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ELECTR!CAL.INSPECTOR RECOR D <br />DATE ID/SIG.COMMENTSAPPROVALS <br />Site-Work <br />Underqround <br />Pole Bases <br />Lioht Standards <br />Spas. Pool, Fountains <br />Siqns (monument) <br />Life Safety /Low Voltage <br />Fire Alarm / Dampers <br />Communications Cable <br />Buildinq <br />Under Slab / Floor <br />4t11/*../k4124zon fe)Bonding / Grounding / UFER <br />U ITransformers <br />Torqueinq <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilinqs (Hard & Soffit Rough <br />Ceilinqs (T-Bar Rouqh) <br />+qr*l/(Al210ofr ?D)lVeter Release <br />)t <br />Rouqh <br />?hl/\ferhService Meter $luDTi 'g) <br />'rh^AL,a;FINAL .i/il l.2o?t ffr) <br />RemN Etc. <br />_()\RA',ilON <br />IherebyaffirnlunrlerpcnrltyofFriur_vthalIanrexenptfroDrtheContmcb6 Licensclawforthefollowingreavn(Sec.7o.ll.5 <br />llusincss and Prolcssion (lodc): Any City or County which rcquircs a [rcnnil to construct, altcr. irnprovc. dcrnolish or rclair any <br />() thc provisions ol'tl. Conlraclor's l.iccnsed l-aw {Chaptcr 9. Cornrncncing with Scclion 7(X[ ol l)ivision J ol'lhc Busincss and <br />Pr)fcssions Code) or that lt or \he is crcDrpt therefront and tlE hasis lor tl* allegcd eienptirn. Any violatiut ofSeclion 7031.5 by a0y <br />nppticanr for r pennil suhjecls the dpplicrnt to n civil peDrlty of not more thiln llve hundred dollars ($5{){)). <br />_1. ar owncr ol tlE prclaflv. or nry ('trlpklvccs with wagcs as thcir solc compcnsation. will do thc work arxl the stMurc is frrt <br />ittrcftled orolferedforsale(Sec.T(}il.BusinessandPmfcssionsCodc:The(inxrnclor'sLiccnscLawd€snolapplytoanowncrof <br />the pfi4Er1y wlx) builds o, in{x,ves llrrqn and who doca such work hin)selt ot lErself or lh()uBh his or lter ou enrpiryees, <br />providcd (hat $uch itnprovcrncnls nrc rrn intcndcd oroll'crcd lbr snlc. Il: howeyF. thc building or irnprovcnrnl is sold within onc yetr <br />irf conrplctirr, rlrc Owrcr tluildr'r will hnvc llE burden of pnrvir)g tlu( lr or sh#id Btr build or improve rhe pmpeny for rlr puqn* of <br />nrle). / / <br />_1. as owncr ol the Prrpcr ty. arl cxclusircly coDtrilclinE wilh <br />and huli's\i(n) (irde: l lrt (i)r[rnct(tr \ [-i(Ulsc l-rw docs nol <br />corslrucr tlt pNject (Sec.7O14. Ilusilcss <br />wlro builds rrr in:proles thereon. <br />and who coilracts for such pr(t'cts wilh a Contrack)(s)Contracrcr's Liccnsc [jw). <br />I anr cxetrDt urrdet Sect <br />2'17 ?,o?h- <br />I hcrcby allirDr uxlcr I)cnnlty (,I pcrjury ('nc <br />_l have ail willnuinlnir a (,l C(rlsetr(Itrsurc lirr w,rkers'cr)rnpensati(,n, a\ pnrvrlerl for hyScctxrn 1700 ofthe <br />lrtx)r G)dc, li,r thc pcrfornurec of thc worl lbr which t|t pcrnrit is issucd- <br />thc sork tar which this l{nDit is issur(|. My workcrs' ronrltDsrtiur itNurdlcc carricr ilrl lx)licy Dunttf,l ix'c: <br />l1)licy <br />-l <br />ccnify thilt in thc trrli,rnHncc otlh!'work fot which this lrcrmit is issucd, I nol cnrpk)y aily ltrsorl ln ary nranncr <br />il l sh)uld hccorrc subjcct to (hc <br />conrply with tho* provisions.. <br />s as to bccorrc subjcct t) lhc workcrs'cornpcns{tion lnw\ ofCalil'ornia. and <br />wrrrkcrs'conrpcnrationpn)visi(,DsofSccti(xl.1700oflhcLutx)r(i)dc,Ishall, <br />IVARNING: l;ililure to scure sorlicrs N,npensnlion coverogc is xnd subFct an cmployer lo qiminal pcnaliies and <br />civil litres up to otre huodred lhousund rlollnrs (1il iu oI conlfctrsaliur. danuges as provided for llle <br />Sccli()n J076 (,1 lhc t-alxr'(l(xlc. irilcrcsl ud lacs. <br />,*", -2-lj'?{)t4 <br />I hercby afllnil under lrcnaky ofperjury tba'(m ti.ense,l unls <br />of lhe Businas\ lnd Proltssions Code. anl nrv license is in full <br />9 (conrtrrcncinB with S€ction 70UJ) ol Division l <br />l-iccnse Class:NuDrber: <br />C0hlraclor <br />CONSTRUCTION LENDINC AGENCY <br />I hcrcby allirD undcr [rilally of pcrjurv that thcrc is a conslruction bnding agcncy firr thc;crlbrrnarce ol lhc work lbr which this tErtrrit is <br />issucd (Sec. :1097. Civ. C.). <br />lf,nder's Naille: <br />kndcr's Ad,lrcs.: <br />APPI,ICAN'T I)F]CI,ARA'I'ION <br />I lrrclry dflirnr uD(lcr Irnalty of pcr iur y onc of thc f(,llowing dcclarilli(rrs: <br />Dcnx,lition Pcrnrils-Asl{sk,s N({ificrttr)n l;cdcral Rcttulations (Titlc.l0. Pda, <br />_Rcquircd lxltcr (,f Nr{ilicalion <br />_l ccilily lhnl thc Itdcral rcBulalions rcga'ding b this piljcct. <br />cc(ili llHl I hnve rcn(l this applicrliotr url stalc lhat lhc is I agrN () conply witlr ull City and County <br />oilinanccs and Slatc Laws rclding lo buildinS ol this City and County lo cntcr upon thc <br />at)(!yc nlenti(nrcd p()l)ertv Iiil' <br />ApDli(ant or Agml <br />I'crn)ilcc nxnrc <br />Purlx)ses.a'17 2D2o <br />t <br />./Date:_