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ELECTRICAL.INSPEGTOR RECORD <br />APPROVALS DATE ID/SIG.COMMENTS Oena-Builda D.cldadon <br />I h.rcby aflim undd pdalty ofp.dury lh Imcx pr lm $. Cont@toR Licolc rlw for thc followin8 Bd Gcc.7ol I 5 BEins <br />dd Prcl6sion Codc), Aiy City d Couiiy which rcquirs . pcmir lo consttud, .lt r, improv., dcmolbh or Gp.t dy lrructur.. rdor !o irs <br />i$udcc, also rcquic $c.lplient for tuch Fmn io fil.. si8n.d siaiml ih{ hc or sh. is lic.h!.d plBuur lo ln! prolisio* ofrh. <br />conrracrors Lic.6.d Llw (claocr 9, cohoacins with s.crion ?000 of Divisio. 3 ol rnc Bsin4 dd Prof*ions Co&) or 0'ar hc d <br />ihc is .xdpt fiftfrm 4.1 th. b$is ad fi. .ll.g.d d.mplion Any viol ion of S..id ,03 L5 by uy lppli@t fd . lcmn tubjccls lhr <br />appli@r ro a civil pci.lty of iol noE $d liv. hundicd dolle (1500). <br />_1, a own.r of rh. FoFrry, or my cmploy6 with v.Bs a thct solc compcnsBtion, will do thc *ork and rh. strucrw ir not intcndcd <br />or oiI@d tor solc ( Scc 70.14, BEings ud Prcf6sios Cod.: Tha ConEaclor'r Li.asc Law dcs nol lpply lo6 own.r oa $. prorEdy <br />whobuilds or improvd lhc6n, ddvhod@ ruch vor& hiN.lf or h6clf or lhrcu8h hi! o. hd M mployB, provid.d 0rir rlch <br />inprovmoE e .ot i.rad.d o off.rcd id !.1.. lf, howd.r, $c blildi.B o imp,ormat i5 sold widrio o.. y@ of compl.trm. lh. <br />O*ncrBuilds will h.vc thc burd.n ofproving tha h. d!h. nol build tr ihpovc fd $. purpos. of5al.) <br />_1, a oend ol lh. prop.ny, m aclusivcly @nFactinS vnh liccns.d conlreroB ro conslrucl rh. pbj.d ( S.c 70.44, Buins ud <br />P.ofBsion Cod.: Th. ConE ctols Lic.n& Law d6 ror apply ro u ownd of prop.ny who buil& or inp.oy€ rh@on , &d who <br />contr&ts lor such proj4E with a cortEclo(s) liensd puBuer 6 rn. contrrcror's Lic.nr. L:w ) <br />_l e.rmptund.r S..lion <br />-B <br />& P C fd $L rc&. <br />WOR(XRS COMPENSATIOII DECLARATION <br />I hdrby affim und.r pcnalty of p.dury orc of lhc follNin8 d.cla.tioE: <br />_l hav. ad willmainrain a Ccnifical. ofconrel b Sclfluur. fd wort6' comp6s.rion, s provi.Ld tor by S&i6l70O ofth. <br />ljlor C.d., fm th. p.rfro@ oaln. wort lqwhi.h lhc prmi! ir isru.d. <br />_l hav. bdwillm.inriin wdk.6 @mpasari@ i6uru..! a r.quir.d by Scction 3700 of thc Labor Codc, for $c p.rfo6Mc. of $. <br />wort for vhich !ni6 P.mit ii irlu.d My work 6 comp4atio iosur c. tria od policy numb.r !!. <br />(ryldo i.cd nor bc cmd.rcd ,( lnc pa R <br />/ I ca,& rhd i. fi. Drfomuc. oafi. sork ror <br />bccm. ssbjd ro fi. *ortd ' @npa$tin l.ws <br />for On. hun&cd doll6 1llooi or 16, <br />which rhk h@n i! i$!.d.I sh <br />of Califomi\ ed asrcc fiat if I <br />compcnsation p.ovisions of Scctio l-o <br />WAB.litlG Failur. ro s@u!. vorl6 composation covnagc t unl cmploycrlo rimiral p.nrl(i4.nd civil <br />fin.s up to onc hondrcd thous&d dolld (t100,000),in.ddnion to <br />lh. Labor Codc, int rd 4d allohcy s f.a. <br />on. dnag6 6 plovid.d forth.S.crion 1016oi <br />LICENSED CONTRACTORS DECI,ARATIOI{ <br />I hcrcby aflim und.r pmslty ot pdjury thar I m liccnscd un&r prcvision of Cn+t.r 9 ( <br />lhc Suein.$ ud ProlBionr Codc, dmy lic.nsc is in ful l forc. and .ff.... <br />I h@by alfim unds p€ial9 ol pdjury tt{ rh@ ir . cNrrucrior I <br />i6su.n (Se. 1097, Civ. C.). <br />$. p.rfffianc of thc wdk fq whicl tlk Fmn n <br />APPLICANT'S DECI {IIATION <br />D.molirio. Pmir-A!b4l6 Notifi@rid Fcddal R.gul{joir (Tirl. 40, P.n 6) <br />_ R.quiEd Lata .f Notilieio <br />6,,.,rhc f.deril Egul arions Egdding <br />I hav. r.ad rhir applicarion I .gr.? tocomply wnh.llCity&d Coury <br />ordiioc6 dd Slatc Lavs rcla{is lo bui <br />abov. n.nrion.d prop.ny ftr inrpccrion <br />v6 ofrhis City dd County 1o drd <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 />Bu ilding <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 />EXPI RED <br />Rough <br />Service Meter FEU U I l!'15 <br />FINAL SAMC 8-43. :go. 566 C6: <br />Notes, Remarks, Etc. <br />Communications Cable <br />Sub-Panels