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ELECTRICAL-INSPECTOR RECORD
<br />APPROVALS IDiSIG.COMMENTS O*n.rBuildd D.clerrion
<br />I hcEby affim undcr p.r.lty oapqiu.y thar I a dcmpt am th. CoIlracbB Licdi. t:w for rhc followi.BEaon Ge 70ll.t Burina
<br />ud Proft$ion Codc): Aiy City d Cornty vhich Equir6 . pcmn to coisrud, alrd, imp@vc, d.molish or rcp.ir &y sddur.. Fid ro irt
<br />i$uecc, alro r.quire th. lpplic{l tor suc! p.6t to filc ! 5i8!.d ilrt m.nt thlr h. or 5h. is li.dscd puEet lo thc prcvtioi of $c
<br />ConrEcrtrt Ltms.d L.w (chaprq 9, comtunci's with s.ctiu 70oo ofDivision 3 of$c Buins &d Prof$i@ cod.) or th hGd
<br />rh. ir cxrmpt th.Ei.om dd $. blrir i6 rh. illcecd.x@t on Any violalion ofS.crio.703l J by ey +pli6l for a p.oir subjGts lhc
<br />applican! lo acilil p.nalty ofnot mor€ the fiv. hun.lr.d dolls (1500).
<br />_1. a ow..! of lh. prcpdy, or hy cmploycB with wa86 a rh.ir sol. conpdsdion. qill do tnc wort dd lh. rlruclw is nor inradcd
<br />or ofcr.d fr salc ( S.c.?04a, D$inB &d Proiqrio,s Codc: Thc Coitacld! Lic.ns. Law do6 nor .pply lo ,n osncr of thc propdy
<br />who buildt o! inprova thd.d, ed who do6 3@h *ork hituclf orh6clf or $rough his or h.r @n cnploy.B, providctl d.r 5!ch
<br />inprovo.ib a nor inrod.d or off.r.d fo ral. I( ho*.va, d'c buildinS o improvcmor is rold wirhin dcy@of conpl.riM, rh.
<br />Ownd-Build.r willh.v. d1c bu.do of provinS drat hc o, lhe nor build or inprolc for th. purpcc ofsal.).
<br />_1, d owncrolthc prop.ny, d dcluivcly cont&tinssilh li.as.dconhcrs to co8lruci th€ rrojar ( Scc ?o44, Bqins! ud
<br />Prof6sion Codq Thc Conltulo/s Lic.nsc Lav dN nor rpply lo e ownd of prop.ny who bqilds tr imprcv.! rh6.on, ud who
<br />cont &B for such proj.cb *nh a Corlrrclo(, Iictrcd pusuur to lhc Conr.cror's LiccN. kw )
<br />_l m .xcmF undcr S.clio. _.8 & P.C. iGrhkE6on
<br />IOBKEB'COIIEEISAIION.DEELA rcN
<br />I h.!.by ainm undcr p.&hy of pcrjury oDc olihc following dcclddions
<br />_l h!v. ud will mrintlin r Ccnifiqt. of Conscnt to S6lf-lnsur. for wo*.E' comp.nsalion. s pBvidcd for by S.crion 1700 of lh.
<br />L.bor Codr, for thc p.rf@oc. of lnc wnl( for which rhc p.mn is irsucd
<br />I hatc dd willoainuih *ortcR' comp.nralion ituuree. d r.quircd by Setioi l70o oflhc L!!or Cod.. ad fic p6fmac. of 0tcwo for which 6is p.mn ir i$!.d My vo*d conp.r3.tio. iBurda @id dd policy numbc. ac
<br />1^o,,*,.
<br />nor b. cmpla.d if thc pmn i aor On. h!n&.d doll4 {ll00l or l6d
<br />rh. p.rfomuc. of th. work ld which
<br />'his hdn
<br />ihc wo*.R ' comp.nsition laws oaCaliiomi4 ud
<br />o",xl G'"O
<br />ofS.dion 3700 ofrh. Lahor Cod.,l rhall. fonhwid-e6
<br />?"..
<br />WAiNINGT FliluE to scclrc wdt.6 compcnrari
<br />fin.s,p lo o.. hundrcd rhoEmd dolla (l100,000),
<br />th. Lnbor Codc. inrcrAt d rnomcyt f.6
<br />cct d cmploycr to riminal pcnahi.s dd civil
<br />damas6 a providcd for $. Scdion 3076 of
<br />LICENSf, D CONTR CTORS Df, CL R TION
<br />I h.r.by amm und.r p.naliy of pdjury rh.l I o lic.nscd !.d6 povisio of Chaflr , Gon
<br />thc Busioss d Plofssiois Codc, dd my licc.r is in fullforc. and c(ccr
<br />I hdcby afiim uidc. poalty of p.rlury $.1 lhd is s coslructio lodi.g !8.n.y lor tic pafmu.c ol thc wdi fd shich this p.mn i!
<br />is!.d (Scc lO9?, Civ C.).
<br />A}PLICANT'S DECLAR,{TION
<br />D.nolnion l.mir5'Aib6tor N.tiii.,tion r.d.ral R.guldrons (Tirl.40, Pan 6)
<br />_ Rcquircd Lcucr of Nofi fi @tid
<br />,"y rhal fic Ldcral rcsllations rcg{dmg 6bql6 rcmD}.I d. lot
<br />,.t I hav. r.ad thls applic,rion andsllrc
<br />ordiie.6 dd Sutc La$ rla ne to building ad County ro at6 upon lh.
<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 />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
<br />:ATI]l(EIJ
<br />Rough !
<br />Service Meter I 'ED U | .ur
<br />FINAL SAM() 843, 290, 5t e67
<br />Notes, Remarks, Etc.
<br />DATE
<br />ab.v. n.ntion.d ,ropd, for inrperid
<br />Sub-Panels
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