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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS Omd-Build.r D.clmion
<br />I ncr.b, .mm und.r Fndiy of Fjury lhai I m .xmF fm fi. CdtrutoB Licqsc kw for thc followins r.6on (se.703 1 s BBi.Bs
<br />and Prcf6sion Cod.): Any Cit, q County which rcqutd ! pcmit lo @nstrucl, all.r, improvc, dhdkh or ..pair ay rucrlE, p.ior lo iB
<br />issuecc, ilso rcquirB lnc sppliohl fo. iuch pcmir ro fiI. a sisncd slardat th.t hc or sh. is li..nr.d puBudr lo $c provisims oa fi.
<br />Conmctq's Lic.,sd La* (Ch.pl.r 9, Commacin8 wnh S.clion 7000 ofDivision 3 oflh. Bqins ud Prof6i.N Cod.) or tlar hc m
<br />shc t cxmpl 1h6cfrcm od thc b6t f6 lh. .ll.g.d acnption Any violaiio oa S.ction 701 L5 by uy appli@r for 3 pmn 3ubj.cB U.
<br />applicsl io ! civil p.mlty ol nor hoE lha fiv€ hun&.d donss (1500)
<br />_1, a o*n.r orth. Fop.dy,6 my.mploy.6 wnh *!86 s ln.nsol. cmpcns.tion, sill do lhc *ork dd rh. rhct@ t not inrdd.d
<br />or ofi.r.d for sal. i S.c 7044, asins 6d Prof6sion. cod.: Th. Conhcror! Li..nsc Law d@s nor apgly to an own& oi rh. pror.ny
<br />who builds or improvGlhcrcon, udvho do6 such worl hiruclf or hdclf or lhroqh hi5 or hcr @n cmpioycs, prcvi&d thal &ch
<br />improv.nciE dc iot iitcnd.d or ofi.rcd for salc lf, hovcrcr. th. blildins or inptrovcmcit is sold within on. ycdofcompl.nd, thr
<br />OqncrBuilddrill tarc thc bu.dn of proyinr th.l h. or$. nolbuild or improvc tor lhc purpsc ofsalc)
<br />_1,6 owna oilh. prcPllty, m.xcluivcly conreins vilh Iic.ns.dconracroE to consrrucl rhr poj.ct ( S(. 7044, B6ins &d
<br />Prof6sim Cod. Th. ConEacbr's Lrkns. t:w dc nol rtply ro s ownd ofprop.ny who builds or improvg d6con, dwho
<br />co rads for ruch prcj&6 pir} a cotr&1o(, li@Ed plKuot to fic conhctor's Lic.ns. La* )
<br />_l @ .x.mpt undcr S.ction _,8 & PC fo rhis cson
<br />YANXEBTq9UTENIAIPN.DEELABATAT
<br />I b.r.by atlim u.d.. p.nalty ofpqjury orc orrh. foll@in8 delraiosl
<br />I havc dd willmainl.in aCcnifiql. ofcoos.r to S.lf-lnsurc fo.wod<.6 compasatio,6 provid.d io by Sad@ 1700 of t.
<br />Labor Codc, for lh. PrfmMc. of lhc vork for vlrich th. p.mit n isru.d
<br />_l h.vced qill m.in6in wdkcE' @mpdlation i.lurMcc, a Equt.dbyS.c on 3100ofthc Lnbor Codc. for rh. p.rf@ecc ol dt
<br />work ior which lhis ptmil is iisu.d My wdk.B .omFnsalid insurue ffi.r ud policy numb€r ak
<br />,olicy Numbs:_Expi6
<br />(This sctioi i..d io( b. compld.d ii tc pmn is
<br />JZ,ry rh m,h. p.rromu.. or'h. worr ror
<br />b.(M. subj('
<br />'o
<br />rh( uo .E ' compcnsdron lrff
<br />conp.nsation provisions oaSatid !700 of$. L.bor Cod., I shall, fodhviti
<br />o*J--L-24- r, f o*,x-
<br />WARNING Faihrc lo s.cut work.u' comp€n$tion cov.rag. is
<br />fincs up lo on. hun.lcd thous$d dolla (3100,000),in lddilion to thc cmt
<br />rhc L*or Codc, inr.rd ed .lrmcr'r fc6,
<br />vid.d lor rh. S.clion l076ol
<br />i h.rcby arfim u.da pa!19 of pfju.y lhat I m li.c6.d undd provisid of chlplg 9 (
<br />rh. Busin6s d Polsios cod., ed my licf,sc is in rull fo@ ed cfl*1
<br />4-o
<br />I hcrcb, afiim ud6 p.ialry ot pdjury Uat 0!@ b a coErructid I
<br />isu.d (se. 3097, civ c.).
<br />of th. wdk id which thir rcmjl is
<br />b comply wnh dlCiV and Counry
<br />v6 ot thii City od County ro .nra upon thc
<br />!bov. m.niion.d propdy aor inrparion
<br />>.-24-&
<br />)
<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 />lvleter Release Exp Flcn
<br />Rough FE8 ;| 2AB
<br />Service Meter SAMC e-re
<br />FINAL rv, o06, 667
<br />Notes, Remarks, Etc.
<br />Darc
<br />-o*nd
<br />-
<br />hyrdr.d dollE {1100) or lB,
<br />APPI ICANT'S DECLARATION
<br />Dinolnioi Pcmits-Asb.sbs Notifietioi F.dcral R.8llslios (Titl.40, P.n 6)
<br />_ R.quircd Ldt rofNotifioti@
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