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ELECTRICALNNSPECTOR RECORD <br />APPROVALS OATE ID/SIG.COMMENTS Ownd-Buildcr D.clelid <br />I ncrby affim undd F.alty ofpdjury fi.lI m.xmF fom fi. CdlBcroB Lic6s. Liw fo!$c followin3 rc6onGcc.7031.5 Asi.6. <br />ed Proi6ioi Codc): Any Ciry tr Comty which R9un6 a p.mit lo onsLacl, altcr. implovc, dcmolish ot tpan dy slrucluE, rior to it! <br />issumcc, also r.qut6 rh. applicbt for such pcmn b filc a siSrcd srarcm.nr $at hc o. sh. i! licos.d puBudt ro th. !.olilions oi $c <br />Corradd! Lt.i$d La* (Clupi.r 9, Commadng with Sccdon 7000 oi Divkion 3 ol thc Busin6s ud Prcf$iiois Cod.) or o'rt hc d <br />ih. t cr.hpt th.rcfrom od lh. bdis fo rhc all.s.d cxmption Any viola'ion ol Scction ?03 I 5 by any .ppli@r for a pcmir subj.qe th. <br />applimr ro a civil poalty of nd hw $u fivr I'un&cd dollds 11500) <br />_1, s own., of t ,c piopalr, o ny ddoy6 *i$ wag6 a th.ir solc @mp.nrdio[ pill do $c wort .nd thc s!ruc(@ t not irt6d.d <br />or ofi@d ror !dl. ( S.c 7044, B6ind dd Pbfssion! CorL Ttu Co.ddtrt Lic*. L{.loa nd.pply bs om6 oa$. propcdy <br />who builds or impaDve th@o, d who dH such wort him.lfor h6.laorlhrcugh his o. h.r *n.Eployei, Fovid.d lh.rilch <br />ihprcvdcnB e nor inted.d or offq.d 16 s.lc. If, h@ry.r, th. buildiisd ihprcvoat k sold wilhin on. yo of compl.r6, rh. <br />Owhd-Build.r will havc lhc hur&r of proying th* h€ or rhc not build or ihprov. for lh. purposc of salc) <br />_I,6 opndoath. propcny, m cxclusiv.ly contricrin8 pith liq.ns.d contractors ro mnnruct rhc projd ( S.c 7044, Bsin6s ad <br />Profssion Cod.: Thr Coff&lort Liccnsc Lrw dB nor apply to d own.r of propoly who build, or imprcvq rh@on , od who <br />co.racts ro' ch prcjccB wnh r conrrcto(, lic.ns.rl pusuet ro rhc conrldors LiccN. Law ) <br />_l m.xcmF undrSalion <br />lqaxtxslourlNArqN !a.ua! <br />I hdcby affm mdcr p..nlty oip.lrry on. ofth. followiie d.clraiiosl <br />_l hav. &d will haiitaii . Ccniflqtc of Cdsdt to sdf-lns!rc for wo*6'@mpc6a o.,6 pr orid.d for by S@don 1700olrh? <br />Labor Cod., io rhq p!rfo!l@@ of thc wok fo which drc p.mn is iisuld <br />I hav. Md ,ill frainrain wnk6' cmFnsdon ins!re@. a rcqlircd by Setion 1700 ollhc Lrb.r Co.k, 16 thc pqfom&c. of rh. <br />*orl for whic! Oii ponn is issucd My eort6' @nposado. insura@ @i6 dd policy nnmb.. d. <br />PolicyNumb.i Exri6: <br />1(*o, *^^ <br />nol bc coopl.tcd ifthc pmil is for Onc hund,cd dolh {1100} or 16, <br />fi. pdfom&c. of rh. work fd wni.n tht <br />bci . subjccl to th. vortds cohDdsation lavs ofcaliim <br />cofr!.ns.tio. provisioB of S.ctio.l70o oltl. Labor Cod.,I rh.ll. fonhwirh <br />-'>-t+-o L <br />WARNING Failur. ro sau!. work.s comp.nsarion cov.,a8ct <br />fin.s up to onc hundr.d lhousod dollm (1100,00o),in.ddiion ro <br />fic Labo. Codc, int.r.si ud aliomcy\ f.6 <br />a prolid.d for lhc S.ctioi 1076 of <br />IICENSELCONIBACf9EIDICLABAIIA.N <br />I hcr.byaafim und.rpcnalry olp.'lrryrhatl d [c.nscd undcr provEion olCher.r 9 (@mmcncr <br />rhc Bliin6s Md Prctsids Codc, ad ny lic.ftc b in tull forc. ud cfqct. <br />Lie.!.Clss Li@ns. Numb.r <br />-o <br />I h6.by alilm und, p.!.lty oip.rlury O.t tha. is a cdsbucdon lodiig <br />ksucd (Scc 3097, Civ. C.) <br />ofrh.wdk for which Ihis p.mir is <br />APPLiCA]!T'S DECLARATION <br />D.mohion Pcmil$Alb6r6 Nodfication F.<Lrul Rqulation! (Tirlc 40, Pan 6) <br />_ Rcquircd Lcn.r of Noifieion <br />/*"' <br />lhat thc fcddal rcgulations rcsedin8 6b6t6 r.noval uc not <br />rh Ihav. r.ad thi!.pplic,lion dsEtc thd rh..omply wnh lll Cily d Counry <br />ordinmca dd Slalc hws rcl.ri.s to blildin8cNtrucrion,this City dd Counry ro.nrq uDon $c <br />.bov. m.nrion.d prcp.ny fd io.Fclion purr@a <br />..>_ol <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 />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 E_-XP'RED <br />EXPII IED <br />Rough i"i:U = I ZIE <br />Service Meter FEB: I SAMC 8,43. 2llo r.. -- <br />Notes, Remarks, Etc. <br />Transformers <br />FINAL <br />--__t_- <br />f------T------ <br />tl