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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE tD/stG.COMMENTS OMd-Buil&r Dels.lim
<br />I hftby .ffim und.r Fnal9 of pcjury lhal I M .xmpt aom th. Cofirci6' Lie.& Law aor thc following Bd Gd.?03 L 5 AcinB
<br />Md rrcfdid Cod.) Any City or Codq which Equi6 . p.mt ro cMstrucr, altc., imprcv., d.molbh q r.pat &y irudur., Fn ro it!
<br />isuec., &o rcqukq th. .ppli. l aor Nch p.mit !o filc a sisn.d nalmat th.l hc s sh. ii licos€d pcuMr to $. Foyisiffi of th.
<br />Cdr&lqt Li€a$d tiv (Ch.pld 9, Confrmcing wilh Scdi6 7000 of Division 3 ol rh. BBin6 &d Prof6ionr Codc) d rhat h. u
<br />sh. k .rmpl thd.fron ed dc bais fd Oc allcg.d cxmptior .Any viohiion of S4tim ?03 I 5 by {y .pplicdt fo . Fmn subjelt $c
<br />applicet to . civil Fnrlty of nd noE thd fivc hrnd.d dolls (1500)
<br />_1, a own, of thc Fopcny, tr my rmployd wnh w.86 6 dr.n rc,! conp.nlaion, will do th. wort ad rh. srrcrE is nol inrod.d
<br />G olIdcd fd sal. ( SE.70rt4. BBi,a ed PDfsions Cod. Tn. Cdtuior's Lica.c Lr* dB rd apply [o M omr of rhc p.op.ny
<br />who buildi n improra $@6, dd *ho dc seh work him.lf or b6.lf or inrcu8n his or hd @n dploy6, provid.d dlal such
<br />inprovdcnl! e nor irtcnd.d or ofid.d for sd. Ia, how.v6. {ic blildiig o improvcm.rt h sold within on. y@ of compl.ud, thc
<br />Ownd-Buil{t r qill tsv. lh. burd6 of prcvin8 ln.t lE or sh. nol build or improvc fm thc purpos. of r,l.)
<br />_1. 6 ow.d of th. prcpdry, m crclBiv.ly conb&ring *irh liccnscd cqrdoE ro co,hd rh. pmjat ( S.c 704r, BsinBs d
<br />Prcl6ion Codc Thc Conlra.iols Lic.ns. kv dG ,ot apply !o e M6 of propary who buil.Lr @ imprcv6 rha6 , ed who
<br />conrea fG soch prcjeB wirh a coir&ro(, Iimscd puEU t ro rh. conhrcrors Liens€ Llw )
<br />_l m.xmpt u.&r Setio _.8 & P C for thii rcson
<br />WORXXf,S COMPENSAI'ION DECLARATION
<br />I h@by .lfim und.r parlty of pcrjury o.c ol th. lollowinS del&6rioN:
<br />_l hav. &d will mainraiD a Cdi6c.r. of Corodl to Scltlnsrc ftr *mt6' 6mp.n!atiM, s prcvid.d for by Salion 3?oo oflhc
<br />L.bor Cod., for lh. psfo1M@ ol $c wdk for which rh. p.mn ir isru.<,.
<br />_l h.vc ud qill tuitrnh wrt6 @F.nri6 iBum@. s r.guiEd by Sccrio 3?00 of ih. rior Cod., fo $c pdfm{e of $.wt f6 *hict lhil Fmir k isu.d M, qort6' cdpcN.ri@ incufuo 6ia 6d policy nMbd uG
<br />Policy Nunbr ' Expi6:
<br />{Thir scriM ,..d troi b. c@pl.cd if {r Fnir n ror oD. hindEd doll6 ll ! o0l or 16,
<br />_I enily thar in thc pdfome€c of rh. voi( fo wnich dis iE,it is isruc4 I shall Dd .mploy ey pdso. in dy nsnd !o s lo
<br />bcc.ft subjd ro rh. wo*6 corrFruaio.la* of cnliamir. d sEE tar ifr shootd b.@hcsubjdrro rh. wor6'
<br />mmFrdion prcvisio.s olSccliq 3700 of.h. Labo. Cod., I shall, fothwilh comply wid $G. Fovisi$
<br />WARNING FailE to rftuE wdlca @npc rnio covd.8. is uilawful, d rh.ll subjdr & .mploya to simin.l paaldG &d civil
<br />fin6 up lo d. hundrd IhoBMd doll$ (l100,000),in alditim ro $. cct ol cmpcns.doi, deBB6 s provid.d atr dc S.dio 30?6 of
<br />$c Lrbor Codc. inrddr ed !nm.y's f.6.
<br />LICENSED CONTRACTORS DECLARATION
<br />I he.by amm unds p.mlty of prjury thar I a liei$d unda prcvisio ofchapkr 9 (commadng wirh Sdion ?OOO) oa DvisioD t of
<br />lhc Bsin6s ed PrcfsiG C.d.. Dd ny li.dsc is in full f@. rd.ft d.
<br />D,!. .t- /2./o /
<br />CONSTRUCTION LENDING AGENCY
<br />I hcrcby affim unds p6dty oi pajury thar rh6. is a @nsfuclid ldding .8ory fd tn. pc.f(fu@ of thc adt ad *l ch this pdmn is
<br />i$!cd (se. 309?, Civ c)
<br />APPLICANI'S DECI-ARATION
<br />D.mlnion Pmic Asb6tos Nolificatid F.d.r,l Rc8!1.!o! (Tirlc 40, P&I6)
<br />Rcquird L.trcr of Norifi cdian
<br />_l *nif, tha{ th. ,.doal rcguldions E8dding sb6tc rdoval dc nor appliEblc ro lnis p,ojer
<br />_ I conry tn,r I h.v. r.:d this rppli€rion d sbr. lnd .h. abovc infomarion is coro! I asra to .ompl, *id aI Cny da County
<br />ordindc6 &d Ststc Llvs Elating to buildinS costru€tion, d ha.b,.utdia Epr66r.1ic oflhis Ciry ed County lo.nt.r upon thc
<br />a6orc mdlioncd pop.ny for i.sp..rion purp6B
<br />.e--z -/a 4-
<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 Rou gh
<br />Ceili s (T-Bar Rough)
<br />Meter Release FYD llrErr
<br />Rou h FEB O I
<br />'nicService Meter
<br />:vu. ob6, 66
<br />Notes, Remarks, Etc.
<br />FINAL
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