s@ wo,k6' mmp.Nrio. .or.ftg. is unl.waul, ud shall subjd' e aIplot.r ro siminal FEli6 dd <br />I h€aby rmnn undr pdalryoapdjury lbar I an licos.d undd pnn ision otChafls 9 (.omfrn.in8 sirh S.ciiotr 7000) orDivision .1 <br />or rhc B6in* ed Prot*io6 cod., ,nd ny licds. is in 6ill roc ed:sr <br />rrcrnffit8iil4idfl: <br />DF(I ARAI ION <br />ll{ <br />\#/tz <br />caNirauqlrQdLEllltlc-acElcl <br />I n@hy aiIlm undd p.nalty oa perjury lhar lh@ is a e[dtuclioo hndr.8 ,!.ncy aor rh. poforrr@c of $c @rlt aor whlch lhis Fmit is <br />trucd (s(. 109?. ci! c.) <br />ATII.ICAILDECI,ASAIIOX <br />I h)y atrm ond( !.nrlty ol psjury one ot lhc lollowiru dcldat ions: <br />D.nolilion Pmils-Asbelos Nolific.tion Faldal Rcsulal iom (TnL 40. Pan6) <br />Rtuuircd t!(d olNo 6calion <br />-l <br />cErify lhrt lhc f€d€ral rcsularion. Egeding abdos r6ovdl d€ nor applicable lo Ihis prcj.d. <br />-I <br />calif, thar t hdv. r6d rhis applicarioD ed slatc thal tlE sh,vc infomalion is cor.cr I agrd ro co <br />ordinan.cs and srar. t-arvs rclar <br />at{\e Dqlio.ed prop€ny for <br />APPROVALS 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 Voltage <br />Fire Alarm / Dampers <br />Communications 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 Rouqh) <br />Meter Release <br />Rough l2-/"t/lx )fi'KK <br />Service lvleter <br />Un /6 <br />^*9.,Notes, Remarks, Etc <br />mply snh all Cnyand Counly <br />,'*ru{);;*" <br />DATE <br />FINAL <br />6 t/t 1 <br />ll ,F