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ELECTRICAL.INSPEGTOR RECORD <br />APPROVALS 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 />Bondin / Grounding / UFER <br />Transformers <br />Torquing <br />Sub-Panels <br />Roof Top Equipment <br />Walls (Conduit) <br />Walls (Rough) <br />Ceilings (Hard & Soffit Rou h <br />Ceilin s (T-Bar Rough) <br />I\/eter Release PiRED <br />Rou h <br />Service Meter <br />FINAL <br />Notes, Remarks, Etc <br />OMd-Build.r Dcded@ <br />! h*by affim undc. pmalty oipcrjury tnai I m.x.mpt fom th. Co.lh.ioE Lic.nrc La* for thc follo*insrcson (s 703r.5 Busin6s <br />ud Prcfesion Codc) Any Ciry or County uhich Equird. p.mn to colruc( ah6, imprcvc, dcmolish or rcpair &y stru.tuE, pri6 lo its <br />irsuec!, alio r.qltq thc rpplic.nt for luch pcmn ro filc ! dsn.d rtatcmqt thor hc orsh. is licascd pu*uinttorh.provisioBoflhc <br />Contr&lor\ Ltqscd Llw (Chsprd 9, Cdm.ncin8 wnh S.c on ?0o0 ofDiri3io.3 of $.Bsinsdd Prof6sions Coddo.$arhcd <br />rhc is .xcmpt thcr.from dd lh. bak for rh. all.8.! .rcmflion Any violaion of S.cion 703 I t by ey applidt fo, . plmn subjatr rhr <br />rppli@l to rcitilFnalty ofnol m@ d'& 6vc hon&.d doll6 (t500). <br />_1, a ow..r oi dc prcp.ny, tr my .mployq wnn wag6 6 thcir solc €ompcnradon, will do rhc wo,k aod $c rucrw. t nor int.ndcd <br />s ofad.d ftr s.lc ( Sd 7oaa, Ssin6 dd Profeimr Cod. Th. Cdtuor'r Lictu. L.w doq n6t.rply to& own.r oa$. prop.ny <br />who buildr or imFovB lh.Ed, ed who d@ ruch work hiGclf or h6df or tirough his d hcr own .hploycq!, provid.d Ur.r luch <br />impov6.ni5 @ not int nd.d or o,I6.d for sdc. If, howcvd, rh. building d imFov.ma( ir sold ei$io o.c ,@ of compbron. $c <br />O*n*Builda will havc lhc burd., of provirg rhar hc or shc .ot blild or improv. for lnc plQosc ol salc) <br />_1,6 owno of rhc pbpc,ry, @ aclusivcly conractin8 wnh licens.d .onr&r6B to constrlct th. prcj.c! ( S( 7044, auins ed <br />Proa.ssion Cods Thc Conr.cbr's Liccnsc I-3w dG not apply lo own.r of pr@dty who buil& or inprovB lhe@n , sd who <br />.oftds ior ruch proj.c6 with r Cor&ro(, limEd p!6uer 6 rn. Conrfttofs Licc.r. Lar ) <br />I @ .rcmpt und.r S.crion <br />WORJ<ERS COMPENSATION DECLARATION <br />I h.r.byaffimund.rpc.al9 orpoluryoncof rh.followingd.clr. ds <br />_l hav. dd will m.inhin r Ccnifidt. of Conscnt lo Sclf,lnsur. ior wortcG' cofrp€nsalion, 6 provid.d for hy S.crio l?OO.fth. <br />L{bor Cod., for the p!'{mu@ ol$c *ort forwhich rhc p.mn is iisuld <br />,I hav. dd will dainldin vork.s cohp..sarion in$rsc., a equiEd by S.crion 1700 oflh. Labor Cod., ior rh. pelomdE ofrh. <br />work for which $is pqnil h i$ucd My vdkd cmp.Bltion inilru@ Fi.r dd policy numbcr dc <br />PolicyNumb..: Expirq: <br />-/**" *^ ^ <br />nor bc cmplcr.d if lhc p.mt t for On. <br />rh. pdfom cc oa lnc *ork for <br />wor*.rs' comp.nsadon cov.r <br />c hundr.d rhoEud dollG (1100,0m),in on, daa!6 a prolidcd for thc S.craon 10?6 oa <br />I h.r.by alrlm und., ,.nahy of psjury lhd I m lic.ns.d und.r proltion of Cnaflf 9 <br />lh. Businsi dd Profsions Codc, &d ny licos. ir in aull forc. and cif.cr <br />ollhcwok fe which thisplmn ii <br />APTLICANT'S DECt-ARITION <br />Dcmolition Pmn! Asb6t6 Nodfi@tion Fcdml Rc8ulltionr (Iirlc 40, Pan 6) <br />_ R.quircd Lclrcr of Nodti€lion <br />I.3F ro conply vnh lll <br />.bov. m.nrion.d prop.ny lq i <br />DATE <br />Air Conditioners <br />Factory Wired Unit <br />E} <br />FEI _ I ZUIU <br />lnr.r6t &d atom.y \ f.cs <br />iaucd(Sm. !09?, civ. C.). <br />L.h&r's Addr65 <br />f- ----T-----t <br />f-----_l-------