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ELECTRICAL.INSPECTOR RECORD <br />DATE ID/SIG.COMMENTS OwtrcFBuildcr D.cleltion <br />I hq.by rfiirm und.r p.nnty of p..jury $!t I m d.opl lom rhc Coffa.tors Lienc L.* for tI. follo*inB r.&n (6 701 I 5 Businse <br />Md Prof.sion Cod.) Any City o, Cou y which r.quir.s ! ptrnn b 6.sdd. r.r, i6prov., d.nolilh or r.pair uy lrtucllrc, prior lo n3 <br />i3san@, also r.quir€s Lh. lpplimt for !uc[ p@it b fiI. . sisn d st!h. rhd h. or sh. is lic.red plBd rorh! provi3io6 oftb. <br />Contlctolt LiceBcd L6w (Chrplcr9, Comcncins wirn Sdio.7000 oaDivision I ofrtu Bulincs! ud Prof.ssions Cod.) or thrt he or <br />sh. is .x.hpt $a.liom .nd fi. bsis for th. .ll.8cd .i.nplion Ary violalion of Sction ?Ol I 5 by ey rpplimt for I p.mir tubj.c! rlE <br />.pplicant io a civil p."rlty of nor norc lhd llvc huldrcd dolla,slt50o) <br />_1, as oMd ol ih. propdy, or ny cnploy.4 with vas* !3 th.ir el. @mp.ns iot\ wrll do rhc work ed rh.,lrudur. is nol int.ndcd <br />or ofl.r.d tor $]. ( Se ?Oa4, BusiEr rd Profslioni Cod.r Th. Co.u..tor'! Li€nF L.* do., mt.pply to a omd ofil. propsty <br />*ho buil& or inptov.r th.r.on, ud *ho do.s sch sork hins.la or n c.ll o. throu8h hn or h.r n.mployd, protid.d 6d su.h <br />imprcvcm.nB d..ol i .nd.d orofcr.d for bL lt howds, rh. building or iDprov.m. is sold wirhin on. y{ of@mpldioq rh. <br />OM.FBuild.r will h!v. rh. bud.n oi lrovins rh.t h. or sh. n6t build or ioprov. for fi. pu.pos. of ,il.) <br />l, !s own.r ofdc prop.ny, !m.xchsiv.ly co.t.ciina *ith lic.ns.d ontrcrors to onntud.h. prdjftr ( S.c 7044, Bu5iniis Dd <br />Prcr.r5ion Codc Thc Co"lraclor's Li@ns. ljw do6 ror rpply to e omq of propdy who builds or ihprov.s tlqoo , Md vho <br />conu.cB for sch p.qetl wth ! conr.cro(i) lio.nr.d pusuel ro tnc conhcror't Lienle Llw ) <br />I d.xemfl nnd.r Scdion <br />-B <br />& PC iorrhisr.Mn <br />voa{EBslor4tE}saror_lEelaBdlrox <br />I h.r.by afirm und.r p.nalty ofpdjury o.. oa th. rollowi.B dal&rtions <br />_l hiv.6d will naindn a Cqriliot. ofcon* toS.lf l@r. hr sork@ @mpe45!rio'r, a providc<l lor by SErion l?00 ofth. <br />Libor Codq lor fi. pcr{omu* of dr. wor\ fo, which ihc p.m i!issu.d <br />IhNcudwillm6i linwork.ra omp.n*tion insunnc.. s r.qun.d by S.clion l?00 of$. Llborcodc,lor the psfomme oftn. <br />worl fofuhich lhi! pcdn is iscd My workql @hp.ndion insu,uc. ffi.r Md policy nunbs & <br />(ThG s.clion...d not 6. conpl€ted ifth. p.rnn is for on. hDndr.d dolla {1100) or l.s) <br />I ccnily rhat in nE pcrformance oathevork aor *l,ich lhGperm is isu.d. l 5h,ll ndt employ any pe4on i. any sa.nerso asro <br />b@a6. sbjd to rhc workc( @np.nssrion d .gre.lhat ifl should b@m subjfrt to dr. workqs <br />coDp.ns.rion provisio.s olsection r?0o oflh.I ehill, fonhwirh comply wirh tho( provtsion5 <br />64 <br />WALNING failur.to s.curc worli.6 ul,ulul, d shlllsubjcd employq lo qiminrl pcmlti.s Md civil <br />finB up ro om nund,ld thousd dollss (S 1oo,oc)),in rddnion to lt). 6s of6mp..stioq d.nDgq a pro$d.d fo. tli. Sdtion 30?6 ol <br />!h. ljbor Cod.. i erdt Dd.trm.y'. l&s <br />!!cE!s!!loxrracrotlp!e!4!/qi)N <br />I h.rdy .rfim u.d.r p.nilry oa p.rjury thll I o lic.oi.d und.r prcvisioi of Chap!.r e (@mm.ncins wirh S€rion 7000) ol Divnion I of <br />t'. aulid.rs and P.ofcslionr Codc, md fty hc.n* ir in tullforc. ud.ila <br />- t1-o.-,ef <br />I hereby .1trrn under p.n.x, oapdjurylhst <br />i.su.d (Sec 1097, Civ C ) <br />is ! @osrruclion lcodina ls.ocy for tn. p*fom.n@ of th. work aor which Lhis psnir i5 <br />APPLTCA T'S DIJCLARATION <br />Demolido. P.mireAsb.stos Notificarion Frdsrl R.guhriois (Tnh 40, P.n 6) <br />Rcquir.d rats of No$n6tioD <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 />Bondrng / Grounding / UFER <br />Transformers <br />Torquing <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilings (Hard & Soffit Rough <br />Ceilings (T-Bar Rough) <br />Rough <br />Service Meter --aFINAL'/&/alJ -e.firu/ <br />M\WP51\P6m -lnsp€cton Forms\E16c1n€r-hsp6ciron Rocord doc 03 31 06 <br />APPROVALS <br />Ac+ <br />L.nds'tAddr?s <br />Under Slab / Floor <br />lt/leter Release <br />Notes, Remarks, Etc.