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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 />Torqueing <br />Sub-Panels <br />Air Conditioners <br />Roof Top Equipment <br />Factory Wired Unit <br />Walls (Conduit) <br />Walls (Rough)l\b t ct"D ryfy}fveyT- <br />Ceilings (Hard & Soffit Rouqh t\\rct Dk)\/ta &k? <br />Ceilings (T-Bar Rouqh)I lr <br />lvleter Release <br />Rough <br />Service [Vleter I <br />FINAL t-''ft'20fl)lJ@ttfu6{d <br />NoJeq, Remartis, Etc <br />lr d0, cl, I I \Y <br />OWNER AUII,DER DEI-(:ARATION <br />I hdeb, amm undd paalry of pnj!ry <br />'ha1 <br />I M .r.ml from rhc ( o mcloE LicN L.tr aor lhc follo\rins !@q'n (S{ 70ll I t <br />Ausinds od Prolsion Codc): Any Cily or Cou y \vhth r.qun6 a F.ril lo conerud. alld. imrNq d,nolkh or q;r dy <br />srocrre pnor ro irs isue.c. rLo r.qut6 rhe ,ppli.d lor $'ch pemn to nl. a sign.d sr.rmmt rhar h. or sh. b licds.d pusunnl <br />to rhe Fovisio6 olthc Conllactois t,iccnFd l-au (Chaprq 9. Com'ncncins trirh Serion 7000 olDivisio.I ofth€ lrusin* 6d <br />Prolcsions Cod.) or rhal h€ or shc is *dpr lho.Foo dd lhc b6is ior th. allcg.d crmption Any liolalion ofsedion 70ll 5 by atr) <br />.pplicad n a p.nni srbj.dsrh. applic.mtoacivilpenohyofnormorclhmiiv€hundrcddollars($500) <br />l. ar oNnd orrhe pi,pcay, ornry e iplo16 wih \ralcs ac rlEii qne.ornp.nsarion. silldo th. Nork md the slruclu. s hr <br />inro dl .rolTddl aorel.tS( 704,r, Busins.nd kofsions ( ode I he Conrlacroas l.icor LiN do6 nor apply rD m o$ne ol <br />th.ln,pdy uho ho ds dr imFo\6 rhd.. tud who do6 su<h {ol1 nins.lfor h6ellorrtrc{th iis or hd o*n.mploy.6. <br />provid€d rfiar su.h im[ro!'ndB e nor inrdddl or orc.d rnr ek I[ h6s6 d. rh. hrildinB or inllrovoEd t $ld rvilhin on( tar <br />olcompkion. rh€ O$ nd ttuildE will h{\! lhc trrrdd of prorins rha h. or S. did nor build or in4m\ c $. .ioFlt tor !h€ purFE oi <br />l. arornd.arheFor.ry, m.r.l$i\tly.onta.rn8 $nh lr.sse{ cont.dos'o consro.t thc proj€ci (S(.7014, aBhas <br />and fllfsion Codc: r hc Contrrctois l-icense Law do6 nor appl! lo an osnr o r pror.ny Nho buil& or improvs thqsn, <br />.nd sho onrmds lor $rh proj..a qhn. ( onrado(s) licns.d pruo0nl lolhe Cootradois l,ic€nsc l,a\) <br />I mrc\cntr tr dd Srd o <br />Drre osrer: <br />woRKrrls-otuPrN.iATroN <br />DECIABAIIIII <br />I hdeby allinn r.dd pcnahyofprjurron of$. follosinS 'lclffarioBl <br />I lEv. tuldsill <br />'ainranr <br />. Cdific.rc of cotror h self-lmrrc for $ ork6 snrDosrion. 6 Drorid.d for by s<rtun 1700 ol rh. <br />l{bor Code lor lhc p6tt man.r o r lhc *ork lor *hich ilE tmil i3 is$'.d <br />Ihavcandwillman trnr worlds compersation in$mnce. as Eqtrircdbys<rion]r700{rrh.l-ahorcod..lorrhcpafomrnc.ot <br />lhe rvork lor rvhicl lhis pennir is issu.d My \rork6 con,pqsarn insurtu.. ceiG od a)li., numb.r o.: <br />I c.nifylhar in rhe p(formaic. oath. *.rk f(tr Nhthrhis psnii is issu.d,I sh.ll or enployanyFmon itr anydinnd <br />$ 6to b€ome srbj(' <br />'o 'h€ <br />*oltss co,npeB.lion la*s ofa.lifornia..nd asE rh.r rrI s,x,trld h..on 3ubjd ro thc <br />workcl compeGalion pro\isions of Sdn,n 1700 ofthc Lab.r Codc. ! stall. ronhwnh.o,nplr {irh rhos. provisions.. <br />t\ARNING: failwe ro sectrrc \orkei co,npcnsrri,,n co\o'n!r is rtrli\ tu]. t d slrll sn,i..r rtr dnphld lo cnDtsl l{rnlri6 rntl <br />hLml'c(l {lnBinJ doll!^ ($lo(l ). in a,ldnbn r. rhe c.s ot.ornpcns.tion, d.rnaa6 6 proridcd tu rhc <br />I h*by amfln lnds poalty of pcrrwy lhal I m I <br />DI,CIAIA]IQX <br />und6 pmvision orchaplo 9l.omnocins $ilh sdtion 7000) ofDilhio! l <br />.l rh. Businssand ftoa*sions ( ode. md fly liccnsc is in nrlllorccod.n(r <br />I hwby amnn unds rEaally o t p6luD lhal rh <br />issu.d(S(. 10s7. Ci! C ). <br />rion kndins aracy aor rh. p€fonnmcc of Ihcsort fo. $hichrhis t6nir is <br />AjfucAxru[cLAlAIIoN <br />I hsdry nfrnn unda r'f,nally olndjurr onc of th€ follovinJl dslrllions: <br />D.nohion PdmnlAsbBlos Nolilimlion redsal Reruialions I lnt !0. I'an6) <br />Requncd Ldrd oa Norifi.arion <br />l.L,(r,.onrril\ (irhallCirvand(inrnr\ <br />arns olrhis Ciryand Counrylo.nrE uE nrhe <br />Transformers <br />0 <br />. B & P( lor lhisre.so. <br />E la zoa g <br />I <br />s Tv-->