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ELECTRICAL-INSPECTOR RECORD <br />APPROVALS DATE ID/SIG.Own.FBuild.r D.clratim <br />I h.r.by atnm und.r pmilly oip.rj!ry th.t I m.r.npt aom d. Cont6.toB' Licc..c Lav for !h. following r.6o (se.7031 5 Busin6s <br />&d Profdsion Cod.) Ahy City M County which !cq!i!6. p.mn to cm5rtu.! ahd, inprcvc, dcmolilh or r.pat ey fltucturc, Fid ro iE <br />issu&cc, aho rcqutra thc applicet ror slch pmn ro filc a sis,cd srarcncnr that hc ush. t licoscd puBudl to th. FoviiioN of rh. <br />Conretorr Liccn$d Law (Chapia e, Comh.nci.B eirh s.ction 7000 ofDivhion I orrh. Busin6 ed Prof4iod cod.) or 0rar hc d <br />rhc t cx.hpr rh4arm ad lh. bat fd lhc allcs.n.xcnplion Afly violarion ofS..rion 7ol I 5 by uy applicui for a p.mn lubjar fic <br />appli.dt to acivilFn.lty of not ntrc lhm fivc hun&.d doll4 (5J00). <br />_1, a oM6 oflh. prcp.ny, or my.mployG enh wrSd B rbcir.olc cohFnsalion, will do lh. work od rhc ntuct(. is not inrcnd?n <br />or ofi.red fd s6lc ( S* ?044. Bsin6 dd P@iasions Cod.: Thc Conr.clor\ Licds. I-3e do6 not appl, to d oqq of thc propcn, <br />who builds or imprcve th6.on, dd who d€ such work hituclr or h6cli or through hir or h.r @n chployccs, providqd rhal such <br />ihpbv.m.nLt e nor inbdcd or offa.d aG s.l. It hd.v.r, thcbuildinSorimprovncnt is sold within o.c ydof cohpt.non, rh€ <br />Ownr-Build.r will hav. th. burda oa proving lhar h. or sh. not boild or inprovc for th. purpcc ofualc) <br />_I. a ow.d of th. prop.ny. n aclBivrly cont&iing *i$ licoscd @nn?cb* !o @fftruc. th. projd ( Scc. 10.14, Bqin6s dd <br />Prof6sio. Codc Thc ConE&lm t Liqcnsc La* dG not .pply to M owns of propsiy who hlilds or inprove thcrcon , ed who <br />confrcis for such p'oj.ds wnh . conk cto(, li@iscd puftudr ro rhc coifacror'r Li€@. Lrw ) <br />_l M cxcmpl und.rselion _,8 &PC fd lhis rcdon <br />WORXXRS COMPENSATION DECLARATiON <br />I h.r.by affim undcr p.nalty oip.rlnry oo. oathc followin! dccl&.ti@: <br />_l h.v. dd willm.inr.in. Cdifist. of Cmsar to S?laJntur. fo. wort6' cmp6s6lio. 6 provid.d (or by S.ction 37oo of$c <br />tibor Codc, fd lh. prrfrua of lh. wort for which $. pmn it i$ucd <br />_l h8c &d will mainEin wnk6' @hp.ns.rio. iBurd.., a r.qut.d b, Scclion l?00 of rnc L.bor Codc, ror r}. pcrfomec. ot rt. <br />work for *hich lhis p.frit is issu.d. My work4' comp.nsrtid inlurac. c6i.r md policy numbf ar. <br />PolicyNumbs ' ExpiB#;;nol b. cohpl.l.d if rtu pmn is for On. hundrcd dollB 15100, or 16, <br />rh. p.rfom cc of lhc work for which rht pcmit <br />rh. work.s compcns,tion laws ofCalifomi{mrl <br />coftp.isatioi provisioni of S&tion 1700 ol $. L.bor Codc, I shall, lonhwnh <br />WARNDiC Failurc ro seurc workcE' conp€nsation co v(ag. $ un ro criminal P.n.lti6 &d civi! <br />fin.s up 10 onc hundrcd lhosud doll6 (ll0O,00O),in addilion to <br />rh. L.bor Codc, inkr.$ ed atrom?yt fccs <br />domag6 6 pDyidcd for rh! S.crio.30?6 oi <br />LICENSED CONTR CTORS DECLARATION <br />I hd.by ailim undd pa.lty ofprjury thd I m licosd uodq prcviiio. ofch!9t6 9 <br />rh. B!5in6s ud Profdios Codq, dd my licosc is in full foG .nd cff*i <br />>->4'oL <br />I hd.by afiim undq pmalty oi p.rlury rhd $d. i! aconsltuctioi l.ndi oflhc wqk fd which lhis p.mt is <br />i$u.d (se 1097, civ. c) <br />AP}LICA}IT'S DECLARATION <br />D.molition P.mils-Arbdts Norifi.dion F.ddal R.8alad6! (Tid. 40, Pln6) <br />_ R.qutcd L.u.r olNo fiatim <br />d-'-,',"rd <br />alions EBadinS 6b6ts roold d. nol oppli@bl. to $is projccr <br />lpplicarion drd.ihr!$.infomtion ir @ret I .g@ to comply -ill' all City Md Cou.v <br />vd olthi5 City &d C!!n(y lo cnlq upon lh. <br />abovc mcnrion.d propcny for insp€tion purlora <br />-zq-o{ <br />Underground <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 />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 EXF,REN <br />Rough rE8 0 I zop <br />Service Meter SAMC e.ar '.,^ - - --, --w, coo, 067 <br />Notes, Remarks, Etc. <br />COMMENTS <br />Dd. <br />-O*.,. <br />_ <br />L.ndd 1 Addr6 <br />Site-Work <br />Pole Bases <br />Under Slab / Floor <br />FINAL