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ELECTRIGAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS Ownd-B!ild.r D.clmlion
<br />I h.r.by alilm undcr p.ialty oi p.rjury $ai I m .xcmpi fm fi. CdtEctoB Liccns. L.w lor thc followins r.6on (!.c.70r I s Bulind
<br />aid Prcf.$ion Codc) AnyCitto.Clunry which r.qoirq a pmit ro consttuct, .lt r, imFovc, dmolish or rcpair m, srtucrur.. poor ro i6
<br />irsudc., also r.quta $. .pplicant for such p.mn b filc a si8n.d slalmdr that hc or sn. is licdscd purcudt to thc Foriiions ol drc
<br />Co ra€rol s Licds.d Lav (Chipt r 9, Comn.ncinS wi$ Sccion 7000 of Division I oa th. BusinBs sd Prof6ioN Codc) or lnat hc s
<br />shc is .xmF lhd.frcm sd ttu bsis fd lh. .ll.scd dmplion Any viohtior of S4tion ?01 I 5 by dy .pplicdt ror . p.dn tubj.cls tl'c
<br />apDlicdr ro a cival p.n.lly of not moE fid fiv. hu.&.d dolld (1500)
<br />_1, 6 owncr of lhc Fopcny, d my cmployc6 wnh pass s thct solc conp.nsrtion. will do th. *ork md thc s!tucl(c is not inr.ndcd
<br />or oitmd fd salc ( S.c r04t, Blsin6 ad Proicsions CoL: Thc Conh-.clor's Lic.nsc Lau.,06 nd rpply lo 6n owncr oafic proD.ny
<br />who builds or idprovc lhtrcon, d vho d6 such *ork hiruclf or h6clf or rhrcu8h his or hd own .mployc.s, proyidcd rhd such
<br />implov.mcnLs e not inladcd or ofcr.d for sal. It how.v.r. rhc building q inprov.hdt i. sold wnhin on. y.u ofconplcnon, rhc
<br />Ow...Build.r willhrv. th. burdm ofprovin8 tha hc orshc nol build orihprov. aG lhc Frposc ofial.)
<br />_I, s ownd of th. prop.ry, am .xclsivcly conE&tins wrlh liccns.d cont actod lo constlcl th. projd ( Se 7044, Bcin6 ud
<br />Prof6sim Cod.: Th. Contutols Liens hw dG nol agply ro owncr of lropdty who builds d inpro!6 $fton , &d who
<br />conracB for sucn projcds wnh a Contr&ro(, l,ens.d purcu t ro rhc Contacror'3 Licc.s. Law )
<br />WOR(ERS COMPENSATION DECLARATION
<br />I harby af6m und.r pcnalty oI pdjury oi. of rhc follo*ing drcldlioB:
<br />! halc dd villmai.lai. a Ccnifiot oiCons..t to S.lll.suE ior wo'k.E' @mpdsatio, 6 providcd (o! by S*tion 3700 oa$c
<br />Labor Cod., for 6r p.rftucc of 6. work for *nich thc pchit is nsu.d
<br />_l havc udwillmsirrain wqkcs compasalioa i6urucc, s lcquncd by Scctioo 3?00 ofthc Labor Codc, for tlc p.rfom&c. oath.
<br />work for which rhis p.mit n issucd My wdI.B' conp.nsalion inrurdc. 6is dd policy nunb.r &
<br />Policy Numbcr-Expncs
<br />./_*-,^",,",6-*.,,;r*, .
<br />nor b. compl&d ilrh. pmil is lor On. hundrcd doll6 11100| or 16,
<br />rhc po{omuce ol lh. work forwhich s isrucd,I sh.ll nor.nploy oy p.6on in
<br />compcnsarion laE ofCal
<br />700 ofrhc Llbor Cod€, I lhall, fonhwirh
<br />ieu.. wtrl@ts comp.nsation
<br />rhoused dollu (S100,00o),in addtion ior, damagB 6 provid.a ior rh. Scclid 1016 oa
<br />inr.r6r ddaromcyt fc6.
<br />UCE!'ELCONIBAEIOAS.DIIIAIA
<br />I hocb, afllm u.ds pnalty of pnju.y tll3l I o licc.sd uidd provision of ChapE 9 (conh.ncins wirh Scclion 70OO) olDivision I of
<br />thc au$nBs dd Prof6i@s Codc, lnd my licas. is in full forc..nd.fl4t
<br />uod( p.ialty of pctury $ar th6c is a @nstrlctror l.ndi ns !8.ncy for lha p.rfmancc oi thc wdk for which is p.mrt n
<br />ksucd (Scc.309?, Civ. C)
<br />AIIUCATI]IDECLAIAIION
<br />Dcmolilion PcmnsAsbatc Noti6c.lio, Fcdd.lRcgllations (Tnk a0. Pan 6)
<br />_ R.qutcd Lar.r oaNoafiotion
<br />ab6r6 r.mov.l d. nol applicabl. ro rhis p'oj.d
<br />I rg@ ro comply wirh allCiry adCounry
<br />,b.v. h.nlion.d propcny ftr insp.ction
<br />v6 of rhi! City &d County
<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
<br />h;(Pl!:LU
<br />Rough
<br />Service Meter tEtr -{,u tJ
<br />FINAL SAMC 843, 2!r0, 550, 667
<br />Notes, Remarks, Etc.
<br />_l m cr.oprudd S@lion
<br />-B
<br />&PC ftrthEr.en
<br />D . Ovnq
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