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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE 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 (Rough)
<br />Ceilings (Hard & Soffit Rouoh
<br />Ceilings (T-Bar Rouqh)
<br />Meter Release
<br />Rough
<br />Service Meler
<br />FINAL 'l/5/" 5DrA tUl].l bq
<br />Notes, Remarks, Etc.
<br />OWNER BUILDER D'I,CARATTON
<br />I hs.by amfl. unds pdalry of pnju.y rhal I d .:cnfl fton lhc Co.tr.loE' l-!c.nse Lar lnl rhc hlro*ng r.si (sa:$l I 5
<br />Busin6s dd Proasion Cod.) A.y Ciry or Counry uhich rcqunG a p.nnir to coElruc1, 6hE. inp.orc. dtriolish G r.l.lt .n)
<br />srtu.rur., pnor b ns isu c., also r.qun6 the applicel lor such rEftn b fit E risn.d almdt th.l he or sh. is licNn nuEu U
<br />lo lh. prorisioc ofrhc Conra.loas Lic.n.d Law (Chafln L Comc,cios wilh Seclion ?000 ol Diviion .l ofth. B sincss ond'
<br />Pmlsions codc) or ltal lEorshc is.xempl lh€rsfrom md lh€ bssis lor lh. allegcd crmrrtrn Any violarionofsario. T0lr l 5 hya.y
<br />spplicanlfor!p6mnsubj<rsihc,tplicadrroa.ivilp.nalrrofnornor.thanfivchundrcdd.llds(5500).
<br />I. 6 olvn.r of rh. prop.ny. or my cmplor€E wilh Bas6 6 lhet elc ..tpendion, $ill do he s olt ed ft nnrlde i, nor
<br />inr d.d or oits.d fo, slc (SE 7044, ausi.B dd PofBiod Cod.: Thc conlmclois Lic€E Law do6 nol arpl, to d o$ns of
<br />rn. pmFly who hilde or inprcrG thoon. md *ho doe such so* himsclror hn.lfoi (hbuBh hh or hr osn d.ployc.
<br />pRivid.d rhar 3uch impdvdrds e mr inddcl 6fi.Gd forel. lf. ho{e6, tlE llilding or iqmwl is Fld \ihin on. }*
<br />ofsmplcrion. rhc o\rra Buiklo $1n h!. $. hrild oaForinS thd h€ or sh€ did ml t{iH or ilnprorc 6c porsly for (h. ptrtDo* of
<br />I. 6 os..r ol rh. pmpdy, am cxclusivcly contraclins s ith li.ds.{ Nirrdro6 ro oNrd.1 llrc pmjcl (S4 ?044. BB,nN
<br />snd fto,i5si.n Cod. Thc conta.ror's Liccnse La$ doB nor .tpl, to an .\rn( of rop.n,_ \rho builds or in|ro!.s lh66o.
<br />and uho @nlmcrs lor such proj.cls rvnh a cont@ro(O li..6.d prB@r ro rhc contadors Licsc L,w).
<br />I d€\cmpl undr Selion
<br />]IQBKIAS]COTITENSA.IIAI
<br />DECJ.ABAIII}!
<br />I hdcby ammunds p€nah, oapdjuryon.oathc lollo$ in-( ddldalions:
<br />I hav. aln will ,n.inr.in a Cdificatc of Co6or lo S.la'l6uic fo! Bork6 comp@lion. 6 pro\idcd for b, S(tion 3700 of lh.
<br />Lab.r Codc, for rh. tdaomMce of rh. sodr for \vhich lh. F6nit is issu.d
<br />I hi\ c and will mflinlain wort6 conposalion iNurtu.c, d tcrluircd b, s(t ion 1700 olrhc t bor Cod€. t t rhc pdnnlnx .. o I
<br />sh'chrh'slEn it 'sludlHaakd
<br />inuranc. ceid Md policy nunbs e.
<br />/as,--fuc-<c.tc<- /ry"y
<br />,,,*,-7:L:/s
<br />I ceniry rhal in rh€ pflordance olrhc *1rI ror which rhis pmn,r s issu.d, I sh.ll not employ any pnon in any frann.r
<br />e rs ro b.co rc subjdl
<br />'o
<br />lh. work6' .o'npdsilion laws of C.lifohia. ud asE lhat ia ! lhould ti<oo. subjd to rh€
<br />wo*ds conr!.nsarionprcvisionsofSdion1700ofrncLatnr(-odeIshlll.lonhtrithcomplysnhrlt)kpolisions..
<br />'WARNINC: Failu,c ro sd. Norkdd codDoelion cov@rc is ula{6r1. and shall subjsl mploF lo cidi.al pddlrie and
<br />c il fincs !p ro ooc hun&cd rnoosd dolld ($100.000). in addilion lo th. cost ofcomp.Nation, da@ses a prolidcd aor lhc
<br />setio.10?6 ofrhc hhoi Codq i.r6d da om.y-s L6.
<br />/rru4-
<br />r,rt rn#rrionrnlr rox
<br />lI!( r Jt ru r xrN
<br />I h€rcby aflim uodr pdalty oapalury rnd I d li..ns.d u.d6 rolilion ot Chaprg 9 lommmcins {ilh Sc.lion 7000) of Division l
<br />ol th. Ausif,s md ProfsioN Code. dd ny li.d* is in tull aore ed .fidr
<br />L /0a??a?(' /o - /? .-,^u*,
<br />I h6.by affirh und€r Fnall, of pdjury rhar lhs. is a coNtu.rio. Lndins nBmcy aor the p6fon..ncr orlhc\rork ror \fii.hrnis,6nir it
<br />issucd (S€c. 1097. Cr. C ).
<br />t€nd.r's Nam.:
<br />dSEtlc .ILDECIdSAUAI
<br />I hod,, amm undn p6alr, of pdjury onc oalh. lollosinB &cldol ions
<br />Detnohtun P6dns Asb6los Nolificalio. F.ddal Reeulaiioft (Titl€ 40, Pan6)
<br />Rcqnn.d ldrooaNo fication
<br />,lcdrlyrhdrh€tdEalEsullirc(nsdd'ns6h6ros'@,rald(@rapplsbl.rothFpoi6r.
<br />,dldlay rhd I ha,. @d rtu lppliorion &d skr.rhd rh€ above inromarion is corccr. I rsrc ro complyNnh 'll ciry snd counry
<br />Odn0ic6 ud Srar L,$ s Elarns ro bu,ldrns cDnnfldrcn. dd h*by authdri:. ,cprsraivd ofthis cily ed Counly lo dl6 urDn lh.
<br />,r-." --."..n "-*" r".,^di"" ",*,,r,
<br />Approtr,m^ro,skmbrc (W4'' D,," 8*/o 17;,*-.;,*; ---TVTe*&*
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