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ELECTRICALNNSPECTOR RECORD <br />APPROVALS DATE tD/stG.OwnlFauil&r D.clsatim <br />I h.Eby aflim ud.r pnalry ofp.rjury rhar i M.x.mfl fom rh. Co.rdm Li.os. L.w aor (h. aollowin8 r.aon (36.7031.5 Buli.st <br />ed P.oicsioi Codc): Any City or Couty wl'ich quh6 a p.frn lo coi3ttucl, all6, inprovc, ddolth d rp.t uy strucruE. Drior ro iE <br />isrudci, aho r.qui.6 rh. .pplicd fq 6!.h pmit ro fiI. . signcd starmdl ihat h. or sh. is lic.is.d puBudr !o thc povkioN of $c <br />Conlr&br's Lic.rsd Lav (Chapld 9, Conn ncins with Sanior 7000 of Division 3 ol th. Busires d'i Prof*ions Cod.) or lltsl hc m <br />sh. is cx.mpl thcr.frcm ed lhc b6h fslh. all.8.d .x.mprion .Any viol.don of S.clion 7031.5 by dy.pplic t for. p.mn subj.cti thc <br />lpplicdt to a civil pdoltyofnol mtrc th& 6vc hundr.d dollds (1500) <br />_I, a oM.r of th. prcFny, or ny mployq vi *ag4 a dctr sol. con!.Natiotr, will do thc vo* ed thc struclm it no( inioded <br />or ofi*d rq sal. ( Scc 70,r., Buincss od Prof6sions Codc Thc Con@brs Licds. Laq de nd ryply to an own6 olfte prop.ny <br />who builds or imp.ovs lhdco,, ad who d@s such wort hi@lf or h6.lf or drouSh hii or hrow. employcB, provid.d tlat such <br />impbvm.nls dc not int nd.d or of.r.d for s.1.. Ii howcv.r, th. buildin8 oi improvchdt i! sold within onc yu oacompl.io, thc <br />Ownr-Buildr willhatc thc blrdo of proling thal h€ or shc nor buildor rhprcvc ftr rh. purpos. ofsalc) <br />_1,4 ow..r ofrh. prcF ty, n *cluii,.ly conhcting wnh liccns.d codractoB lo costrucl thc prcj.cr ( Se.7044, BEin* ud <br />Prof4im Codq Th. Conr.cbr's Li...!. Lrw do6 .ot apply ro d oMd of prcpdty who builds s improvd lhaen . Md *ho <br />contrrcE for such prol4rs witfi a Conrmto(, lic6r.d puBuot to 0'. Con!-r.brs Li@n& kv ) <br />_l m cimpi urd.r Sccrion _,8 & P C ad thit r.ao. <br />WORI(ERS COMPENSATTON DECLARATION <br />I hcrcby affim und6 paalty oa tErjury onc of lh. aollowinS ddlEtioB: <br />_l hav. ed will hainlain . C.ni6er. of C..r6t ro S.llJB@ for *016 @nP.rs.tio. a pbvidcd fd by S@rion lToO olrhc <br />Labor C!d., for thc p.rf(,lMe of thc work ld wnich th. Fmil ir i6u.d. <br />_l hzv.ad*ill m.inbin wdk4 compaE.tid i6utuc., 3 Egut.d by S.cdo. lr00 of thc kbor Cod., for 6. p.rlmsc. oa thc <br />wdt for phich this pdnn i5 issu.d M, wort6' cmptralio insurucc ceid ed policy numb.r s. <br />Policy Numbs : ExpiE <br />##ffiffi",ilil; <br />for Oic hun&c! dollec 1tl0O) or 16, <br />which this pm'r i3 6sucd,I rh.rl <br />ofCilifomi! dd agE. thal if <br />compcnsation proviions of S.clion 3 of$. L.bo. Cod., I shall, fonhwirh <br />-o <br />WARNINC railur. ro saur. wtrko .omp.nr.rion covcrag. u <br />fin6 up to on. hundrcd fioceddoll6 (ll0o,0m),ri lddrtjon to <br />rhc Labor Codc, inrfBr dd .lrom.y \ f.6. <br />d mploy.r to qiminal p.ralti6 sd.ivil <br />damag6 6 provid.n fo. rh. Scdion 3016 of <br />LICENSED CONTRACTORS DECLA!'{TIQN <br />I n6.by aflln undd Fnalry of pdl ury thor I M licms.d undd provision of Ch.prq 9 ( <br />tlcB!5in4. ad Prof6sions Codc, ed Ey licms. ii ir aullforc. dd.iLct <br />a2 -o <br />I hcr.by affim und6 p.nalty of p.iury lh.r th@ is a @nsFrctio lodi <br />issucd (Scc. 3097, Civ C) <br />APPLICANT'S DECLARAAION <br />Ddolirion Pcmi$Arbcros Notificario F.d.Bl Rcsolarios (Tirl. 40, Pan 6) <br />_ Rcqut.d L.[.r ofNo frqrio <br />conply wili dl Ciry ed Counry'ol rhis Ci9 ud Cou.ry to cil.. upoi rh. <br />abovc mcnrio..d prcp.ny ftr inrp.dio. purpc6. <br />O <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 />ts KPIREE <br />Rough <br />Service Meter FT E I lul I <br />FINAL SAN'C 8 .43. 290. ssi l. dB7 <br />Notes, Remarks, Etc. <br />COMMENTS