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ELECTRICAL.INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS Ownd-Build.r DelMtid <br />I h@by aflim undq pcnrlty ofpdj!., lh.l I n .xmp! fom 6. C@lncroR Lia.sc Llw loi l]1. aollooinE E6on Ge.?03 L5 Buind <br />dd Proi6ion Cod.)r Any Ciq or County which EquirB a pcmn lo coislrld, ahc. ihprcvc. dmoliih or Epri. &y nructur.. pris !o irs <br />issuuc., dso r.qun6 lhc lppli@r for slcl pqmn ro fil. . si8rcd rt.t m6r ihat h. o rh. is lic6s.d puEuet to th. FovisioN of th. <br />Conr6cldk Ltas.d t w (Chaprd 9, Cmhocin8 wilh Scclion 7000 ofDivisioo I of$c Bsin$ dd Prcfgsiois Codc) or thai hc d <br />shc is .xofl lndcfrm dd tt. b$is fo ri! all.8.! .,coprioi Ahy violalion of S.c on 7O3l 5 by ay applimt for . pcmn ,ubj@E fic <br />alplicer ro . ci,il Fnalty of nor morc thd frv. huidrcd dolld (t500). <br />_1, d oM.r ol $. prcp.ny, or ny .mployc *nn wae6 - rh.ir $lc @mpnsalion. *ill do thc *orl Md lhc sn$cruc is nor inlad.d <br />or oltd.d lo srl. ( S.c 704rr, Buin6 od Prof.$io.s Cod. Th. CdtEctols Lic6s. kw dc not apply lo u owncr of rhc ,nop.ny <br />who buil.b or imprcvd lh.run, ed who do6 sucn wo.k hitr.lf or hdclf o. lhmugh hi! or h.r ovn .mployc6, provid.d lhd ruch <br />imprcv.hcnE e not inbdcd or ordcd fd t.l. If, howcvd. rh. buildine o imprcvdhr t 3old within onc ya of conplaro. $. <br />Owr*Buildcr willhav. thc burd.n olprovin8 that h. o, sh. rol build or improv. for thc pu.pc! ofsalc). <br />_1,5 o*nr oflhc plopdry, m.xcluivcly conractin8 with li..nscd conrracioB to corsrrucr rhc Fojcct ( S.c.7044, Bsr.er dd <br />Proi4sion Cod.: Th. ContEctors Liccns. I-3w dB nol spply to M ovnq oipropaty who blilds or ihprove fis.on . and who <br />contracB for such prcjcd! vnh a Conlr&ro,i, licord puuudr to rh. Contacroas Licds. Law ) <br />_t m .xcfrp! undcr S*rion _,B & PC fdiih r6on <br />IYOBEEBSCOMIINIATI9N-DIC <br />I h.r.by lifim undcr p.nalt/ ofPcrjury onc oflh. followin8 d.cl&.tio <br />I hav. ,d will frzint in a C.nificalc of Consmt to S.lijrourc ior *orkcEr conp.nsation, a providcd lor by Scdon 3 700 of $. <br />Labor codc, for th. F.fmdcc of 0t. work fo! ehich lhc pcmir i3 isru.d <br />I hav. od witl nainbi. sd*.6 comp.ns{i@ isorMc.,6 rcauircdby Scction lT00 olthc Labor Codc. fo. th. p.rfom{e ofd. <br />work for *hich ihis p@it is i$u.d My wort.6 comp.nsadon iniuacc .ai.r ud policy numb.r .l <br />Polty Nu6b.r I Expt6: <br />Lliirl,liir,*: <br />b. conplct.d if d'cpmir b fd On. hui&.d dolla 11100) or 16, <br />I pcf@rc. of rh. work am which rhis pmit <br />worl.c 'cmpcnstio laws ofcclifomi\ d <br />isiss!.d, 1 shall ndcnploy y p.Ron in eyfrannd50ab <br />comp.nsaio. provisions ol Labor codc, I sh8ll, lonhwiih <br />D <br />dolls (l100,000).in addid@ ro 6 provid.d fo. $. Scctio; <br />inrcr.n dd anomcyt f.6 <br />LICENSED CONTRACTORS DECLARATION <br />I hcr.by afllm und.r pcnalty ofprjury thol I m lic.nscd und.rprovtion ofChaplr 9 Gonncncing with S.ction 7000) of Divilion.) ol <br />th. Busincs d Profsions Cod., and my licdscis in fulliorcc and.fccr <br />ny of p.rjury rhat thd is a comrtucrion l.nding 6g.acy of thc work for{hich $is p.mit is <br />civ c) <br />APPI ICANT'S DECLARAIION <br />Dmoltion Pmils-Aib6tos Nolificalion F.dml R.gula ohr (Tnl.40, Pan 6) <br />_ R.quiicd Lcu.r of Notifierion <br />4"o^* <br />dc lcdoal rcgulaaons Egddiis 6b.sr6 rcmoval &. nor applicablc lo <br />I ha!.aad$! arplic.tion ud!ta&lhd dc I 33ra Iocmpry*nh lllCily dd County <br />drdindcB Md srak l-3wr rcladng lo buildins v6 ofrhis City dd Cou.ty <br />Site-Work <br />Underground <br />Light Standards <br />Spas, Pool, Fountains <br />Signs (monument) <br />Life Safety /Low Voltage <br />Fire Alarm / Dampers <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 EXPIF IED <br />Rough rlu : I zut9 <br />Service Meter AMC 8<3 20 <br />FINAL <br />Notes, Remarks, Etc. <br />ch6 <br />- <br />L.rdc' t Ad.!$ <br />Pole Bases <br />Communications Cable