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ELECTRICAL.INSPECTOR RECORO DATE ID/SIG.COMMENTS OwncFBuild.r Dâ‚¬cldrrion I h*by.afim !nd.r p.naliy ofpajury thal I M cxm$ fom lhc Colracloft' Lic..t. Laq for ihc rollowins rc6on (ss 703 r.5 Blsinat dd Prcfesio. Cod.): Any City or Couoq vhicb rquira a prmir io @.rEuci sh(, inprcv., d.Dolish or rcp.t dy nruciur.. pritr ro il! issuucc, aho r.quir6 rh. appl'cmt for such Fmn to ft! a siencd srard!.r $d hc or sh. is licoscd puBudt to $. provtio! of th. Confacrors Licds.d L.v (Chaprcr 9. Conmocins wilh Sccion 7000 ol Division ] of rh. aBin6 Md Profdsions Cod.) d rhal n. o sh. is .x.mpt th.rcfrom Md lh. bsis lor lfic illc8cd .xcmptid Any violllion oa Sation 703 I 5 by oy applicut for a p.mn &bjatt lhc applicdtro.civilpcn.llyoanolmorcthsfivchundr.ddolld(1500) _I, d own.r of th. prop.ny, or my cmployc6 with w!86 6 lhct sol. comp.nsation. will do thc wo,k d rhc strucruc ir ror inrod.d or off@d f6 s.lc ( S.c 70,14, Bwine d Proa.sio.s Cod. T1. C..hdd 3 Licdrc Law dos nd .9Dly ro 4 own.r of ftc prcDâ‚¬ry who burl.l! o. inprcvcs th.r.on, odvho do.r su.h vorr hins.lfor h6.ll or $rcush his or h.r own cnployc.s, orovid.d lnr luch imlrov.mdLs d. nor int .dcd or ofi.rcd for sal.. Il how.v.r, th. building or improrcmoi i5 sold vithiD on. y@ of conplcrrd, thc o*nd-Builddwill hav.0. burda ofprovinSth nc orshc no( build or imprcv.lor$c purposc ofsal.) _l,d o*ncroath. prop.ty, e.xclsivcly conn'acinB with lic..s.d cor&rcroE lo construct rh! prcjal ( Sd 70!a, Busii6iud P,olesion Codc: Th. Co.rrclor's Lic.ns. L.w do.s not apply to d ouncr of propdry who build! d ihprovd thd.o. , rnd who contra.$ for s!.h p.o]rB *nh . Co rto(r li@scd puauot lo rh. Con@.tols Liensâ‚¬ Law ) _l m cx.mfl und.r smion ,B &PC iorrhis,.Gon \vORJ<ERS COMP[NSATION DECLARATION I h.r.by affim und.r p.nalty oiF llry onc oflh. folloving dalaa ons _l hrv. ud vill mainr.jn r Ccnifid. of Cons.nt ro S.lf-lnsur. for wo*6 @pcnsario.,6 povi&d forby S@rid3700of t. Labor Codc, for lhc p.rfo'r@@ of thc wolk ro' which $c p.mn k irslrd _lhav.edwillhaintlinwskcB'cohFnsationinsu! c., a r.qun d by S.crion 3700 ot thc Lnbor Cod., fo $c pcrfmac. of rh. wo for which this p.mit is issu.d. My wortcrs comp.nsarion inirinc. @icr dd policy nunbcr s. Policy Numbq Expt6: {Thir s.dio. i..d not b. @mpl.t d if th! p.mn ir for Ooc hundtd doll6 {l l0o) q ld) r](cnrly rhd in fi. pdlomucc ollhc tr orl lor whrch lhis pmrt i! E$.d. I ihall 6ltm. tubjd to th. *o .6' comr.satioi l.,s of CalilohiiL dd.grcc thd ill sh mmpcnsation prcvisions ofScclion 1700oflh. Labor Codci I shall. fonhwiih UARNDiG Farlurc to saurc *ork.R ro 6imin.l pcnaki6 ddcivil find up lo on. hun&.dlhoNsd dollds {S100,000),in ddilion ro ihc thc Labor Codo incrd &d 6rbftcyt fe a providcd for th. S.clion 3076 of LICENS'D (ONTRACTORS DECLARATION I hdcby amm und.r pd.liy oapdluryrh.tl mlic.nscd udd pbvision ofChafld 9 ( $cAusi.ss dd Prolsioff Cod., and my lic.nsc h in fullrorc. ud circcr )_ I h6.by alfim uid,, pcn.lty ol pdjury tul th@ is r coistrudion ladinE .e6c, lor $. plrimarc oi rh. wot fd *hich rhir Fmir i3 isrucd (S*.3097, Civ. C) APPLTCANT'S DECLARATION D.molino. Pcmils-Asb6tos Notific.tio Fcd.ral Regulatons (Tnlc 40, Pd 6) _ R.qliEd Lctr.r olNo ficatd I "x:^fi. acd.ral r.Bulalions rcSedine eb6rc I havc r.ad Ut agplicarion ed rocomply wirh allCiry and Couty nMca od Stalc La*r rclarins to buildinS of$is City sd Cou.ry to orcr upon lhc )-& Site-Work Underground Pole Bases Light Standards Spas, Pool, Fountains Signs (monument) Life Safety /Low Voltage Fire Alarm / Dampers Communications Cable Building Bonding / Grounding / UFER Transformers Torquing Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Rough) Ceilings (Hard & Soffit Rough Ceilings (T-Bar Rough) Ivleter Release EXPIRFN Rough Service Meter rEB 0 | 208 FINAL Notes, Remarks, Etc. _ _ .e, -ev, {JOO, OOZ APPROVALS Under Slab / Floor dbo!. m.nrion.d p,op.dy for inrp.crion f-----r---- -------T-----t I I =