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ELECTRICAL.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DEL( AIIATION <br />I hdcby .mrm urdr ptulty ol p.rjury thar I m €xempr from rhc ContncloB Licdr llw for rn. folloEitrB rcen (Sd.703 1 .5 <br />BEm6s ond holGion Cod.) A.y Ciry o. Coudy whi.h r.qui,6 a p6nn ro onsltucl. aha. imprcvc &.olisi or rcPar M, <br />srocr@, pnor ro irs issudcc. atso r.quic rh. appli.a aor srch F,nit ro fiI. a sisncd stardol rhd h. or sh. t licm*d pmuml <br />ro lhc provisi.tu of thc Cont!,ctols Lic.ns.d lnw (chapla 9. CormminS witb SElion 7000 ot Division J oa th. Busin6s d <br />Pol*io Cod.) or $ar hc or sn is €xm ln@6om nd tn b4s!s lor lhc dlescd .xdFio.. A., violatio. of S.<lion 701I 5 by a.y <br />applicad for a p.mn subjals th. appli@ to a civil pdalry ot nor mor. rhM fivc hundr.d dollds (t500) <br />-1, <br />s oMs oflhc prop.ny. or my .mploy6 r'ilt s6g6 6 thcir sl€ o'npssario.. vill do thc *ort and th. sltulu. is nol <br />intdrd.d or ofidcd for sle (Sa.70.t4. BBins d Prolsiom Cod.: Th. Cohlncrols Licre tiw do6 nol tpply lo u own6 ol <br />rhc popqry who hrildr or inpmv6rh@tr d who do6 srh wrl hims.lf or hdcllor rhmqh his ot hd oM aDloyc, <br />rrcvid€d tnar such inlprc!@l! @ nol int nd.l or ond.d lor eh. Il howd6. lhc hlildi.s or inrlm!@dn i5 $ld wihin onc )q <br />olcompldion. th. Otrn6 Buildd sill hav€ llE hrdor ofFovins lhd lEorsh. did el t ild or inDrcv. th. p.tFly lot dr. t^qse of <br />-1. <br />6 oM6 olrh. prepqry, d cxclciv.ly c6m6cii.e wilh lic.N.d .oitactoB lo coretrucl Ihe pmjd! (Se. ?o44. &Brnd <br />ald P,rlksio Cod.r Th. Conrri.r.rs Li.cnsc Law do6 mt apply lo @ o*ns ofprcp.rly who blilds or ihprord thadn. <br />and who ontlsds for su.h Fojd8 vnh 6 Co 6.ro(s) lic.ro.d puGusrl lo thl conrador3 Lic@ tiq) <br />_l m cx.'nfl @do sdrio._, D. & P C lor Ihis r6on. <br />]r(2aKEalllMt[Nta]Ia!p&ct A8Aua! <br />I hdcb) altdn,.dd p.rlry ot pojury on€ oflhe folLrviry d(ldaliocl <br />I have md wilt mainrain a C..rificar. oacoohr lo Sell I6urc ror woricrr contpdsorion, 6 Folid.d lor by Setion I7LU o I lhe <br />tjbor Cone lor th. pslonne.. oflh€ wort lor *hich the pemit i issued. <br />-! <br />hlve and Nill mtrintain uor[.c' comrsBdion iBuran.., s r.quircd by Sdlion 3T00 or rhe l-abor cod., for lhc pslomdcc ol <br />lh. work for *hich rhi. Dnil i! isstrcl. My wo.k6r conrp€sation insurscc crio a.d Fiicy nunb.r ac: <br />'<-fu825 <a4Bry\,t <br />tE^v-ql.23{A (,I <br />-l <br />csiiay $rl in th. pofoimnc. of lh. wort for which lhis p6sil is issu.d. I shail nor dn9lo, my !6$n in any ndnd <br />s 6 ro bconE subjer ro rhc uort6' coipo&rion la*s olcalifomia, Md .Sr lhal if I sfiould b..onc aubjs' <br />'o <br />rh. <br />work6 comp.oerion nrcvisioB ol Sa]lion 1700 of (hc l-lbor Cod., I lhall lorlhwith comply vilh tliJe ptolisio6 <br />WARNING: l:ailue $ suc \10116 conrpasali.n covmsc is unlawlul ed thrl subjd d mploy6 lo qiminal FtshiB ed <br />ciril fin6 up to onc hu6&al rhousd dollm (S100.000). in oddilion to $c c6$ of cohp.Ntio,, dmas€s 6 provid.d lor rlE <br />Cod., im6d dd anomey s lc <br />4 >-7 * <br />uorlslju-rotr.S rra-E <br />DECL!3,II&! <br />I h@by affm undE pcnahy of Fjuy lhal I d lietu d undd ,rolision oachaprq I (co'n'nflcins rvnh Sdion 7000) of Division I <br />oa $c Busin* &d Pea6ioN C.d., od my lic€N t in tull forc ud.lld. <br />o .1 <br />lr ao t4 Br' <br />colslal]cuolr[NllNclcElrI <br />I h@by amrd undd p.nahy o f pdjury thor the is . coEtddion lddins asdcy for lhc Pdfomd.. oalh€ work lor which I hi! psnn b <br />issu€dlS(. 1097, Civ C.). <br />ATIUCANLDICI48{IIO! <br />I @ afm undd !.nahy of ldjury on. of lhc followins d(ladions: <br />D.rolirio. Pmts-Asbdros Notificarion F.d6al Rqulalions (Iill. 40. Pan6) <br />-Rcqui, <br />ed Lcl16 of Notiarcalion <br />-l <br />cdify rhsl thc f.dsal rcsulllioB Esarding dbclos rdoral @ nor arplicable lo lhis poj.<l <br />-Yicsr'b rha I h.\c Ead rhs apph(arion md {ar. rhar rhc abo!. i.aonnation is cord.l asre lo conplt vhh allCilyand Cou.ly <br />ordiBnce dd Strtc La*s alarirs lo boilding .olfudio[ rnd hd.by aurhoriz. r.?rendirB of lht Cily ed Couly lo dts upon lh. <br />abov. nrdrioncd prop.ny lor iNFdion purlos6 <br />.1H,lic{trt or Asmt Sktrdrure <br />Pemire nrmc tDritrr), F b?trJT <br />t <br />o)^-,,tlelt <br />Site-Work <br />Underground <br />Pole Bases <br />Light Standards <br />Spas, Pool, Fountains <br />Signs (monument) <br />Life Safety /Low Voltage <br />Fire Alarm / Dampers <br />Communications Cable <br />Building <br />Under Slab / Floor <br />Bonding / Grounding / UFER ,(-/,//,{/9 <br />Transformers <br />Torqueing <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilings (Hard & Soffit Rouqh <br />Ceilinqs (T-Bar Rouqh) <br />Rouqh \\7rr ,t4 ./,U/4,4/ <br />Service lrileter <br />FINAL \\\L4 g ,.1,lttft E) <br />Notes, Remarks, Etc I <br />-) <br />L.nd.' ! AddrN <br />- <br />$?Z q <br />Meter Release