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ELECTRICAL.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS oMd-Buildd Deld.tim <br />I h4by ailim undd p.nalry of pdjury $at I m .xmpt iom thc C.nldcloE' Liehs t w for tn. following Eaon (!e.703 1 , AGin.$ <br />dd Prcteio. Cod.)r Any Cily d County which rcquns a p€mn to cdsrtu{ ahd, improv., <Lmolirh or rcpst dy nnduq Fior |o ia <br />isuec., also r.qut6 lhc applicdr f6 such pmit |o filc a sisrcd iarcndt O.t h. @ rh. it limscd p{^ud lo rhc Fovilim of Oc <br />Coi!-&rort Ltas.d tls (Chrgrd 9, C.lmadn8 with Setion ?000 ofDivision t ofthc Buind d Prcf6ions Cod4 c thar h. d <br />sh. is .xm rhd.from dd thc bais fo ilic allcecd dcmption Any tiol.rio of S.cdon 703 L5 by sy applicdl for ! p.mn robjdl. $c <br />applimr ro ! civilFnalry ofnot mrc tle fivc lundEd dollas (ltoo) <br />_I, a o*n6 of lh. Fop.ny, tr ny dpl.yd wifi w.a6 s th.t solc 6mp.n$lion, will do d'. wo,k &d lhc slructw is not inhd.d <br />or offcEd ld s.l. ( S* ?Oaa, Bsirs ud Proterim C!d. Th. Conlr cld s Lic4. tjw dc not eply lo e owncr of lh. pr.!.ny <br />who buil& or imFov6 lh@n. &d who dG seh wdt hirell or h6da or $,orgh his or hcr @n coploycq prcvidd th.t slch <br />imprcvmaB m notinradd d ofldcd for ralc li hwcv*, rhc buildins d ihprovcior i! 3old*ithin one y@ of conplclon, rh. <br />Owno-Builda *ill hav. d. burdm of proving lhal h! 6 sh. rot build tr imFovc tn lhc plrpo* of i.l.) <br />_1, 6 owh.r of th. pop.iy, m qclusiv.ly conlr&1ing wth li..ns.d conF&loR to cmlrucl 6. Foj€l ( Src ?0.14, Bainds Md <br />Pbf6sion Cod. Tfic ConrEcbls Lic€nrc ljw &d f,or apply to e ovnd of propqty who builds d improvB $q@n , ed who <br />@nlrrcls for such prcj*r! *ith 3 conrado(, lifiscd puduet 10 rhc corbacrort Liccnr. La* ) <br />_l m.rmpt or&r Setion B &PC ld tlt @on <br />WORI(ERS COMPENSAAION Df, CLARATTON <br />I haby amm md+ p.nalry of paj!ry on. .f rh. followine dalmtios <br />_l h!v. ed will mainbin s C..lifi@a of Cdsdt lo S.ltJnsur fd *ort6' @pc6ario., d pr. d.d fd by Scd@ l70O ofrh. <br />l,bd C.&, ftr th. p..fmsk of tnc wtrk fG which lh. Fmil is issu.d. <br />I hav. dd *ill nainbin wet6 cmp..srion insurec., a Equt d hy S.clion r?00 of lh. Labor Cod., aor thc p.rfomdcc ol thc <br />wot aor ehicn this p6mit is iss!.d My wart6 mF.sation ihsuru€. ffid ed policy numbd uc <br />Policy Nuhbd ExpiBl <br />(Ihis s@tio. n..d ioi bc .ompld.d if $. Fmn is aor On. hon&.d dolls {l l0o} d l6s) <br />_l c.rlify lhal in lhc psfom eor$cworifqwhichlhisFmtisissu.d,!shaltnormploydypc6qin&ymun.rso6to <br />b.cdc lubjdt to |n. wodca comp.Ndion las ofcaliaonir, ed aSEc thd ifI should hccoru subj.d lo th. *dt6' <br />compcnsarion Fovtions of Scclior 3700 of thc Labor Cod., I shall, lonhwnh cnply with lt6. provisiN <br />on 1:zzzzb4( ewrc*,,\, <br />WARNING FlilaE to sduE *dLc6 cdFrs.lio. @vcragc ii olawful. dd rhall rubj.cr o dploya lo cimiral pa.lti6 ed civil <br />fi.6 !p ro oi. hun.lr.d tnoBud doua (l100,00o),in rddnio ro t. 6t oa c@p.Nrtio, dmra6 a p@vid.d aor dE S.crid 1076 ol <br />rhc L.btr Codc, inrml &d .tlom"y's f6. <br />IICDXiED.CONIIACIABEDICIdBAIIAI <br />I idcby afiim unda p.n.lty of pqjury $ar I M li.dcd ud.r prcvtio ol Chapld 9 {(frfrcnciry *ilh S6ti6 ?000) oa Divhi@ I of <br />fi. Bsin6 ed Prof6ioB Coda d my lico!. i! in futl foE. dd .6ei <br />3--za./a /z__- <br />colgraucuoutErDllc_Acllc! <br />I hftby a0im 6dc. Ftlty of p..rury thlr th6. is ! @sLuclid ltndiq &sdcy for rhe pcrf(fu of thc r6t fc whi.h tht p.mil i! <br />hsu.d (Se. 309?, Civ. C ) <br />APPLICANTTS DECI-ARATION <br />D.mohion P.mils-Asb6ic Notifisrion F.dml R.gulalions (Tnl. 40, Pan 6) <br />R.quircd t llo olNotili€rio <br />_l adiay rhar ln. f.ddal r.gula o.s rcgading ah6r6 Emoval d. not lppliebl. to Uis proj.cr <br />_ I &'n ry 6,1 I tuvc @d d,is appli.lrion ed si'L lhat lh. lhovc inaomlrid is @rer Lgrr ro cMply with all Ciry ed Coury <br />odiidc6 dd Slalc Laws rcl.ti.8 to blilding costructioi &d hftby .unqia rcpllsLlrv6 of this City ed Couity ro atq upon $. <br />abov. maiim.d piop.dy ftr iNF.tim purlxE e--.2/a / <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 />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 />Meter Release EXPII {ED <br />Rough rF_H I ) <br />Service Meter SAMC 8-43. 2r )0. 556 <br />^A'FINAL <br />Notes, Remarks, Etc. <br />-/zrt- - ,/ .z>t-t